Highlights

This report presents results from the 2010 National Survey of Substance Abuse Treatment Services (N-SSATS), an annual census of facilities providing substance abuse treatment. Conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), N-SSATS is designed to collect data on the location, characteristics, and use of alcohol and drug abuse treatment facilities and services throughout the 50 States, the District of Columbia, and other U.S. jurisdictions. Selected findings are given below.

• The N-SSATS facility response rate in 2010 was 91.4 percent. Thirty-two States or jurisdictions had response rates that equaled or surpassed the overall rate [Tables 1.1 and 6.1].
• A total of 14,060 facilities completed the survey. The 13,339 facilities eligible for this report had a one-day census of 1,175,462 clients enrolled in substance abuse treatment on March 31, 2010 [Tables 1.1 and 3.1].
• In the United States, there were 462 clients in treatment per 100,000 population aged 18 and older on March 31, 2010. The rate was highest for persons with both alcohol and drug problems (194 per 100,000 population aged 18 and older), followed by drug problems only (182 per 100,000), and alcohol problems only (86 per 100,000) [Table 6.32].
  

Trends in Facility and Client Characteristics 2006-2010

• The total number of substance abuse treatment facilities remained relatively constant between 2006 and 2010, while the number of clients in treatment increased slightly. The number of facilities responding to the 2010 survey decreased by 3 percent, from 13,771 facilities in 2006 to 13,339 facilities in 2010. The number of clients in treatment on the survey reference date increased by 4 percent, from 1,130,881 in 2006 to 1,175,462 in 2010 [Tables 2.2].
• The operational structure of the substance abuse treatment system (i.e., the type of entity responsible for operating the facility: private non-profit, private for-profit, or government— local, State, Federal,¹ or tribal) changed very little between 2006 and 2010 [Tables 2.2 and Figures 2 and 5].
• The primary focus of activity of facilities (substance abuse treatment services, mental health services, a mix of mental health and substance abuse treatment services, general health care, or other activity) changed very little between 2006 and 2010 [Tables 2.2 and 3.1 and Figure 3].
• The major types of care—outpatient, residential (non-hospital), and hospital inpatient—changed very little from 2006 to 2010 in terms of the proportion of facilities offering each type of care or the proportion of clients in treatment in each type of care [Tables 2.3 and 3.2 and Figures 4 and 6].
• Opioid Treatment Programs certified by SAMHSA for the provision of medication-assisted therapy with methadone and/or buprenorphine were provided by 8 to 9 percent of all facilities between 2006 and 2010 [Table 2.3 and Figure 4].
• The proportion of all clients receiving methadone ranged from 23 percent to 25 percent in the period 2006 to 2010 [Table 3.2].
• The proportion of all clients receiving buprenorphine ranged from 0.3 percent to 2 percent in the period 2006 to 2010 [Table 3.2].
• The proportion of clients in treatment for three broad categories of substance abuse problems—both alcohol and drug abuse, drug abuse only, and alcohol abuse only—changed very little between 2006 and 2010. Clients in treatment for both drug and alcohol abuse made up 43 to 46 percent of all clients. Clients in treatment for drug abuse only made up 35 to 39 percent, and clients in treatment for alcohol abuse only remained fairly steady around 18 percent [Table 3.3].
• Clients under age 18 made up between 7 and 8 percent of all clients in treatment between 2006 and 2010. The type of care (outpatient, residential [non-hospital], or hospital inpatient) received by clients under age 18 differed little from that received by adults, and was stable between 2006 and 2010 [Table 3.4].
  
  

Facility Operation—March 31, 2010²

• Private non-profit organizations operated 58 percent of all facilities and were treating 53 percent of all clients.
• Private for-profit organizations operated 30 percent of all facilities and were treating 32 percent of all clients.
• Local governments operated 6 percent of all facilities and were treating 6 percent of all clients.
• State governments operated 3 percent of all facilities and were treating 4 percent of all clients.
• The Federal government operated 3 percent of all facilities and was treating 4 percent of all clients.
• Tribal governments operated 1 percent of all facilities and were treating 1 percent of all clients [Tables 4.1 and 5.1].
  

Primary Focus of Activity—March 31, 2010²

• The provision of substance abuse treatment services was the primary focus of activity of 61 percent of facilities with 66 percent of all clients in treatment.
• A mix of mental health and substance abuse treatment services was the primary focus of 31 percent of facilities with 28 percent of all clients in treatment.
• The provision of mental health services was the primary focus of 6 percent of facilities with 4 percent of all clients in treatment.
• General health care was the primary focus of 1 percent of facilities with 1 percent of all clients in treatment.
• Activities other than those listed above were the primary focus of 1 percent of facilities with less than 1 percent of all clients in treatment [Tables 4.1 and 5.1].
  
  

Type of Care—March 31, 2010³

• Outpatient treatment was offered by 81 percent of all facilities, and accounted for 90 percent of all clients in treatment.
• Residential (non-hospital) treatment was offered by 26 percent of all facilities, and accounted for 9 percent of all clients in treatment.
• Hospital inpatient treatment was offered by 6 percent of all facilities and accounted for 1 percent of all clients in treatment [Tables 4.2b and 5.2b].

Client Substance Abuse Problem and Co-occurring Mental Health Disorders—March 31, 2010

• Clients in treatment for both alcohol and drug abuse made up 43 percent of all clients.
• Clients in treatment for drug abuse only made up 39 percent of all clients.
• Clients in treatment for abuse of alcohol only made up 18 percent of all clients.
• Forty-three percent of all clients in treatment had diagnosed co-occurring substance abuse and mental health disorders [Table 5.3].
  

Facility Size and Utilization Rates—March 31, 2010

• The median number of clients in substance abuse treatment at a facility was 43 [Table 4.4].
• Ninety-one percent of all residential (non-hospital) beds and 92 percent of all hospital inpatient beds designated for substance abuse treatment were in use [Tables 4.6 and 4.7].
  

Medication-Assisted Opioid Therapy—March 31, 2010

• Clients receiving methadone or buprenorphine in Opioid Treatment Programs (OTPs) accounted for 28 percent of all clients in treatment, although OTPs were available in only 1,166 (9 percent) of all substance abuse treatment facilities [Tables 2.3 and 3.2].
• Private for-profit organizations operated 53 percent of OTPs compared to 30 percent of all substance abuse treatment facilities [Tables 4.1 and 4.20].
• Of the 304,656 clients receiving medication-assisted opioid therapy in OTPs, 98 percent (298,170) received methadone. Of the 27,456 clients receiving buprenorphine, 76 percent received it in facilities that were not OTPs [Table 4.20].
• More than half (53 percent) of clients receiving methadone were in private for-profit facilities compared to 37 percent of clients receiving buprenorphine. Clients receiving buprenorphine were more likely than those receiving methadone to be in private non-profit facilities (47 percent versus 38 percent) [Table 4.20].
• Most (93 percent) of the clients receiving methadone were in facilities whose primary focus was the provision of substance abuse treatment services, while these facilities accounted for only 53 percent of buprenorphine clients. Thirty-eight percent of buprenorphine
  clients were treated in facilities providing a mix of substance abuse treatment and mental health services [Table 4.20].
  

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