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, South Carolina has ranked among the 10 States with the lowest 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). Notably, the rate of past year alcohol dependence or abuse among adolescents has been among the lowest in country for all survey years, while the rates of the same measure have been more variable for other age groups (Chart 1).Similarly, the rate of past year dependence on illicit drugs among young adults (those age 18 to 25) has remained consistently among the lowest in the country, while the rates for the age group 25 and older have remained at or above the national levels (Chart 2).

Substance Abuse Treatment Facilities

According to the National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of treatment facilities in South Carolina has remained relatively stable since 2002. In 2006, there were 104 facilities in South Carolina, of which programs were offered at 14 facilities, and 77 27 were private nonprofit (26%), 30 were private physicians and 19 programs offered buprenorphine for-profit (29%), and 29 (28%) were owned or treatment for opioid addiction.operated by the State government.In 2006, 58 percent of all facilities (60) received Although facilities may offer more than one some form of Federal, State, county, or local modality of care, in 2006 the majority of facilities government funds, and 51 facilities (49%) had in South Carolina (92 of 104, or 89%) offered agreements or contracts with managed care some form of outpatient treatment, and 23 offered organizations for the provision of substance abuse some form of residential care. Opioid treatment 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, South Carolina showed a one-day total of 13,436 clients in treatment, the majority of whom (12,791 or 95%) were in outpatient treatment. Of the total number of clients in treatment on this date, 1,517 (11%) 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, the number of admissions mentioning alcohol has remained relatively steady; while there have been marked increases in the percent of admissions for cocaine and marijuana.Across the years for which TEDS data are available, South Carolina has seen a substantial shift in the constellation of problems present at treatment admission. Alcohol-only admissions have declined from over 46 percent of all admissions in 1992, to just over 30 percent in 2006. Concomitantly, drug-only admissions have increased from 11 percent in 1992, to 29 percent in 2006; and admissions with both alcohol and illicit drugs have nearly doubled from 16 percent in 1992, to 30 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.

In 2005-2006, South Carolina’s rates of unmet drug treatment need varied from among the highest in the country for individuals age 26 and older, to rates similar to the rest of the country for the other age groups (Chart 5).Rates of unmet need for alcohol treatment, however, have generally been at or below the national rates; especially for the 12 to 17 year old age group, where the rates of unmet need have consistently been among the lowest in the country (Chart 6).