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 the age of 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, Nevada has ranked among the 10 States with the highest rates of 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). Rates of abuse or dependence on alcohol or drugs have shown variability across survey years but have generally remained at or slightly above rates for the country as a whole.

Rates of abuse or dependence on alcohol in Nevada have remained at or above the national rate for all age groups and across all survey years, as have rates of alcohol dependence alone (Chart 1).

Rates of abuse of or dependence on illicit drugs show more variability both across survey years and among age groups, although generally the rates have been at or below the national rates (Chart 2).

Substance Abuse Treatment Facilities

According to the annual National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of treatment facilities in Nevada has remained relatively stable from 2002 until 2006, the year for which the most recent data are available. In 2006, the majority of facilities (41 out of 77) were private nonprofit. An additional 22 facilities were designated as private for-profit, and 5 facilities were owned or operated by Tribal governments.

Although facilities may offer more than one modality of care, the majority of Nevada facilities in 2006 (72 out of 79, or 91.1%) offered some form of outpatient care, and 15 facilities (19%) offered some form of residential care. Nine facilities offered opioid treatment programs, and 56 physicians were certified to provide buprenorphine therapy.

In 2006, 65 percent of all facilities (51 of 77) received some form of Federal, State, county, or local government funds; and 35 facilities had agreements or contracts with managed care organizations for the provision of substance abuse treatment services.

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, Nevada showed a one-day census total of 7,248 clients in treatment, the majority of whom (6,747or 93%) were in outpatient treatment. Of the total number of clients in treatment on this date, 469 (6%) 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 15 years, there has been a steady decline in the number of admissions mentioning alcohol and cocaine and a concomitant rise in admissions for methamphetamine abuse.

Across the years for which TEDS data are available, Nevada has seen a substantial shift in the constellation of problems present at treatment admission (Chart 4). Alcohol-only admissions have declined from over 40 percent of all admissions in 1992, to about 25 percent in 2006. Concomitantly, drug-only admissions have increased from 10 percent in 1992, to 35 percent in 2006.

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.

Rates of unmet need for treatment in Nevada vary for alcohol treatment and drug treatment. While the rate of individuals needing and not receiving drug treatment has generally remained at or below the rate for the country as a whole, the rate of individuals needing and not receiving alcohol treatment has generally remained at or above the national rate (Chart 5 and 6).