What are the most common addictions – the ones that are severe enough to necessitate a rehab stay?
Right now, headlines are dominated by the ongoing opioid epidemic in the United States. But rehab programs are filled with more than just people who are addicted to painkillers. Understanding the drug hazards that exist is a crucial part of prevention and treatment.
TEDS – Tracking Rehab Admissions
The best resource for identifying those hazards is the Treatment Episode Data Set (TEDS), a system maintained jointly by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Behavioral Health Statistics and Quality.
TEDS is made up of the data collected by the individual states used to monitor their individual substance abuse treatment programs. Because most states only collect data on those programs that receive state or federal funding, TEDS does not reflect every single treatment admission in the country.
However, it does offer an illuminating snapshot of the current situation.
While an individual state’s information might be more up to date, the most recent TEDS report for the entire country was compiled in 2015. This report yielded some surprising information.
- In 2015, there were 1,644,287 total substance abuse treatment admissions.
- That is up from 1,639,026 in 2014.
- 65.5% of admissions were males.
- The largest age demographic was the 26-30-year-old group, which made up 17.6% of admissions, followed by 31-35 at 15.1%.
- Whites accounted for 65.6% of admissions, followed by African-Americans at 18.8%.
Let’s take a closer look at the Top 10 Addictions that people go to rehab for, as ranked by the total number of admissions.
#1 – Heroin – 25.7% of Treatment Admissions
Heroin is an opioid made from morphine, which is a natural product of the opium poppy. According to the American Society of Addiction Medicine, in 2015, there were 591,000 Americans who had a substance abuse disorder that involved heroin.
After years of decline, heroin’s return to popularity is largely been driven by the crisis of prescription painkiller addiction. 80% of heroin addicts self-report that they started out by misusing opioid medications. By far, admissions for heroin addiction saw a bigger jump than any other substance between 2014 and 2015.
- Treatment Admissions 2015: 422,853
- Treatment Admissions 2014: 368,533
- Percent of Change: +14.7%
- By Age: 26-30: 22.9%, 21-25: 18.5%
- By Gender: 64.1% male
- By Race: 71.7% White
#2 – Alcohol Only—18.7% of Treatment Admissions
Alcohol is the most commonly used – and abused – intoxicating substance in the world. Drinking – even moderately – is associated with over 200 diseases and health conditions. According to the Centers for Disease Control and Prevention, 21,028 people die every year because of alcohol-related liver disease, and another 33,171 die because of health conditions directly linked with drinking.
It is important to note that although alcohol abuse occurs at every age, people age 50 and up make up over 43% of alcohol-related treatment admissions.
- Treatment Admissions 2015: 307,411
- Treatment Admissions 2014: 326,098
- Percent of Change: -5.7%
- By Age: 51-55: 14.4%, 46-50: 14%
- By Gender: 71.4% male
- By Race: 68.4% White
#3 – Alcohol with a Secondary Drug – 14.6% of Treatment Admissions
Alcohol is considered by many to be the greatest gateway drug. In fact, among high school seniors who have used any of the top three gateway drugs – alcohol, tobacco, and marijuana – 54% reported that alcohol was the first substance they had ever tried, compared with tobacco – 32%, and marijuana – 14%.
Mixing alcohol with other drugs is extremely dangerous. 75% of all overdoses and 98% of FATAL overdoses involve more than one substance.
- Treatment Admissions 2015: 240,093
- Treatment Admissions 2014: 260,192
- Percent of Change: -7.7%
- By Age: 26-30: 14.2%, 31-35: 14.1%
- By Gender: 72.3% male
- By Race: 60.4% White
#4 – Marijuana – 14.2% of Treatment Admissions
With the increasingly-legal status of recreational marijuana, this number is only expected to rise sharply. For some, marijuana is placed on this list may be a surprise, because many people are of the opinion that marijuana is not addictive.
This is absolutely NOT the case.
The National Institute on Drug Abuse has determined that approximately 9% of cannabis users eventually become dependent upon the drug. While that may not sound like much, consider this – over 22 million Americans report past-month use. That works out to almost 2 million marijuana addicts.
- Treatment Admissions 2015: 232,927
- Treatment Admissions 2014: 251,928
- Percent of Change: -7.5%
- By Age: 12-17: 22.8%, 21-25: 20.9%
- By Gender: 71.4% male
- By Race: 49.5% White, 32.7% African-American
#5 – Amphetamines – 8.8% of Treatment Admissions
This category includes methamphetamines, ecstasy, bath salts, phenmetrazine, and other related drugs. Of special relevance, methamphetamine is currently a growing drug threat in the United States, primarily because of Mexican drug cartels. Right now, meth prices are at an all-time low and purity is at an all-time high.
- Treatment Admissions 2015: 144,382
- Treatment Admissions 2014: 144,513
- Percent of Change: -.01%
- By Age: 26-30: 21.2%, 31-35: 20.5%
- By Gender: 54% male
- By Race: 74.1% White
#6 – Other Opiates – 8.2% of Treatment Admissions
This category includes both the misuse of prescription opioids and the abuse of illicit synthetic opioids – hydrocodone, oxycodone, hydromorphone, methadone, fentanyl, buprenorphine, codeine, etc.
Synthetic opioids are a particular concern, because in 2016, there were 21,405 deaths involving fentanyl and its analogues. That is more than twice the number of deaths in 2015, and nearly seven times 2013’s total.
- Treatment Admissions 2015: 135,574
- Treatment Admissions 2014: 135,823
- Percent of Change: -.02%
- By Age: 26-30: 24.8%, 31-35: 20.6%
- By Gender: 52.2% male
- By Race: 84.1% White
#7 – Cocaine – 5% of Treatment Admissions
Cocaine consumption and addiction is expected to rise sharply. According to the Drug Enforcement Administration’s 2017 Drug Threat Assessment, retail cocaine prices fell by over 18% between 2015 and 2016, while drug purity rose more than 15%. Right now, the Colombian supply is greater than any other point in history.
It is important to note that the method of consumption matters, in terms of treatment admissions. African-Americans were treated more for smokable cocaine – a.k.a. crack – while whites were treated more for snorting or injecting cocaine.
First-time use has also spiked. 2014, there were “only” 766,000 Americans who tried cocaine for the first time, but in 2015, that number of first-time users rose to 968,000. That is a one year increase of over 26%.
- Treatment Admissions 2015: 82,068
- Treatment Admissions 2014: 88,751
- Percent of Change: -7.5%
- By Age: Smoked Cocaine – 46-50: 20.9%, Cocaine, other routes – 31-35: 16.5%
- By Gender: Smoked Cocaine – 58.6% Male, Cocaine, other routes – 68.6% male
- By Race: Smoked Cocaine – 56.4% African-American, Cocaine other routes – 49.8% White
#8 – Tranquilizers – .9% of Treatment Admissions
This category includes benzodiazepines, which are primarily prescribed for anti-anxiety or as sleeping aids – alprazolam (Xanax), clonazepam (Klonopin), chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan), etc.
It is important to note that women are admitted to treatment for benzodiazepine abuse at a rate that is nearly equal to that of men.
Of special concern, benzodiazepine tranquilizers can be habit-forming even when taken precisely as directed. A benzo dependency can develop in less than two weeks.
However, benzodiazepines should NEVER be discontinued abruptly, because the withdrawal symptoms are extremely dangerous – potentially, even fatal. For that reason, a person wanting to quit using benzos should ONLY do so under the care of a doctor.
- Treatment Admissions 2015: 15,561
- Treatment Admissions 2014: 15,316
- Percent of Change: +1.6%
- By Age: 26-30: 20.3%, 31-25: 17.7%
- By Gender: 53.3% male
- By Race: 82.2% White
#9 – PCP – .3% of Treatment Admissions
Phencyclidine, also known as “angel dust”, is a powerful hallucinogen that can trigger violent behavior. Although PCP is most-commonly mixed with tobacco or marijuana and smoked, it can also be eaten, injected, or snorted.
PCP triggers such profound brain changes that users can experience “flashbacks” long after the drug is discontinued.
Although PCP was originally introduced as a disassociative anesthetic medication, its use by humans was prohibited in 1965, and in animals in 1978.
- Treatment Admissions 2015: 4815
- Treatment Admissions 2014: 4938
- Percent of Change: -2.4%
- By Age: 31-35: 28.8%, 26-30: 23.7%
- By Gender: 62.1% male
- By Race: 61.9% African-American
#10 – Sedatives – .2% of Treatment Admissions
This category primarily consists of barbiturates such as secobarbital (Seconal), phenobarbital, pentobarbital (Nembutal), and the like. Although they have been largely replaced by benzodiazepines, barbiturates are still prescribed in some cases for anxiety, insomnia and seizures.
There is an important consideration about treatment admissions for sedative abuse. It is the only “Top 10” substance that is primarily used by both women and senior citizens.
- Treatment Admissions 2015: 3100
- Treatment Admissions 2014: 2857
- Percent of Change: +8.5%
- By Age: 66 and over: 22%, 26-30: 13.9%
- By Gender: 54.7% female
- By Race: 82.9% White
What Can We Learn from these Top 10 Addictions?
There are several takeaways from the TEDS report:
- Heroin is MUCH bigger problem than most people realize.
- Synthetic opioids are now the largest single cause of opioid overdose deaths.
- Marijuana addiction is REAL.
- Marijuana Use Disorder is a legitimate medical condition.
- Literally, there are HUNDREDS of individual substances that have a high potential for abuse.
- A Substance Use Disorder (SUD) can happen to ANYONE – every gender, age group, race, and ethnicity is affected.
- There is no such thing as a “typical” substance abuser. For example, although MOST treatment admissions for MOST substances are largely represented by white males, that is not the case in every instance:
- The greatest number of alcohol treatment admissions were among older Americans.
- Senior citizens are treated for sedative abuse more than any age group.
- More women than men are treated for sedative abuse.
- African-Americans represent the highest percentage of treatment admissions for smokable cocaine or PCP.
- More people of Asian or Pacific Islander descent are admitted for amphetamine use them for any other substance.
- PCP is the only substance for which Latinos are admitted to treatment at a higher rate than whites, 22.4% versus 19.9%
But this is the biggest takeaway – substance abuse, in all its forms, is a major problem in the United States.
Just how big is this problem?
According to most addiction experts, only about 11% of those individuals with an SUD are currently receiving the professional treatment and support they need.
There are approximately 24 million Americans age 12 or older who meet the criteria for an alcohol or drug abuse diagnosis. That means that right now, there are roughly 21.3 million Americans who need – but are not currently receiving – professional substance abuse treatment.
What Does This Report NOT Tell Us?
In some ways, the TEDS report is limited because it does not tell us what specific services were required for the people receiving professional addiction treatment:
- Medically-supervised detox
- Intensive outpatient
- Partial hospitalization
- Medication assistance
- Treatment for co-occurring mental disorders
Likewise, it does not speak to the accreditation of any specific facility, or the qualifications of the staff.
For that information, it is important for anyone needing professional treatment for alcoholism, illicit drug abuse, or the misuse of prescription medications to do a bit of homework to determine if a specific facility offers everything that they might need.
The best rehab programs will be:
- Accredited – The facility and the clinical staff should all be in compliance with applicable state law.
- Evidence-based – Their treatment protocols will be based in the latest scientific research.
- Medically-supervised – A supervising physician should oversee care, and when necessary, prescribe anti-craving medications.
- Individualized – The treatment strategy should be tailored to the unique needs of the person, as determined by an in-depth assessment by an addiction/mental health professional.
- Comprehensive – They will offer all of the typically-needed services.
- Integrative – Each member of the recovery team works cooperatively with the others, under the umbrella of a shared philosophy.
- Inclusive –Services and support for the family is offered.
- Supportive – Even after “graduation”, aftercare services are available.
Because addiction can strike anyone – even you or someone you care about – is important to know that you are participating in a rehab program that is right for you and your situation.