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, Maine has ranked among the 10 States with the highest rates of the following measures for given segments of the States population (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 alcohol abuse and dependence in Maine have been variable over time but have generally remained close to the national rates for the population age 12 and older (Chart 1).

Rates of illicit drug dependence or abuse, however, have generally remained above the national rates for three population groups: those 12 and older; those age 12 to 17; and those age 18 to 25 (Chart 2).

Substance Abuse Treatment Facilities

According to the annual National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of facilities in Maine providing substance abuse treatment has increased from 177 in 2002, to 191 in 2006. Private for-profit facilities increased from 65 in 2002, to 90 in 2006 and now comprise almost half of all treatment facilities. The number of private nonprofit facilities decreased from 100 in 2002, to 90 in 2006.

Although facilities may offer more than one modality of care, 89 percent (169 facilities) provided some form of outpatient treatment in 2006, and 14 percent (27 facilities) offered some form of residential care. Seven facilities offered opioid treatment, and 71 physicians are certified to provide buprenorphine treatment.

In 2006, 37 percent of all facilities (71) received some form of Federal, State, county, or local government funds, and 106 facilities (55%) 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, on March 31, 2006, Maine showed a one-day census of 7,833 clients in treatment. Of these, 874 (approximately 11%) were under the age of 18. The majority of clients (95%) were in outpatient treatment.

Since 2002, there has been a steady increase in the annual number of admissions to treatment in Maine, from 9,125 in 2002 to 13,683 in 2005 (the most recent year for which data are available). Chart 3 the percent of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 14 years, there has been a steady decline in the number of admissions mentioning alcohol as a substance of abuse, and concomitant increases in the mentions of marijuana, cocaine, and heroin.

Maine has also seen a relatively steady increase in the number of treatment admissions who report using two or more substances prior to treatment admissions (Chart 4). Similarly, Maine has seen a substantial increase in treatment admissions for illicit drugs only, from 18 percent in 1992 to 44 percent in 2005 (Chart 5):

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 individuals needing and not receiving treatment for drug use in Maine have generally remained above the national average (Chart 6). This is particularly true for individuals age 18 to 25 where Maine has consistently ranked among the 10 States with the highest rates of unmet need.

On the other hand, rates of individuals needing and not receiving treatment for alcohol use have generally remained at or below the national average. The one exception was the rate for unmet treatment need for individuals age 12 to 17, which has remained above the national average (Chart 7).