The National Survey on Drug Use and Health (NSDUH) was released August 20, and surprised us by showing a decrease in treatment for illicit drug use in 2018, following an increase every year since 2015. Why was this? “While we do not know for certain, our thought is that the structure of the survey question may not be capturing all types of treatment being delivered,” a SAMHSA spokesperson said. “For example, as noted in the video presentation, MAT actually increases — although this is not captured by the current NSDUH.” As a result, the survey will include MAT in the FY 2020 version.
But MAT has been in existence for decades, in the form of methadone/OTPs, and then buprenorphine.
Is the reason a reticence to seek treatment in light of the concerns about confidentiality, with 42 CFR Part 2 in jeopardy? That’s what H. Westley Clark, M.D, J.D., former director of SAMSHA’s Center for Substance Abuse Treatment, sayd.
In any event, where did all the money go, if not to treatment for heroin?
There was good news also: Heroin-related opioid use disorder decreased significantly among young adults 18-25 years of age.
But marijuana is still the most widely used illicit drug, with frequent use by youth associated with risk for opioid use, heavy alcohol use, and major depression.
The survey also showed problems with co-occurring mental illness – people are more likely to use cigarettes, illicit drugs, and marijuana, to misuse opioid pain relievers, and to engage in binge alcohol use – than those without mental illness. Furthermore, substance misuse, regardless of substance, is associated with risk for serious mental health problems.
HHS Secretary Alex Azar, M.D. admitted that there are problems with treatment. “Many challenges remain, with millions of Americans not receiving treatment they need for substance abuse and mental illness,” he said in a press statement August 20. “Connecting Americans to evidence-based treatment, grounded in the best science we have, is and will remain a priority for President Donald Trump, for HHS, and for SAMHSA under Assistant Secretary Elinore McCance-Katz.”
For the video, an excellent one by McCance-Katz, an M.D. and Ph.D., go to: https://www.youtube.com/watch?v=Hb7pPHuRNMA
For the report, go to: https://www.samhsa.gov/data/nsduh/reports-detailed-tables-2018-NSDUH
For Dr. McCance-Katz’s slides, go to https://www.samhsa.gov/data/