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, New Hampshire has consistently ranked among those 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). On the global measure of past year abuse of or dependence on illicit drugs or alcohol, two age groups—those 12 to 17 and those age 18 to 25—have been ranked among the highest rates in the country.

Overall rates of dependence on or abuse of alcohol in New Hampshire have generally remained among the highest in the country since 2002. This is particularly true of the rates of past year dependence or abuse of alcohol for individuals age 18 to 25, which were among the highest in the country in 2005-2006.

Similarly, rates of past year dependence on or abuse of illicit drugs has remained consistently high for the age group 18 to 25, as well as for those individuals age 12 to 17. In 2005-2006, past year rates for both of these groups were among the highest in the country.

Substance Abuse Treatment Facilities

According to the National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of treatment facilities recognized in New Hampshire has decreased from 64 in 2002 to 57 in 2006, the most recent year for which data are available. In 2006, the majority of treatment facilities were private nonprofit (43 of 57 facilities or 75%). An additional 10 facilities were private for-profit, and one facility was owned/operated by a tribal government. This decrease in facilities between 2002 and 2006 is attributable primarily to the loss of seven private for-profit facilities.

Although facilities may offer more than one modality of care, the majority of facilities in New Hampshire in 2006 (42 of 57, or 74%) offered some form of outpatient care. A total of 17 facilities offered some form of residential care, and 6 facilities offered an opioid treatment program. In addition, 23 physicians and 10 treatment programs are certified to provide bupenorphine treatment.

In 2006, 68 percent of all facilities (39 of 57) received some form of Federal, State, county, or local government funds, and 22 facilities (39%) 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, New Hampshire showed a one day census total of 4,083 clients in treatment, the majority of whom (3,706 or 91%) were in outpatient treatment. Of the total number of clients in treatment on this date, 502 (12%) were under the age of 18.

Between 1992 and 2006 (the most recent year for which data are available), there has been a doubling in the number of admissions reported to the TEDS in New Hampshire—from 2,149 in 1992 to 5,729 in 2006.

The chart on the right shows the percentage of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 15 years, there has been a modest decline in the number of admissions mentioning alcohol as a substance of abuse, and increases in the mentions of both cocaine and heroin (Chart 3).

Across the years for which TEDS data are available, New Hampshire has seen a substantial shift in the constellation of problems present at treatment admission (Chart 4). Alcohol-only admissions have declined from 40 percent of all admissions in 1992 to 25 percent in 2006. Concomitantly, drug-only admissions have increased from 7 percent in 1992 to 23 percent in 2006.

Unmet Need For Treatment

NSDUH defines unmet treatment as an individual who meets the criteria for abuse of or dependence on illicit drugs or alcohol according to the DSM-IV, but has not received specialty treatment for that problem in the past year. Generally, rates of unmet need for treatment for alcohol use have remained at or above the national rates for all population groups. In 2005-2006, the rate of unmet need for alcohol treatment for individuals age 18 to 25 was among the highest in the country.

Similarly, the rates of unmet drug treatment need in New Hampshire have been at or above the national rates for all age groups, except for those age 26 and older. In this age group, the rate of the unmet treatment need has consistently been among the lowest in the country. In contrast to this, rates of unmet drug treatment need for individuals age 12 to 17 have consistently been among the highest in the country (Chart 5).