The National Survey on Drug Use and Health (NSDUH) generates state-level estimates for 23 measures of substance use and mental health problems for four age groups: the entire state population over age 12 (12+); individuals age 12 to 17; individuals age 18 to 25; and individuals age 26 and older (26+). Since state estimates of substance use and abuse were first generated using the combined 2002-2003 NSDUHs and continuing until the most recent state estimates based on the combined 2005-2006 surveys, Iowa has been among the 10 States with the lowest rates on the following measures (Table 1).

Abuse and Dependance

Questions in NSDUH are used to classify persons as being dependent on or abusing specific substances based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (American Psychiatric Association, 1994). As might be inferred from Iowa’s ranking among the states with the lowest rates of past month illicit drug use, Iowa has also consistently ranked among the 10 States with the lowest rates of past year drug dependence or abuse for the State population age 12 and older, as well as for the population age 12 to 17. In 2005-2006, Iowa ranked among the 10 States with the lowest rates on this measure for all age group (Chart 1).

Conversely, rates of alcohol dependence or abuse have been at or above the national rates across all survey years. This is particularly true of the State population age 12 to 17 where rates of past year alcohol dependence or abuse have consistently been among the 10 highest in the country (Chart 2).

Substance Abuse Treatment Facilities

treatment program. In addition, 13 physicians and buprenorphine treatment for opiate addiction. In 2006, 82 percent all Iowa facilities (102) received majority (108 or 86%) were private nonprofit, and some form of Federal, State, county, or local government funds, and 97 facilities had agreements or contracts with managed care organizations for the

Although facilities may offer more than one provision of substance abuse treatment services.modality of care, the majority of facilities in 2006 (113 or 90%) offered some form of outpatient treatment. Residential treatment was offered by 28 facilities and four facilities offered an opioid

Treatment

State treatment data for substance use disorders are derived from two primary sources—an annual one-day census in N-SSATS and annual treatment admissions from the Treatment Episode Data Set (TEDS).4 In the 2006 N-SSATS survey, Iowa showed a one-day total of 7,229 clients in treatment, the majority of whom (6,660 or 92%) were in outpatient treatment. Of the total number of clients in treatment on this date, 793 (10%) were under the age of 18.

Chart 3 shows the percent of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 13 years, there has been a steady decline in the number of admissions mentioning alcohol as a substance of abuse and increases in marijuana (from 36% in 1992 to 54% in 2006) and methamphetamine (from 4% in 1992 to 26% in 2006).

Across the years for which TEDS data are available, Iowa has seen a substantial shift in the constellation of problems present at treatment admission. Alcohol-only admissions have declined from 53 percent of all admissions in 1992 to 28 percent in 2005. Concomitantly, drug-only admissions have increased from 6 percent in 1992 to 23 percent in 2006 (Chart 4).

Unmet Need For Treatment

NSDUH defines unmet treatment need as an individual who meets the criteria for abuse of or dependence on illicit drugs or alcohol according to the DSM-IV, but who has not received specialty treatment for that problem in the past year.

Iowa has consistently ranked among the 10 States with the lowest unmet need for drug treatment for the population age 12 and older, as well as for the population age 12 to 17 (Chart 5). In 2005-2006, the rate of unmet need for drug treatment for all population groups was among the lowest in the country.

Similar to the rates of alcohol dependence and abuse, rates of unmet need for alcohol treatment in Iowa have been at or above the national rate and in 2005-2006 were among the highest in the country for all population groups except those age 26 and older (Chart 6).