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, West Virginia has ranked among the ten states with the highest 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).

When illicit drug dependence or abuse is considered separately, however, the rates for individuals age 18 to 25 have consistently been among the 10 highest in the country across all survey years (Charts 1 and 2).

Substance Abuse Treatment Facilities

According to the National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of treatment facilities in West Virginia has remained relatively stable since 2002, numbering 83 facilities in 2006. Of these, 59 facilities (71%) were private nonprofit, and another 18 (22%) were private for-profit.

Although facilities may offer more than one modality of care, the majority of facilities (60 of 83 or 72%) offered some form of outpatient treatment. A total of 25 facilities offered some form of residential care, and 8 facilities provided opioid treatment. In addition, 51 physicians and 18 programs are certified to provide buprenorphine treatment for opiate addiction.

In 2006, 61 facilities (74%) received some form of Federal, State, county, or local government funds, and 39 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, West Virginia showed a total of 8,691 clients in treatment, the majority of whom (8,075 or 93%) were in outpatient treatment. Of the total number of clients in treatment on this date, 382 (4%) were under the age of 18.

Chart 3 shows the percentage of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 6 years for which data are available, there has been a decline in the number of admissions mentioning alcohol and a substantive increase in the number of admissions mentioning opiates other than heroin as a substance of abuse.

West Virginia has seen a change in the constellation of problems present at treatment admission. Alcohol-only admissions have decreased from 42 percent of all admissions in 2001 to 35 percent in 2006. Concomitantly, drug-only admissions have slightly increased from 29 percent in 2001 to 34 percent in 2006, and admissions with both alcohol and drugs have increased almost four-fold from 8 percent in 2001 to 31 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.

Conversely, unmet need for alcohol treatment in West Virginia has generally been at or below the national rate for all age groups and particularly for that age 26 and older (Chart 5).