Behavioral Health Barometer: United States: 2014

2015·3.1 MB·English

Behavioral Health Barometer
United States, 2014
Acknowledgments
This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by
RTI International under contract No. 283–07–0208 with SAMHSA, U.S. Department of Health and Human
Services (HHS).
Public Domain Notice
All material appearing in this report is in the public domain and may be reproduced or copied without
permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be
reproduced or distributed for a fee without the specific, written authorization of the Office of Communications,
SAMHSA, HHS.
Electronic Access and Printed Copies
This publication may be downloaded or ordered at http://store.samhsa.gov. Or call SAMHSA at
1–877–SAMHSA–7 (1–877–726–4727) (English and Español).
Recommended Citation
Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: United States,
2014. HHS Publication No. SMA–15–4895. Rockville, MD: Substance Abuse and Mental Health Services
Administration, 2015.
Originating Office
Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services
Administration, 1 Choke Cherry Road, Rockville, MD 20857.
i
CONTENTS

FOREWORD .........................................................................................................................................iii
YOUTH SUBSTANCE USE ...................................................................................................................1
Marijuana Use ...................................................................................................................................1
Nonmedical Pain Reliever Use ...........................................................................................................2
Illicit Drug Use ...................................................................................................................................3
Cigarette Use ....................................................................................................................................4
Binge Alcohol Use ............................................................................................................................5
Initiation of Substance Use ................................................................................................................6
Risk Perceptions ...............................................................................................................................7
YOUTH MENTAL HEALTH AND TREATMENT ....................................................................................8
Depression .......................................................................................................................................8
Treatment for Depression ..................................................................................................................9
ADULT MENTAL HEALTH AND TREATMENT ...................................................................................10
Thoughts of Suicide ........................................................................................................................ 10
Serious Mental Illness ......................................................................................................................11
Treatment for Serious Mental Illness ................................................................................................ 12
SUBSTANCE USE .............................................................................................................................. 13
Alcohol Dependence and Abuse ..................................................................................................... 13
Illicit Drug Dependence and Abuse ..................................................................................................14
Heavy Alcohol Use .......................................................................................................................... 15
SUBSTANCE USE TREATMENT .......................................................................................................16
Enrollment and Treatment Focus ..................................................................................................... 16
Alcohol ............................................................................................................................................17
Opioids (Medication-Assisted Therapy) ............................................................................................ 18
Illicit Drugs ...................................................................................................................................... 19
FIGURE NOTES .................................................................................................................................20
DEFINITIONS .....................................................................................................................................22
SOURCES ..........................................................................................................................................24
ii
FOREWORD

The Substance Abuse and Mental Health Services Administration (SAMHSA), an operating division
within the U.S. Department of Health and Human Services (HHS), is charged with reducing the impact
of substance abuse and mental illness on America’s communities. SAMHSA is pursuing this mission
at a time of significant change. Health reform has been enacted, bringing sweeping changes to how the
United States delivers, pays for, and monitors health care. Simultaneously, state budgets are shrinking,
and fiscal restraint is a top priority.
This is the second edition of the Behavioral Health Barometer: United States, one of a series of state and
national reports that provide a snapshot of behavioral health in the United States. The reports present a
set of substance use and mental health indicators as measured through data collection efforts sponsored
by SAMHSA, including the National Survey on Drug Use and Health and the National Survey of
Substance Abuse Treatment Services. This array of indicators provides a unique overview of the nation’s
behavioral health at a point in time as well as a mechanism for tracking change and trends over time. As
new data become available, indicators highlighted in these reports will be updated to reflect the current
state of the science and incorporate new measures of interest. The Behavioral Health Barometers will
provide critical information to a variety of audiences in support of SAMHSA’s mission of reducing the
impact of substance abuse and mental illness on America’s communities.
This national report, along with a Behavioral Health Barometer for each State and the District of
Columbia, will be published on a regular basis as part of SAMHSA’s larger behavioral health quality
improvement approach.
Pamela S. Hyde, JD, Administrator
Substance Abuse and Mental Health Services Administration
iii
YOUTH SUBSTANCE USE
MARIJUANA USE
Past-Month Marijuana Use Among Adolescents Aged 12–17 (2008–2013)1
10%
7.9%
8% 7.4% 7.4% 7.2% 7.1%
6.7%
6%
Healthy People 2020
In the United States, the percentage of
Target: 6.0% or below 1t
adolescents aged 12 to 17 who have used
4%
marijuana in the month prior to being
surveyed increased from 2008 to 2011,
then decreased in 2012 and 2013. This
2%
percentage has been above the Healthy
People 2020 target of 6.0% since 2008.
0%
2008 2009 2010 2011 2012 2013
Year
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008 to 2013.
Past-Month Marijuana Use Among Adolescents, by National Survey (2002–2013)
Despite differences in methods between surveys, data from the National Survey on Drug Use and Health (NSDUH),
Monitoring the Future (MTF), and the Youth Risk Behavior Survey (YRBS) generally all show that the percentage of
adolescents who used marijuana decreased from the early 2000s to the middle-late 2000s and then increased gradually
in more recent years.
25% 23.1% 23.4% 9th–12th Grades
22.4% (Youth Risk Behavior
20.8% Survey)
20.2%
19.7% 22.6% 22.9% 22.7%
20% 21.5% 21.2% 21.4% 12th Grade
19.9% 19.8% 19.4% 20.6% (Monitoring the Future)
18.8%
18.3%
15% 13.1%
12.3% 12.4% 12.4% 12.5%
11.8%
11.2% 10.9% 11.2% 8th and 10th Grades
10.4% 10.0% 9.8% Combined (Monitoring 1b
10%
the Future)
Aged 12–17
5% 8.2% 7.9% 7.6% 6.8% 6.7% 6.7% 6.7% 7.4% 7.4% 7.9% 7.2% 7.1% (National Survey
on Drug Use and
Health)
0%
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Year
Statistical tests (t-tests) have been conducted for all statements appearing in the text on this page of the report that compare estimates between years or subgroups 1
of the population. Unless explicitly stated that a difference is not statistically significant, all statements that describe differences are significant at the .05 level.
YOUTH SUBSTANCE USE
NONMEDICAL PAIN RELIEVER USE
Past-Year Nonmedical Pain Reliever Use Among Adolescents, by National Survey and
Gender (2002–2013)2
Data on adolescents aged 12–17 from NSDUH and
on 12th graders from MTF generally show a decrease
in past year nonmedical use of pain relievers for both
males and females.
11.6%
12%
10.9% 10.9%
10.7% 10.7% 10.6% 10.7%
10.3%
9.9%
9.6%
10%
9.3%
8.3% 8.4%
8.1%
7.9% 7.8% 7.9% 7.9% 7.8% 12th Grade Males
7.6%
8% 7.4% 7.4% (Monitoring the Future)
7.4% 7.8% 8.1% 2
7.5% 6.5%
7.2% 7.3% 7.4% 7.0% 7.2% 7.2% 7.0% 6.5% 12th Grade Females
6.8% 5.6% (Monitoring the Future)
6% 6.5% 6.3% 6.4% 5.6%
5.7% 6.0% 4.8% Aged 12–17, Females
5.5% 5.4% (National Survey on
5.1%
Drug Use and Health)
4% 4.5%
Aged 12–17, Males
(National Survey on
Drug Use and Health)
2%
0%
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Year
In NSDUH, the percentage of adolescents aged
12-17 with past year nonmedical use of pain
relievers tended to be higher for females than
males, and in MTF this percentage among 12th
graders tended to be higher for males than for
females. The different age groups used for these
estimates (all adolescents aged 12 to 17 in NSDUH
and just 12th graders for MTF) are likely the reason
for these different data patterns.
2
YOUTH SUBSTANCE USE
ILLICIT DRUG USE
Past-Month Illicit Drug Use Among Adolescents Aged 12–17, by Race/Ethnicity
(2009–2013)3
12% 11.8% In the United States, 8.8% of
adolescents aged 12–17 (an
11.4% 8.8%
estimated 2.2 million adolescents)
11.1%
in 2013 reported using illicit drugs
11% 10.8% 10.8% within the month prior to being
10.5% surveyed.
Black
10.2%
10.1% 10.1% 10.1% 10.3% 3t
10%
9.7%
The percentage of U.S. adolescents using
9.8% 9.6% illicit drugs decreased from 10.1% in 2009
9.7% 9.7%
to 8.8% in 2013. During this time there were
9.5% 8.8% significant decreases for white and Hispanic
9% ( , ) Total
adolescents but not for black adolescents.
White
Hispanic
8.7%
or Latino
8% Source: SAMHSA, Center for Behavioral Health Statistics and Quality,
2009 2010 2011 2012 2013 National Survey on Drug Use and Health, 2009 to 2013.
Year
Past-Month Illicit Drug Use Among Adolescents Aged 12–17 (2013)
8%
7.1% Marijuana and nonmedical use of
psychotherapeutics were the most
commonly used illicit drugs by U.S.
6% adolescents aged 12–17 in 2013.
3b
4%
2.2%
2%
0.6% 0.5%
0.2% 0.1%
0%
Marijuana Nonmedical use of Hallucinogens Inhalants Cocaine Heroin
psychotherapeutics
Source: SAMHSA, Center for Behavioral Health Statistics and Quality,
National Survey on Drug Use and Health, 2013.
Statistical tests (t-tests) have been conducted for all statements appearing in the text on this page of the report that compare estimates between years or subgroups 3
of the population. Unless explicitly stated that a difference is not statistically significant, all statements that describe differences are significant at the .05 level.
YOUTH SUBSTANCE USE
CIGARETTE USE
Past-Month Cigarette Use Among Adolescents Aged 12–17, by Race/Ethnicity (2013)4
8%
In the United States, 5.6% of
7.2%
adolescents aged 12–17 (an
5.6%
estimated 1.4 million adolescents)
6% in 2013 reported using cigarettes
within the month prior to being
surveyed.
4% 3.6% 3.7%
4t
3.2%
2.5%
In 2013, white adolescents had
a higher percentage of cigarette
2%
use (7.2%) than blacks, Native
Hawaiian or other Pacific
Islanders, Asians, or Hispanics.
0%
White Black Native Asian Hispanic or
Hawaiian or Latino
Other Pacific
Islander
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2013.
Past-Month Cigarette Use Among Adolescents Aged 12–17, by Race/Ethnicity
(2009–2013)3
12%
10.7%
In 2013, the percentage of
9.8% cigarette use was higher
10% 9.3%
9.0% among adolescents who lived
8.4%
8.2% in nonmetropolitan areas (8.4%)
7.8%
8% 7.2% than adolescents who lived in
7.9% 6.6% White metropolitan areas (5.1%). 4b
7.6% 6.1%
5.6%
6%
4.8% Total
From 2009 to 2013, the
4% 5.3% 4.9% 3.7% Hispanic percentage of U.S. adolescents
4.4% or Latino
4.1% using cigarettes decreased
3.2% Black from 9.0% to 5.6%. There were
2% significant decreases for whites,
blacks, and Hispanics.
0%
2009 2010 2011 2012 2013
Source: SAMHSA, Center for Behavioral Health Statistics and Quality,
Year
National Survey on Drug Use and Health, 2009 to 2013.
Statistical tests (t-tests) have been conducted for all statements appearing in the text on this page of the report that compare estimates between years or subgroups 4
of the population. Unless explicitly stated that a difference is not statistically significant, all statements that describe differences are significant at the .05 level.
YOUTH SUBSTANCE USE
BINGE ALCOHOL USE
Past-Month Binge Alcohol Use among Adolescents Aged 12–17, by Gender
(2008–2013)1
12%
In 2013, 6.2% of U.S.
adolescents (an estimated 1.6
8.9% 8.9% 6.2%
10% million adolescents) were binge
Healthy People 2020
Target: 8.6% or below alcohol users in the month prior to
being surveyed, a decrease from
8%
8.9% in 2008. This percentage
5t
Males has been below the Healthy
6% 7.9% Total People 2020 target since 2010.
7.4%
7.2%
Females
6.2%
4%
The percentage of binge drinking among
adolescents decreased from 2008 to 2013 for
2% both males and females.
0%
2008 2009 2010 2011 2012 2013
Source: SAMHSA, Center for Behavioral Health Statistics and Quality,
Year National Survey on Drug Use and Health, 2008 to 2013.
Past-Month Binge Alcohol Use Among Adolescents Aged 12–17, by Race/Ethnicity
(2013)
8%
7.3%
Among U.S. adolescents,
6.3% higher percentages of
whites and Hispanics
6% 5.6%
engaged in past-month
binge drinking than did
4.5%
blacks or Asians.
3.9%
4%
5b
2.8%
2%
0%
White Black American Native Asian Hispanic or
Indian or Hawaiian or Latino
Alaska Native Other Pacific
Source: SAMHSA, Center for Behavioral
Islander Health Statistics and Quality, National
Survey on Drug Use and Health, 2013.
Statistical tests (t-tests) have been conducted for all statements appearing in the text on this page of the report that compare estimates between years or subgroups 5
of the population. Unless explicitly stated that a difference is not statistically significant, all statements that describe differences are significant at the .05 level.
YOUTH SUBSTANCE USE
INITIATION OF SUBSTANCE USE
Past-Year Initiation of Selected Substances Among Adolescents Aged 12–17
(2009–2013)
12%
10.8% The percentage of U.S.
10.5%
10.2% adolescents who were past-
9.8% 9.7%
year initiates of alcohol use,
Used Alcohol
for the First Time cigarette use, nonmedical
use of psychotherapeutics,
8% or marijuana use (i.e., used
the substance for the first 6t
time in the year prior to being
5.5% 5.5%
5.2% 5.0% 4.8% Used Marijuana surveyed) decreased from 2009
for the First Time to 2013. In 2013, nearly 1 in
5.2% 10 adolescents (9.7%) used
4% 4.9% 4.7% Used Cigarettes
4.1% alcohol for the first time in the
for the First Time
3.7%
3.5% past year.
3.2% 3.0% 2.9% Nonmedical Use of
2.4% Psychotherapeutics
for the First Time
0%
2009 2010 2011 2012 2013 Source: SAMHSA, Center for Behavioral Health
Statistics and Quality, National Survey on Drug
Year
Use and Health, 2009 to 2013.
Past-Year Initiation of Selected Substances Among Adolescents Aged 12–17, by
Race/Ethnicity (2013)6
Among U.S. adolescents in 2013, whites were more likely than Hispanics to have initiated alcohol use in the past year and were
more likely than blacks to have initiated cigarette use or nonmedical use of psychotherapeutics in the past year. There were no
differences between racial/ethnic groups in past-year initiation of marijuana use.
12%
10.5%
9.1% 9.1%
6b
8%
White
Black
4.1%
4% 3.6% Hispanic or Latino
3.0%
2.6% 2.4%
1.9%
0%
Alcohol Cigarettes Nonmedical Use of
Prescription Drugs
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2013.
Statistical tests (t-tests) have been conducted for all statements appearing in the text on this page of the report that compare estimates between years or subgroups 6
of the population. Unless explicitly stated that a difference is not statistically significant, all statements that describe differences are significant at the .05 level.