Chartbook on Behavioral Health Treatment Demand and Provider Capacity in the United States

Publication Date

Apr 13, 2021

Authors

Ellen Bouchery
Mathematica

March 2021

Link to Printer Friendly Version in PDF Format (80 PDF pages)

ABSTRACT: This chartbook is a compendium of tables presenting data relevant to behavioral health treatment demand and provider capacity to provide needed treatment. Data is presented from multiple sources: the National Survey of Substance Abuse Treatment Services (N-SSATS), the National Mental Health Services Survey (N-MHSS), the National Survey on Drug Use and Health (NSDUH), the Treatment Episode Data Set (TEDS), the Transformed Medicaid Statistical Information System (T-MSIS) Substance Use Disorder Data Book, and quality measurement data submitted to the Centers for Medicaid & Medicare Services. Taken together, these tables provide a broad overview of issues facing the behavioral health treatment system.

Reports were prepared under contract #HHSP233201600021I between the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Behavioral Health, Disability, and Aging Policy (BHDAP) and Mathematica. For additional information about this subject, you can visit the BHDAP home page at https://aspe.hhs.gov/bhdap or contact the ASPE Project Officers at HHS/ASPE/BHDAP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201; Judith.Dey@hhs.gov, Laura.Jacobus-Kantor@hhs.gov, Helen.Lamont@hhs.gov.

DISCLAIMER: The opinions and views expressed in this report are those of the authors. They do not reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. This report was completed and submitted on April 22, 2020.

ACRONYMS

A. SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

B. MENTAL HEALTH TREATMENT DEMAND AND CAPACITY

C. CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

D. DESCRIPTION OF DATA SOURCES

National Survey of Substance Abuse Treatment Services
National Mental Health Services Survey
National Survey on Drug Use and Health
Treatment Episode Data Set
Transformed Medicaid Statistical Information System SUD Data Book

LIST OF TABLES

TABLE A.1.a: Number of Persons and Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older, 2004-2018
TABLE A.1.b: Number of Persons and Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older, 2015-2018
TABLE A.2.a: Number of Persons with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older by Age Group, 2015-2018
TABLE A.2.b: Percentage of Persons with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older by Age Group, 2015-2018
TABLE A.3: Number of Persons and Percentage of Population Who Received Substance Use Treatment at Any Location or a Specialty Facility in the Past Year Among Persons Ages 12 and Older, by Substance and Age Group, 2015-2018
TABLE A.4: Number of Persons Receiving Substance Use Treatment in the Past Year Among Persons Ages 12 and Older, by Location of Treatment and Substance, 2015-2018
TABLE A.5: Number and Percentage of Substance Use Treatment Admissions to Publicly-Funded Facilities for Persons Ages 12 and Older, by Primary SUD, 2007-2017
TABLE A.6: Percentage of Substance Use Treatment Admissions to Publicly-Funded Facilities Originating from Various Treatment Referral Sources, by Type of Care, 2017
TABLE A.7: Number of Clients in Specialty Treatment Facilities, by State and Service Setting, 2013, 2015, and 2017
TABLE A.8: Number of Clients Receiving Select Opioid Use Disorder Treatment Medications from Specialty Treatment Facilities by State, 2013, 2015, and 2017
TABLE A.9: Percentage of Clients Receiving Medications in Specialty Treatment Facilities, by State, 2013, 2015, and 2017
TABLE A.10.a: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Disorder
TABLE A.10.b: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Disorder
TABLE A.11.a: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Type
TABLE A.11.b: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Type
TABLE A.11.c: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Type
TABLE A.12: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Setting
TABLE A.13: Days of Service Provided to Medicaid Beneficiaries Who Received Each Service Type in 2017
TABLE A.14: Percent of Persons 12 and Older Needing SUD Treatment Who Perceived a Need for Treatment and Made an Effort to get Treatment, 2015-2018
TABLE A.15: Percentage of Population Needing but not Receiving SUD Treatment in the Past Year, by Age Group and State, 2017-2018
TABLE A.16: Number of Residential and Inpatient Beds Designated for SUD Treatment and Their Utilization Rates, by State, 2013, 2015, and 2017
TABLE A.17: Number of DATA-Waived Providers, September 2019
TABLE A.18: Mean Rate of IET-AD for Members of Health Plans Participating in NCQA’s State of Health Care Quality Report, 2005-2018
TABLE A.19.a: Rate of IET-AD for Medicaid and/or CHIP Beneficiaries, by State FFY 2018
TABLE A.19.b: Rate of FUA-AD for Medicaid and/or CHIP Beneficiaries, by State FFY 2018
TABLE A.20: Continuity of Care for Medicaid Beneficiaries Treated for a SUD Who Received Services in an Inpatient or a Residential Setting in 2017, by State
TABLE B.1: Number of Persons with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, 2008-2018
TABLE B.2: Percentage of Population with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, by Age Group, 2008-2018
TABLE B.3: Number of Persons with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, by Insurance Status, 2008-2018
TABLE B.4.a: Number of Persons with a MDE or Suicidal Thoughts in the Past Age Group, 2008-2018
TABLE B.4.b: Percentage of Population with a MDE or Suicidal Thoughts in the Past Year, by Age Group, 2008-2018
TABLE B.5: Number of Persons Receiving Any MH Services in the Past Year, by Age and Insurance Status, 2008-2018
TABLE B.6: Number of Clients Receiving Specialty MH Treatment in the Past Year, by State and Service Setting, in 2014, 2016, and 2918
TABLE B.7: Number of Residential and Inpatient Beds Designated for MH Treatment and Utilization Rates, by State, in 2014, 2016, and 2018
TABLE B.8: MH Quality Measures from NCQA’s State of Health Care Quality Report, 2018
TABLE B.9.a: Rate of AMM-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
TABLE B.9.b: FUH-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
TABLE B.9.c: SAA-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
TABLE B.9.d: SSD-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
TABLE B.9.e: Percentage of Children Ages 6-20 Hospitalized for Treatment of Mental Illness Who Received a FUH-CH for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
TABLE C.1: Mean Hourly Wage for Occupations Providing Behavioral Health Treatment, 2008-2018
TABLE C.2: Total Employment for Occupations Providing Behavioral Health Treatment, 2008-2018
TABLE C.3: Number and Percentage of Persons with Both a MDE in the Past Year or Alcohol Use in the Past Month Among Persons Ages 12-17, 2008-2018
TABLE C.4: Number and Percentage of Persons with Mental Illness and a SUD in the Past Year Among Persons Age 18 and Older, by Age Group, 2015-2018

ACRONYMS

The following acronyms are mentioned in this report.

ADHD	Attention Deficit Hyperactivity Disorder
AMM	Antidepressant Medication Management

CHBSQ	SAMHSA Center for Behavioral Health Statistics and Quality
CHIP	Children’s Health Insurance Program

DQ	not reported because of severe data quality issues
DS	data suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries
DSM	Diagnostic and Statistical Manual of Mental Disorders

EAP	Employee Assistance Program
ED	Emergency Department

FFY	Federal Fiscal Year
FUA	Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence
FUH	Follow-Up After Hospitalization for Mental Illness

HbA1c	Hemoglobin A1c

IET	Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment

LDL	Low-Density Lipoprotein

MAT	Medication-Assisted Treatment
MDE	Major Depressive Episode
MH	Mental Health

N-MHSS	National Mental Health Services Survey
N-SSATS	National Survey on Substance Abuse Treatment Services
NA	Not Available
NCQA	National Committee for Quality Assurance
NR	Not Reported
NSDUH	National Survey on Drug Use and Health

OES	Occupational Employment Statistics

SAA	Adherence to Antipsychotic Medications for Individuals with Schizophrenia
SAMHSA	Substance Abuse and Mental Health Services Administration
SSD	Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications
SUD	Substance Use Disorder

T-MSIS	Transformed Medicaid Statistical Information System
TEDS	Treatment Episode Data Set

A. SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

Table A.1.a. Number of Persons and Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older, 2004-2018
Substance	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Number of persons (in thousands)
Marijuana	4,469	4,090	4,184	3,941^a	4,228	4,322	4,505	4,165	4,304	4,206	4,176	4,007	3,992	4,057	4,421
Cocaine	1,571^a	1,549^a	1,665^a	1,604^a	1,412^a	1,108	1,012	821	1,119	855	913	896	867	966	977
Heroin	270^a	227^a	324	214^a	283^a	369	361	426	467	517	586	591	626	652	526
Alcohol	18,654^a	18,658^a	18,852^a	18,687^a	18,478^a	18,763^a	17,967^a	16,672^a	17,714^a	17,298^a	16,994^a	15,736	15,057	14,504	14,818
Percentage of population
Marijuana	1.9^a	1.7	1.7	1.6	1.7	1.7	1.8	1.6	1.7	1.6	1.6	1.5	1.5	1.5	1.6
Cocaine	0.7^a	0.6^a	0.7^a	0.6^a	0.6^a	0.4	0.4	0.3	0.4	0.3	0.3	0.3	0.3	0.4	0.4
Heroin	0.1^a	0.1^a	0.1	0.1^a	0.1^a	0.1	0.1	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2
Alcohol	7.8^a	7.7^a	7.7^a	7.5^a	7.4^a	7.5^a	7.1^a	6.5^a	6.8^a	6.6^a	6.4^a	5.9^a	5.6	5.3	5.4
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for number of persons are from Table 7.45A and for percentages are from Table 7.45B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020. NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 years and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters such as jails and hospitals. Survey respondents were identified as having a SUD if their survey responses indicated that they met symptomatic criteria for substance dependence or abuse based on definitions found in the fourth edition of the DSM. The NSDUH survey was redesigned between 2014 and 2015. Estimates for the disorders related to the substances included in this table are comparable before and after the redesign. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table A.1.b. Number of Persons and Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older, 2015-2018
Substance	Number of Persons (in thousands)				Percentage of Population
Substance	2015	2016	2017	2018	2015	2016	2017	2018
Illicit drugs^a	7,737	7,381^e	7,545	8,094	2.9	2.7	2.8	3.0
Marijuana^b	4,007	3,992	4,057	4,421	1.5	1.5	1.5	1.6
Illicit drugs other than marijuana^b	4,494	4,056	4,308	4,408	1.7	1.5	1.6	1.6
Cocaine^c	896	867	966	977	0.3	0.3	0.4	0.4
Heroin^c	591	626	652	526	0.2	0.2	0.2	0.2
Hallucinogens	267	343	316	273	0.1	0.1	0.1	0.1
Inhalants	121	110	98	129	0.0	0.0	0.0	0.0
Methamphetamine	872	684^e	964	1,051	0.3	0.3^e	0.4	0.4
Misuse of psychotherapeutics	2,742	2,541	2,530	2,552	1.0	0.9	0.9	0.9
Pain relievers	2,038	1,753	1,678	1,694	0.88^e	0.7	0.6	0.6
Stimulants	426	540	572	561	0.2	0.2	0.2	0.2
Tranquilizers or sedatives	789	737	823	751	0.3	0.3	0.3	0.3
Tranquilizers	688	618	739	673	0.3	0.2	0.3	0.2
Sedatives	154	205	198	113	0.1	0.1	0.1	0.0
Benzodiazepines	NA	NA	NA	NA	NA	NA	NA	NA
Alcohol^c	15,736	15,057	14,504	14,818	5.9^e	5.6	5.3	5.4
Illicit drugs or alcohol	20,810	20,112	19,700	20,258	7.8	7.5	7.2	7.4
Both illicit drugs and alcohol	2,663	2,326	2,349	2,654	1.0	0.9	0.9	1.0
Illicit drugs only	5,074	5,055	5,196	5,440	1.9	1.9	1.9	2.0
Alcohol only	13,073^e	12,731	12,156	12,165	4.9^e	4.7	4.5	4.4
Opioids (heroin and/or pain relievers)^d	2,375	2,144	2,110	2,028	0.9^e	0.8	0.8	0.7
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for number of persons are from Table 7.45A and estimates for percentages are from Table 7.45B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020. NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 years and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Survey respondents were identified as having a SUD if their survey responses indicated that they met symptomatic criteria for substance dependence or abuse based on definitions found in the DSM-IV. Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for 1 or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., pain relievers, tranquilizers, stimulants, and sedatives). The total number of individuals with a disorder related to illicit drugs is less than of the sum of individuals with a disorder related to each type of illicit drug because a given individual may have a disorder related to more than 1 illicit substance. The category Illicit drugs other than marijuanaexcludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. The NSDUH survey was redesigned between 2014 and 2015. Estimates for marijuana, cocaine, heroin, and alcohol use disorders are comparable before and after the redesign. Estimates for the other substances are not comparable before and after the redesign. Respondents were classified as having an opioid use disorder if they met DSM-IV criteria for heroin use disorder, prescription pain reliever use disorder, or both in the past year. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table A.2.a. Number of Persons with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older by Age Group, 2015-2018 (numbers in thousands)
Substance	Ages 12-17				Ages 18-25				Ages 26 and Older
Substance	2015	2016	2017	2018	2015	2016	2017	2018	2015	2016	2017	2018
Illicit drugs^a	855^e	789	741	681	2,530	2,428	2,512	2,599	4,352	4,164^e	4,292	4,814
Marijuana^b	651^e	584	557	512	1,796	1,743^e	1,799	2,003	1,560^e	1,665	1,701	1,907
Illicit drugs other than marijuana^b	324^e	305	274	245	1,075	927	1,028	914	3,095	2,824	3,006	3,248
Cocaine^c	31^e	29^e	19^e	5	229	215	243	212	637	623	703	760
Heroin^c	6	1	4	4	155	152	165^e	101	430	473	483	421
Hallucinogens	66	65	56	38	117	171	130	138	84	107	130	97
Inhalants	56	54	28	34	15	13^e	29	40	51	42	41	55
Methamphetamine	22	10	24	18	156	135	188	134	694	539^e	751	899
Misuse of psychotherapeutics	216	226	197	183	687^e	544	639	551	1,840	1,771	1,693	1,819
Pain relievers	122	152	99	104	427^e	291	339^e	248	1,489	1,310	1,240	1,343
Stimulants	38	56	62	53	159	170	187	185	229	315	323	323
Tranquilizers or sedatives	99	98	84	68	243	212	288	224	446	427	451	458
Tranquilizers	77	86	80	61	234	188	278	223	376	343	380	390
Sedatives	26	32	10	12	22	30^e	24	9	106	143	164	91
Benzodiazepines	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
Alcohol^c	623^e	488	443	401	3,821^e	3,684	3,444	3,424	11,291	10,885	10,618	10,994
Illicit drugs or alcohol	1,233^e	1,064^e	992	916	5,327	5,236	5,076	5,118	14,250	13,812	13,632	14,225
Both illicit drugs and alcohol	245^e	213	192	166	1,024	876	879	905	1,394	1,237^e	1,278	1,582
Illicit drugs only	610	576	549	515	1,506	1,552	1,632	1,694	2,958	2,927	3,014	3,231
Alcohol only	378^e	275	251	234	2,797^e	2,807^e	2,565	2,519	9,897	9,648	9,340	9,411
Opioids (heroin and/or pain relievers)^d	127	153	103	108	515^e	392	445^e	312	1,733	1,599	1,562	1,608
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for ages 12-17 are from Table 7.46A. Estimates for ages 18-25 are from Table 7.48A and estimates for ages 26 and older are from Table 7.49A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020. NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 years and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Survey respondents were identified as having a SUD if their survey responses indicated that they met symptomatic criteria for substance dependence or abuse based on definitions found in the DSM-IV. Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for 1 or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., pain relievers, tranquilizers, stimulants, and sedatives). The total number of individuals with a disorder related to illicit drugs is less than of the sum of individuals with a disorder related to each type of illicit drug because a given individual may have a disorder related to more than 1 illicit substance. The category Illicit drugs other than marijuanaexcludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. The NSDUH survey was redesigned between 2014 and 2015. Estimates for marijuana, cocaine, heroin, and alcohol use disorders the redesign. Respondents were classified as having an opioid use disorder if they met DSM-IV criteria for heroin use disorder, prescription pain reliever use disorder, or both in the past year. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table A.2.b. Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older by Age Group, 2015-2018
Substance	Ages 12-17				Ages 18-25				Ages 26 and Older
Substance	2015	2016	2017	2018	2015	2016	2017	2018	2015	2016	2017	2018
Illicit drugs^a	3.4^e	3.2	3.0	2.7	7.2	7.0	7.3	7.6	2.1	2.0	2.0	2.2
Marijuana^b	2.6^e	2.3	2.2	2.1	5.1^e	5.0^e	5.2	5.9	0.8	0.8	0.8	0.9
Illicit drugs other than marijuana^d	1.3^e	1.2	1.1	1.0	3.1	2.7	3.0	2.7	1.5	1.3	1.4	1.5
Cocaine^d	0.1^e	0.1^e	0.1^e	0.0	0.7	0.6	0.7	0.6	0.3	0.3	0.3	0.4
Heroin^b	0.0	0.0	0.0	0.0	0.4	0.4	0.5^e	0.3	0.2	0.2	0.2	0.2
Hallucinogens	0.3	0.3	0.2	0.2	0.3	0.5	0.4	0.4	0.0	0.1	0.1	0.0
Inhalants	0.2	0.2	0.1	0.1	0.0^e	0.0^e	0.1	0.1	0.0	0.0	0.0	0.0
Methamphetamine	0.1	0.0	0.1	0.1	0.4	0.4	0.5	0.4	0.3	0.3^e	0.4	0.4
Misuse of psychotherapeutics	0.9	0.9	0.8	0.7	2.0	1.6	1.9	1.6	0.9	0.8	0.8	0.8
Pain relievers	0.5	0.6	0.4	0.4	1.2^e	0.8	1.0^e	0.7	0.7	0.6	0.6	0.6
Stimulants	0.2	0.2	0.2	0.2	0.5	0.5	0.5	0.5	0.1	0.1	0.2	0.2
Tranquilizers or sedatives	0.4	0.4	0.3	0.3	0.7	0.6	0.8	0.7	0.2	0.2	0.2	0.2
Tranquilizers	0.3	0.3	0.3	0.2	0.7	0.5	0.8	0.7	0.2	0.2	0.2	0.2
Sedatives	0.1	0.1	0.0	0.0	0.1	0.1^e	0.1	0.0	0.1	0.1	0.1	0.0
Benzodiazepines	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
Alcohol^b	2.5^e	2.0	1.8	1.6	10.9^e	10.7	10.0	10.1	5.4	5.2	5.0	5.1
Illicit drugs or alcohol	5.0^e	4.3^e	4.0	3.7	15.3	15.1	14.8	15.0	6.9	6.6	6.4	6.6
Both illicit drugs and alcohol	1.0^e	0.9	0.8	0.7	2.9	2.5	2.6	2.7	0.7	0.6	0.6	0.7
Illicit drugs only	2.5	2.3	2.2	2.1	4.3^e	4.5	4.8	5.0	1.4	1.4	1.4	1.5
Alcohol only	1.5^e	1.1	1.0	0.9	8.0	8.1	7.5	7.4	4.8	4.6	4.4	4.4
Opioids (heroin and/or pain relievers)^c	0.5	0.6	0.4	0.4	1.5^e	1.1	1.3^e	0.9	0.8	0.8	0.7	0.7
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for ages 12-17 are from Table 7.46B. Those for ages 18-25 are from Table 7.48B and those for ages 26 and older are from Table 7.49B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020. NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Survey respondents were identified as having a SUD if their survey responses indicated that they met symptomatic criteria for substance dependence or abuse based on definitions found in the DSM-IV. Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for 1 or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., pain relievers, tranquilizers, stimulants, and sedatives). The total number of individuals with a disorder related to illicit drugs is less than of the sum of individuals with a disorder related to each type of illicit drug, because a given individual may have a disorder related to more than 1 illicit substance. The NSDUH survey was redesigned between 2014 and 2015. Estimates for marijuana, cocaine, heroin, and alcohol use disorders are comparable before and after the redesign. Estimates for the other substances are not comparable before and after the redesign. Respondents were classified as having an opioid use disorder if they met DSM-IV criteria for heroin use disorder, prescription pain reliever use disorder, or both in the past year. The category Illicit drugs other than marijuanaexcludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

TABLE A.3. Number of persons and percentage of population who received substance use treatment at any location or a specialty facility in the past year among persons ages 12 and older, by substance and age group, 2015-2018
Substance for which treatment was received and age group	Number of persons (in thousands)				Percentage of population
Substance for which treatment was received and age group	2015	2016	2017	2018	2015	2016	2017	2018
Any treatment
Illicit drugs	2,288	2,181	2,448	2,097	0.9	0.8	0.9	0.8
12 to 17	141	121	143	130	0.6	0.5	0.6	0.5
18 to 25	469^a	418^a	442^a	311	1.3^a	1.2^a	1.3^a	0.9
26 and older	1,678	1,643	1,864	1,656	0.8	0.8	0.9	0.8
Alcohol	2,245	2,301	2,463	2,342	0.8	0.9	0.9	0.9
12 to 17	94	93	95	73	0.4	0.4	0.4	0.3
18 to 25	387	347	354	314	1.1	1.0	1.0	0.9
26 and older	1,764	1,860	2,014	1,955	0.8	0.9	0.9	0.9
Illicit drugs or alcohol	3,679	3,755	4,010	3,723	1.4	1.4	1.5	1.4
12 to 17	198	180	184	159	0.8	0.7	0.7	0.6
18 to 25	669^a	624	641	547	1.9	1.8	1.9	1.6
26 and older	2,812	2,950	3,185	3,018	1.4	1.4	1.5	1.4
Specialty treatment
Illicit drugs	1,541	1,406	1,674	1,392	0.6	0.5	0.6	0.5
12 to 17	63	64	56	80	0.3	0.3	0.2	0.3
18 to 25	296^a	259	319^a	201	0.8^a	0.7	0.9^a	0.6
26 and older	1,182	1,084	1,299	1,111	0.6	0.5	0.6	0.5
Alcohol	1,352	1,208	1,362	1,387	0.5	0.4	0.5	0.5
12 to 17	37	48	39	26	0.2	0.2	0.2	0.1
18 to 25	210	175	214	180	0.6	0.5	0.6	0.5
26 and older	1,105	985	1,109	1,181	0.5	0.5	0.5	0.5
Illicit drugs or alcohol	2,346	2,229	2,530	2,359	0.9	0.8	0.9	0.9
12 to 17	80	89	91	83	0.3	0.4	0.4	0.3
18 to 25	417	383	441^a	331	1.2	1.1	1.3^a	1.0
26 and older	1,849	1,756	1,999	1,946	0.9	0.8	0.9	0.9
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Number and percentage receiving treatment from any provider are from Table 7.50A and Table 7.50B, respectively. Number and percentage receiving treatment from a specialty provider are from Table 7.55A and Table 7.55B, respectively. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020. NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 years and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Specialty treatment facilities include hospitals (inpatient only), drug or alcohol rehabilitation facilities (inpatient or outpatient), and MH centers. Any treatment includes treatment received at specialty facilities and at an emergency room, private doctor�s office, self-help group, or prison/jail. Estimates include persons who received treatment specifically for use of illicit drugs or alcohol, as well as persons who received treatment for use of unspecified substance(s). The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

TABLE A.4. Number of Persons Receiving Substance Use Treatment in the Past Year Among Persons Ages 12 and Older, by Location of Treatment and Substance, 2015-2018
Location of Treatment and Substance for which Treatment was Received	Number of Persons (in thousands)				Percentage of Population
	2015	2016	2017	2018	2015	2016	2017	2018
Illicit drugs
Total population	2,288	2,181	2,448	2,097	100.0	100.0	100.0	100.0
Hospital -- inpatient	445	359	519	436	19.5	16.5	21.2	20.8
Rehabilitation facility -- inpatient	637	497	614	513	27.8	22.8	25.1	24.5
Rehabilitation facility -- outpatient	1,097	940	1,226	1,008	48.0	43.1	50.1	48.1
MH center -- outpatient	665	691	747	670	29.1	31.7	30.5	31.9
Emergency room	216	232	304	271	9.4	10.6	12.4	12.9
Private doctor's office	419	501	688	539	18.3^b	23.0	28.1	25.7
Self-help group	1,152	929	1,204^b	949	50.3	42.6	49.2	45.2
Prison/jail^a	192	156	264	178	8.4	7.1	10.8	8.5
Alcohol
Total population	2,245	2,301	2,463	2,342	100.0	100.0	100.0	100.0
Hospital -- inpatient	452	524	557	555	20.1	22.8	22.6	23.7
Rehabilitation facility -- inpatient	631	589	541	636	28.1	25.6	22.0	27.2
Rehabilitation facility -- outpatient	751	744	784	934	33.5	32.3	31.8	39.9
MH center -- outpatient	598	540	584	717	26.6	23.5	23.7	30.6
Emergency room	253	303	331	320	11.3	13.2	13.4	13.7
Private doctor's office	309^b	417	433	518	13.8^b	18.1	17.6	22.1
Self-help group	1,291	1,211	1,445	1,393	57.5	52.6	58.7	59.5
Prison/jail^a	157	150	197	148	7.0	6.5	8.0	6.3
Illicit drugs or alcohol
Total population	3,679	3,755	4,010	3,723	100.0	100.0	100.0	100.0
Hospital -- inpatient	702	732	844	834	19.1	19.5	21.0	22.4
Rehabilitation facility -- inpatient	974	918	911	961	26.5	24.5	22.7	25.8
Rehabilitation facility -- outpatient	1,524	1,446	1,644	1,629	41.4	38.5	41.0	43.8
MH center -- outpatient	1,093	1,054	1,157	1,173	29.7	28.1	28.9	31.5
Emergency room	453	530	573	538	12.3	14.1	14.3	14.4
Private doctor's office	686^b	883	961	943	18.7^b	23.5	24.0	25.3
Self-help group	1,948	1,808	2,098	1,917	53.0	48.2	52.3	51.5
Prison/jail^a	288	252	360	265	7.8	6.7	9.0	7.1
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for number and percentage receiving treatment for illicit drugs are from Table 7.52A and 7.52B, respectively. Estimates for number and percentage receiving treatment for alcohol are from Table 7.53A and 7.53B, respectively. Estimates for number and percentage receiving treatment for illicit drugs or alcohol are from Table 7.54A and 7.54, respectively. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020. NOTE: Estimates for illicit drugs or alcohol include persons who received treatment specifically for illicit drugs or alcohol as well as persons who received treatment for unspecified substances. Respondents could indicate multiple locations of treatment; thus, these response categories are not mutually exclusive. The NSDUH surveys only the noninstitutionalized population in the United States. Thus, individuals residing in jails and prisons are not surveyed. This category indicates individuals currently living in the community who received treatment in a jail or prison in the past 12 months. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table A.5. Number and Percentage of Substance Use Treatment Admissions to Publicly-Funded Facilities for Persons Ages 12 and Older, by Primary SUD, 2007-2017^a
Substance	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017
Number of admissions (in thousands)
Total	2,162,877	2,265,477	2,223,634	2,089,744	2,086,256	1,988,253	1,917,850	1,806,513	1,840,614	1,916,523	2,005,395
Alcohol	844,544	898,125	891,667	814,827	788,268	739,104	681,781	620,139	590,851	602,480	590,681
Opiates	399,853	448,725	475,839	479,972	523,618	528,039	550,990	554,591	622,212	644,935	682,074
Cocaine	278,430	258,757	207,881	169,707	161,370	134,928	114,589	95,931	90,814	92,004	102,482
Marijuana	346,496	392,278	405,400	388,935	384,426	348,820	320,248	277,616	262,295	261,070	250,786
Stimulants	219,332	190,546	168,511	164,163	158,636	169,667	187,398	193,771	192,063	231,590	239,852
Other drugs	31,503	37,493	42,973	45,689	45,253	42,709	40,316	36,217	40,292	45,299	46,763
None reported	42,719	39,553	31,363	26,451	24,685	24,986	22,528	28,248	42,087	39,145	92,757
Percentage of total admissions
Alcohol	39.0	39.6	40.1	39.0	37.8	37.2	35.5	34.3	32.1	31.4	29.5
Opiates	18.5	19.8	21.4	23.0	25.1	26.6	28.7	30.7	33.8	33.7	34.0
Cocaine	12.9	11.4	9.3	8.1	7.7	6.8	6.0	5.3	4.9	4.8	5.1
Marijuana	16.0	17.3	18.2	18.6	18.4	17.5	16.7	15.4	14.3	13.6	12.5
Stimulants	10.1	8.4	7.6	7.9	7.6	8.5	9.8	10.7	10.4	12.1	12.0
Other drugs	1.5	1.7	1.9	2.2	2.2	2.1	2.1	2.0	2.2	2.4	2.3
None reported	2.0	1.7	1.4	1.3	1.2	1.3	1.2	1.6	2.3	2.0	4.6
SOURCE: Treatment Episode Dataset 2017 Report: Admissions to and discharges from publicly-funded SUD treatment. Number of admissions from Table 1.1a and percentage of admissions from Table 1.1b. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/TEDS-2017.pdf. Accessed on February 22, 2020. NOTE: Based on administrative data reported to TEDS by all reporting states and jurisdictions. Significance tests were not conducted for these estimates because TEDS data include the universe of admissions that meet each state's reporting requirements for publicly-funded facilities.

Table A.6. Percentage of Substance Use Treatment Admissions to Publicly-Funded Facilities Originating from Various Treatment Referral Sources, by Type of Care, 2017^a
Type of Care	Self or Individual	Court or Criminal Justice System	Other Community Referral	Substance Use Care Provider	Other Health Care Provider	School (education)	Employer/EAP
Total	42.7	28.3	11.8	10.0	6.1	0.7	0.4
Ambulatory
Outpatient	26.6	46.6	13.9	4.9	5.8	1.7	0.5
Intensive outpatient	31.7	36.0	15.7	10.4	5.4	0.4	0.3
Rehabilitation/residential
Short-term (<30 days)	37.8	18.0	10.3	25.2	8.3	0.1	0.4
Long-term (30+ days)	36.7	29.5	10.8	17.5	5.0	0.1	0.3
Hospital (nondetoxification)	56.0	8.7	10.4	15.4	9.4	0.1	0.1
Medication-assisted opioid therapy
Outpatient	72.8	5.8	9.6	7.6	4.1	*	0.1
Detoxification	76.5	1.8	3.5	14.6	3.6	*	*
Residential	33.2	12.9	6.9	41.1	5.9	*	*
Detoxification
Freestanding residential	62.6	10.3	8.2	10.1	8.2	0.1	0.7
Hospital inpatient	74.2	4.4	12.9	3.0	5.0	0.6	0.1
Ambulatory	51.4	22.5	12.0	5.2	8.6	*	0.3
SOURCE: Treatment Episode Data Set 2017 Report: Admissions to and Discharges from Publicly-Funded SUD Treatment, Table 4.3b. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/TEDS-2017.pdf. Accessed on February 22, 2020. NOTE: Based on administrative data reported to TEDS by all reporting states and jurisdictions. Types of care categories are mutually exclusive. * Less than 0.05%. Significance tests were not conducted for these estimates because TEDS data include the universe of admissions that meet each state's reporting requirements for publicly-funded facilities.

Table A.7. Number of Clients in Specialty Treatment Facilities,^a by State and Service Setting, 2013, 2015, and 2017^b
State	Total (across other columns)			Outpatient (1-month count)			Residential (1-day count)			Inpatient (1-day count)
State	2013	2015	2017	2013	2015	2017	2013	2013	2017	2013	2015	2017
Total	1,249,629	1,305,647	1,356,015	1,127,235	1,161,456	1,238,654	107,727	119,900	99,881	14,667	24,291	17,480
Alabama	15,089	14,548	13,771	13,632	13,125	12,821	1,205	1,391	920	252	32	30
Alaska	3,900	3,363	3,556	3,531	2,932	3,235	359	431	304	10	0	17
Arizona	31,832	33,978	41,929	29,449	30,671	39,317	2,016	2,845	2,024	367	462	588
Arkansas	5,927	7,154	6,089	5,124	4,704	5,124	715	2,415	869	88	35	96
California	117,159	111,961	118,607	101,899	95,834	104,972	14,300	14,156	13,020	960	1,971	615
Colorado	42,256	34,793	32,213	40,306	33,452	30,867	1,804	1,186	1,224	146	155	122
Connecticut	33,267	37,817	41,873	31,148	35,970	39,513	1,823	1,540	2,024	296	307	336
Delaware	5,278	10,327	7,738	4,969	6,495	7,603	170	3,800	115	139	32	20
District of Columbia	3,833	2,824	2,763	3,324	2,392	2,326	468	431	437	41	1	0
Florida	53,641	63,287	62,427	45,069	51,823	55,212	7,786	8,531	5,656	786	2,933	1,559
Georgia	24,003	25,379	25,466	21,630	22,845	23,162	2,062	1,987	1,826	311	547	478
Hawaii	5,205	5,768	4,922	4,820	5,113	4,490	385	611	432	0	44	0
Idaho	6,619	6,287	7,026	6,467	6,125	6,827	137	148	156	15	14	43
Illinois	42,945	44,616	44,265	39,856	41,234	41,152	2,876	3,176	2,894	213	206	219
Indiana	28,288	25,465	33,301	27,466	23,861	31,808	531	930	978	291	674	515
Iowa	9,731	8,975	11,631	8,946	8,180	10,894	738	747	706	47	48	31
Kansas	10,863	11,471	10,710	9,916	10,603	9,985	935	834	702	12	34	23
Kentucky	24,071	23,565	29,228	21,175	20,697	26,069	2,509	2,347	2,841	387	521	318
Louisiana	9,903	12,011	10,066	8,241	9,930	8,473	1,464	1,765	1,352	198	316	241
Maine	11,373	10,849	11,801	10,865	10,483	11,482	362	289	257	146	77	62
Maryland	42,128	46,913	48,654	39,992	44,659	46,815	1,704	1,989	1,702	432	265	137
Massachusetts	44,133	45,438	58,280	40,227	40,734	53,719	3,171	3,602	3,291	735	1,102	1,270
Michigan	47,749	46,781	54,064	42,045	43,577	51,159	5,241	3,043	2,790	463	161	115
Minnesota	18,034	19,235	25,993	14,223	15,676	17,210	3,753	3,487	8,707	58	72	76
Mississippi	6,726	4,699	4,164	5,360	3,547	3,355	994	841	617	372	311	192
Missouri	23,028	25,015	21,914	21,600	22,590	20,328	1,279	2,223	1,238	149	202	348
Montana	4,429	5,064	5,762	3,809	4,785	5,429	488	187	241	132	92	92
Nebraska	6,374	5,735	6,461	5,690	4,909	5,604	684	824	828	0	2	29
Nevada	7,048	6,930	5,903	6,403	6,179	5,203	492	487	597	153	264	103
New Hampshire	6,702	8,164	8,631	6,326	7,766	8,235	367	394	366	9	4	30
New Jersey	36,605	36,708	35,659	33,068	32,578	32,662	2,813	3,404	2,364	724	726	633
New Mexico	12,868	15,062	18,808	10,949	14,499	18,141	1,808	449	605	111	114	62
New York	114,660	113,713	110,078	103,167	101,982	100,629	9,839	9,986	7,507	1,654	1,745	1,942
North Carolina	40,575	42,026	49,179	37,394	38,374	46,460	2,481	3,196	2,130	700	456	589
North Dakota	1,785	2,404	2,781	1,222	1,949	2,340	510	396	419	53	59	22
Ohio	37,262	45,129	56,197	34,397	42,006	52,395	2,365	2,406	3,081	500	717	721
Oklahoma	16,700	16,783	14,466	15,356	15,512	13,250	1,204	1,171	1,074	140	100	142
Oregon	21,898	30,401	24,027	20,537	29,047	22,579	1,299	1,258	1,400	62	96	48
Pennsylvania	57,715	59,584	64,303	52,011	53,822	57,460	5,245	5,433	6,318	459	329	525
Puerto Rico	15,169	11,358	9,232	12,119	7,817	6,051	2,511	2,971	1,632	539	570	1,549
Rhode Island	10,404	14,269	8,001	10,039	9,005	7,660	323	1,723	269	42	3,541	72
South Carolina	15,824	18,236	16,844	14,906	16,473	16,060	552	614	538	366	1,149	246
South Dakota	3,267	2,964	2,941	2,569	2,308	2,367	623	585	440	75	71	134
Tennessee	14,149	22,445	16,765	11,698	20,187	14,821	2,010	1,994	1,485	441	264	459
Texas	34,704	35,293	35,474	28,843	26,984	30,140	5,065	6,391	4,224	796	1,918	1,110
Utah	12,586	12,496	14,326	11,183	11,070	12,491	1,389	1,379	1,706	14	47	129
Vermont	5,230	7,380	7,015	4,124	6,522	6,796	1,013	164	148	93	694	71
Virginia	22,838	22,305	22,413	21,879	20,807	21,306	712	1,174	908	247	324	199
Washington	42,030	50,633	43,846	39,680	43,724	41,390	2,210	6,762	2,265	140	147	191
West Virginia	10,057	10,099	18,115	9,547	9,500	17,283	492	545	698	18	54	134
Wisconsin	28,657	24,371	22,628	26,314	23,235	20,885	2,068	888	950	275	248	793
Wyoming	2,798	3,261	3,236	2,465	2,916	2,689	326	331	543	7	14	4
U.S. territories	314	315	473	260	248	410	51	43	63	3	24	0
SOURCE: N-SSATS 2013, 2015, and 2017. NOTE: Inpatient and residential client counts represent the number of clients receiving services on March 31 of the indicated year (see Questions 28a and 29a in N-SSATS 2013 and Questions 29a and 30a in N-SSATS 2015 and 2017). Outpatient client counts represent the number of clients who received outpatient services in March of the indicated year and who were still enrolled in care at the facility where they received those services on March 31 (see Question 30a in N-SSATS 2013 and Question 31a in N-SSATS 2015 and 2017). Totalclients is the sum of inpatient, residential, and outpatient clients. Client counts reflect information reported by all facilities responding to the survey with no adjustment for nonresponse. The survey response rate was 94%, 92%, and 89% in 2013, 2015, and 2017, respectively. The N-SSATS survey is limited to providers that offer specialized treatment programs for SUDs. Primary care providers who provide SUD treatment services as part of a general health care program are not included in these estimates. Significance tests were not conducted for these estimates because N-SSATS surveys the universe of specialty SUD treatment facilities.

Table A.8. Number of Clients Receiving Select Opioid Use Disorder Treatment Medications from Specialty Treatment Facilities,^a by State, 2013, 2015, and 2017^b
State	Total			Receiving Methadone			Receiving Buprenorphine			Receiving Injectable Naltrexone
State	2013	2015	2017	2013	2015	2017	2013	2015	2017	2013	2015	2017
Total	383,130	439,602	518,155	331,215	356,843	382,867	48,134	75,724	112,223	3,781	7,035	23,065
Alabama	8,785	8,457	8,511	7,738	7,639	7,441	967	787	969	80	31	101
Alaska	285	444	506	144	331	364	137	91	137	4	22	5
Arizona	7,585	8,291	10,472	6,425	7,107	8,621	1,040	987	1,363	120	197	488
Arkansas	992	1,484	1,305	831	1,095	754	161	389	520	NA	NA	31
California	33,301	38,607	45,472	30,899	35,231	39,376	2,154	2,922	3,385	248	454	2,711
Colorado	2,561	2,290	3,526	2,084	1,934	2,468	379	256	734	98	100	324
Connecticut	16,540	14,658	16,332	15,531	14,072	13,793	980	544	2,050	29	42	489
Delaware	2,826	5,834	5,935	2,422	3,266	3,555	380	2,425	1,827	24	143	553
District of Columbia	1,856	1,428	1,803	1,760	1,315	1,736	93	104	67	3	9	0
Florida	16,471	20,978	23,441	14,441	17,670	18,300	1,700	2,922	3,620	330	386	1,521
Georgia	10,542	11,990	12,666	10,194	11,212	11,628	297	659	869	51	119	169
Hawaii	700	745	977	612	623	733	87	121	215	1	1	29
Idaho	147	678	511	NA	312	364	137	353	117	10	13	30
Illinois	13,230	15,053	16,984	11,922	13,559	13,732	1,199	1,303	2,815	109	191	437
Indiana	10,037	8,393	10,249	9,265	7,073	6,673	744	1,178	2,416	28	142	1,160
Iowa	692	889	1,574	623	783	1,200	69	106	325	NA	NA	49
Kansas	2,284	2,585	2,606	2,077	2,313	2,292	207	261	261	NA	11	53
Kentucky	4,719	5,136	9,866	1,626	2,955	4,896	3,079	2,158	4,727	14	23	243
Louisiana	2,193	4,731	4,853	1,907	3,502	3,422	271	1,153	1,365	15	76	66
Maine	4,503	5,304	6,474	3,658	3,751	3,928	838	1,529	2,501	7	24	45
Maryland	22,278	26,692	31,149	19,564	22,927	25,026	2,622	3,533	5,443	92	232	680
Massachusetts	19,626	22,146	33,877	15,479	17,633	21,739	3,861	4,113	10,705	286	400	1,433
Michigan	9,116	12,064	12,476	7,851	9,806	10,237	1,187	1,900	1,725	78	358	514
Minnesota	5,048	6,258	7,341	4,533	5,530	6,033	483	667	1,124	32	61	184
Mississippi	257	274	249	183	176	169	70	97	57	4	1	23
Missouri	3,817	4,764	5,578	2,704	3,083	3,699	738	1,155	1,275	375	526	604
Montana	382	773	739	174	489	483	190	284	193	18	NA	63
Nebraska	954	688	615	553	619	427	78	52	154	323	17	34
Nevada	1,572	1,847	1,910	1,493	1,555	1,670	75	261	233	4	31	7
New Hampshire	2,656	4,754	6,966	2,340	2,748	3,377	311	1,991	3,447	5	15	142
New Jersey	12,818	14,506	16,262	11,704	13,103	14,040	1,036	1,166	1,496	78	237	726
New Mexico	2,752	5,029	6,330	2,407	4,088	5,184	332	890	1,064	13	51	82
New York	43,740	41,502	45,739	38,873	34,535	35,540	4,540	6,394	8,232	327	573	1,967
North Carolina	14,930	19,382	22,781	11,499	13,665	14,497	3,369	5,637	7,765	62	80	519
North Dakota	9	109	221	NA	NA	67	9	84	144	NA	25	10
Ohio	7,580	14,092	20,635	4,908	6,147	6,909	2,618	7,347	10,991	54	598	2,735
Oklahoma	3,279	3,760	3,656	3,091	3,500	3,197	188	227	349	NA	33	110
Oregon	4,348	5,322	7,006	4,045	4,663	4,657	288	601	2,132	15	58	217
Pennsylvania	23,096	24,262	28,258	20,623	20,408	22,136	2,308	3,530	4,659	165	324	1,463
Puerto Rico	8,761	5,230	4,206	8,348	4,515	3,615	380	702	586	33	13	5
Rhode Island	4,243	7,552	5,094	3,517	6,213	4,155	715	1,078	874	11	261	65
South Carolina	5,020	5,334	6,367	4,323	4,524	5,360	671	799	946	26	11	61
South Dakota	83	10	176	82	5	154	1	5	10	NA	NA	12
Tennessee	2,974	5,721	6,561	2,427	4,421	4,776	488	1,179	1,628	59	121	157
Texas	12,497	12,126	12,730	11,662	9,833	10,973	673	2,189	1,402	162	104	355
Utah	3,028	3,489	4,404	2,635	2,459	2,557	345	790	1,417	48	240	430
Vermont	1,435	3,901	3,765	918	1,624	2,151	504	2,275	1,459	13	2	155
Virginia	6,655	7,096	9,542	5,323	5,735	6,650	1,278	1,319	2,601	54	42	291
Washington	8,950	10,953	15,834	7,495	9,191	10,903	1,335	1,534	4,670	120	228	261
West Virginia	5,510	5,330	7,132	4,299	3,120	3,109	1,134	2,072	3,539	77	138	484
Wisconsin	5,279	6,542	6,236	4,003	4,769	4,101	1,206	1,521	1,449	70	252	686
Wyoming	188	92	256	NA	NA	0	182	73	171	6	19	85
SOURCE: N-SSATS 2013, 2015, and 2017. NOTE: The number of clients receiving methadone, buprenorphine, or injectable naltrexone is based on counts of clients receiving these services, as reported in Questions 28c, 29c, and 30c in N-SSATS 2013 and Questions 29c, 30c, and 31c in N-SSATS 2015 and 2017. Counts represent the number of clients who received outpatient services in March of the indicated year and who were still enrolled in care at the facility where they received those services on March 31. Totalclients is the sum of clients receiving methadone, buprenorphine, or injectable naltrexone. In the 2013 and 2015 surveys, responding facilities reported the number of clients who were dispensed methadone, dispensed or prescribed buprenorphine, or administered Vivitrolat the facility. In 2017, the questions for all these medications were edited to limit the clients reported to those receiving the medications for opioid use disorder,and Vivitrolwas replaced with naltrexone.Client counts reflect information reported by all facilities responding to the survey with no adjustment for nonresponse. The survey response rate was 94%, 92%, and 89% in 2013, 2015, and 2017, respectively. The N-SSATS survey is limited to providers that offer specialized treatment programs for SUDs. Primary care providers who provide SUD treatment services as part of a general health care program are not included in these estimates. Significance tests were not conducted for these estimates because N-SSATS surveys the universe of specialty SUD treatment facilities.

Table A.9. Percentage of Clients Receiving Medications in Specialty Treatment Facilities^a, by State, 2013, 2015, and 2017^b
	Total			Receiving Methadone			Receiving Buprenorphine			Receiving Injectable Naltrexone
	2013	2015	2017	2013	2015	2017	2013	2015	2017	2013	2015	2017
Total	31	34	38	27	27	28	4	6	8	0	1	2
Alabama	58	58	62	51	53	54	6	5	7	1	0	1
Alaska	7	13	14	4	10	10	4	3	4	0	1	0
Arizona	24	24	25	20	21	21	3	3	3	0	1	1
Arkansas	17	21	21	14	15	12	3	5	9	NA	NA	1
California	28	34	38	26	31	33	2	3	3	0	0	2
Colorado	6	7	11	5	6	8	1	1	2	0	0	1
Connecticut	50	39	39	47	37	33	3	1	5	0	0	1
Delaware	54	56	77	46	32	46	7	23	24	0	1	7
District of Columbia	48	51	65	46	47	63	2	4	2	0	0	NA
Florida	31	33	38	27	28	29	3	5	6	1	1	2
Georgia	44	47	50	42	44	46	1	3	3	0	0	1
Hawaii	13	13	20	12	11	15	2	2	4	0	0	1
Idaho	2	11	7	NA	5	5	2	6	2	0	0	0
Illinois	31	34	38	28	30	31	3	3	6	0	0	1
Indiana	35	33	31	33	28	20	3	5	7	0	1	3
Iowa	7	10	14	6	9	10	1	1	3	NA	NA	0
Kansas	21	23	24	19	20	21	2	2	2	NA	0	0
Kentucky	20	22	34	7	13	17	13	9	16	0	0	1
Louisiana	22	39	48	19	29	34	3	10	14	0	1	1
Maine	40	49	55	32	35	33	7	14	21	0	0	0
Maryland	53	57	64	46	49	51	6	8	11	0	0	1
Massachusetts	44	49	58	35	39	37	9	9	18	1	1	2
Michigan	19	26	23	16	21	19	2	4	3	0	1	1
Minnesota	28	33	28	25	29	23	3	3	4	0	0	1
Mississippi	4	6	6	3	4	4	1	2	1	0	0	1
Missouri	17	19	25	12	12	17	3	5	6	2	2	3
Montana	9	15	13	4	10	8	4	6	3	0	NA	1
Nebraska	15	12	10	9	11	7	1	1	2	5	0	1
Nevada	22	27	32	21	22	28	1	4	4	0	0	0
New Hampshire	40	58	81	35	34	39	5	24	40	0	0	2
New Jersey	35	40	46	32	36	39	3	3	4	0	1	2
New Mexico	21	33	34	19	27	28	3	6	6	0	0	0
New York	38	36	42	34	30	32	4	6	7	0	1	2
North Carolina	37	46	46	28	33	29	8	13	16	0	0	1
North Dakota	1	5	8	NA	NA	2	1	3	5	NA	1	0
Ohio	20	31	37	13	14	12	7	16	20	0	1	5
Oklahoma	20	22	25	19	21	22	1	1	2	NA	0	1
Oregon	20	18	29	18	15	19	1	2	9	0	0	1
Pennsylvania	40	41	44	36	34	34	4	6	7	0	1	2
Puerto Rico	58	46	46	55	40	39	3	6	6	0	0	0
Rhode Island	41	53	64	34	44	52	7	8	11	0	2	1
South Carolina	32	29	38	27	25	32	4	4	6	0	0	0
South Dakota	3	0	6	3	0	5	0	0	0	NA	NA	0
Tennessee	21	25	39	17	20	28	3	5	10	0	1	1
Texas	36	34	36	34	28	31	2	6	4	0	0	1
Utah	24	28	31	21	20	18	3	6	10	0	2	3
Vermont	27	53	54	18	22	31	10	31	21	0	0	2
Virginia	29	32	43	23	26	30	6	6	12	0	0	1
Washington	21	22	36	18	18	25	3	3	11	0	0	1
West Virginia	55	53	39	43	31	17	11	21	20	1	1	3
Wisconsin	18	27	28	14	20	18	4	6	6	0	1	3
Wyoming	7	3	8	NA	NA	NA	7	2	5	0	1	3
SOURCE: N-SSATS 2013, 2015, and 2017. NOTE: The percentages of clients receiving methadone, buprenorphine, and injectable naltrexone are based on counts of clients receiving these services (as reported in TABLE B.2) relative to the total number of clients (indicated in TABLE B.4.a). Client counts reflect information reported by all facilities responding to the survey. The survey response rate was 94%, 92%, and 89% in 2013, 2015, and 2017, respectively. The N-SSATS survey is limited to providers that offer specialized treatment programs for SUDs. Primary care providers who provide SUD treatment services as part of a general health care program are not included in these estimates. Significance tests were not conducted for these estimates because N-SSATS surveys the universe of specialty SUD treatment facilities.

Table A.10.a. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Disorder^a
State	Total Number of Medicaid Beneficiaries	Any SUD		Alcohol		Cannabis		Opioids
State	Total Number of Medicaid Beneficiaries	Number	Percentage	Number	Percentage	Number	Percentage	Number	Percentage
Total	53,462,361	4,084,089	7.6	858,776	1.6	532,392	1.0	1,164,950	2.2
Alabama	512,074	51,300	10.0	6,311	1.2	5,395	1.1	10,516	2.1
Alaska	158,199	18,048	11.4	6,690	4.2	2,522	1.6	4,471	2.8
Arizona	1,512,837	108,967	7.2	26,748	1.8	15,907	1.1	28,644	1.9
Arkansas	460,867	12,265	2.7	1,957	0.4	1,986	0.4	1,289	0.3
California	10,050,069	422,080	4.2	85,881	0.9	47,477	0.5	84,719	0.8
Colorado	1,052,116	67,997	6.5	16,624	1.6	5,758	0.5	15,818	1.5
Connecticut	713,934	87,004	12.2	21,759	3.0	13,951	2.0	34,393	4.8
Delaware	179,030	18,528	10.3	3,911	2.2	2,562	1.4	9,956	5.6
District of Columbia	200,116	15,642	7.8	3,558	1.8	2,021	1.0	3,569	1.8
Florida	2,410,115	136,441	5.7	22,415	0.9	17,729	0.7	27,281	1.1
Georgia	1,110,320	63,803	5.7	9,648	0.9	7,562	0.7	11,099	1.0
Hawaii	307,278	18,200	5.9	3,145	1.0	1,943	0.6	3,736	1.2
Idaho	161,110	10,416	6.5	1,433	0.9	675	0.4	2,393	1.5
Illinois	311,088	15,377	4.9	4,233	1.4	2,867	0.9	2,833	0.9
Indiana	1,097,727	94,721	8.6	18,063	1.6	11,985	1.1	28,386	2.6
Iowa	627,465	51,123	8.1	11,815	1.9	9,178	1.5	5,459	0.9
Kansas	249,801	20,250	8.1	3,330	1.3	3,531	1.4	2,745	1.1
Kentucky	1,115,633	137,127	12.3	15,667	1.4	11,357	1.0	47,530	4.3
Louisiana	594,525	39,945	6.7	5,791	1.0	5,798	1.0	7,067	1.2
Maine	169,150	20,830	12.3	3,178	1.9	1,176	0.7	9,328	5.5
Maryland	980,899	117,863	12.0	58,880	6.0	2,343	0.2	65,868	6.7
Massachusetts	1,429,779	180,056	12.6	44,726	3.1	18,337	1.3	79,511	5.6
Michigan	2,050,490	190,471	9.3	40,457	2.0	23,032	1.1	43,138	2.1
Minnesota	905,247	100,405	11.1	27,790	3.1	14,319	1.6	21,377	2.4
Mississippi	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Missouri	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Montana	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nebraska	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nevada	528,501	41,400	7.8	9,136	1.7	5,204	1.0	10,581	2.0
New Hampshire	165,862	13,430	8.1	2,462	1.5	933	0.6	7,214	4.3
New Jersey	1,358,106	81,928	6.0	18,591	1.4	9,824	0.7	28,208	2.1
New Mexico	255,223	19,153	7.5	4,896	1.9	2,816	1.1	6,269	2.5
New York	4,814,854	412,492	8.6	104,428	2.2	79,048	1.6	117,969	2.5
North Carolina	1,106,940	109,346	9.9	16,011	1.4	12,398	1.1	26,252	2.4
North Dakota	35,353	3,072	8.7	651	1.8	522	1.5	317	0.9
Ohio	2,459,666	362,088	14.7	63,859	2.6	57,873	2.4	102,734	4.2
Oklahoma	438,682	42,095	9.6	4,921	1.1	4,062	0.9	8,737	2.0
Oregon	844,280	90,062	10.7	22,781	2.7	13,307	1.6	22,106	2.6
Pennsylvania	2,336,316	278,008	11.9	52,061	2.2	36,626	1.6	108,875	4.7
Puerto Rico	2,548,531	15,227	0.6	2,668	0.1	1,803	0.1	5,620	0.2
Rhode Island	267,077	17,881	6.7	5,245	2.0	1,677	0.6	9,826	3.7
South Carolina	620,945	42,561	6.9	6,903	1.1	6,502	1.0	6,457	1.0
South Dakota	71,413	5,875	8.2	1,600	2.2	1,106	1.5	505	0.7
Tennessee	1,066,003	89,695	8.4	11,994	1.1	11,794	1.1	18,377	1.7
Texas	2,500,164	113,195	4.5	17,682	0.7	17,425	0.7	17,085	0.7
Utah	198,617	11,367	5.7	1,725	0.9	970	0.5	3,910	2.0
Vermont	143,771	19,100	13.3	4,096	2.8	2,206	1.5	9,906	6.9
Virginia	671,301	50,330	7.5	6,698	1.0	4,106	0.6	15,142	2.3
Washington	1,442,574	137,886	9.6	31,221	2.2	20,585	1.4	44,119	3.1
West Virginia	459,782	45,593	9.9	6,109	1.3	3,142	0.7	20,453	4.4
Wisconsin	724,820	79,303	10.9	18,077	2.5	8,530	1.2	22,546	3.1
Wyoming	43,711	4,143	9.5	951	2.2	522	1.2	616	1.4
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table A.1.i. (Produced based on the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020. NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

Table A.10.b. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Disorder^a
State	Total Number of Medicaid Beneficiaries	Polysubstance		Stimulants		Tobacco		Other
State	Total Number of Medicaid Beneficiaries	Number	Percentage	Number	Percentage	Number	Percentage	Number	Percentage
Total	53,462,361	1,104,594	2.1	464,803	0.9	2,314,143	4.3	394,095	0.7
Alabama	512,074	12,529	2.4	4,345	0.8	39,328	7.7	4,855	0.9
Alaska	158,199	5,426	3.4	2,161	1.4	8,393	5.3	1,772	1.1
Arizona	1,512,837	30,458	2.0	22,226	1.5	51,908	3.4	10,554	0.7
Arkansas	460,867	2,206	0.5	1,200	0.3	7,568	1.6	1,264	0.3
California	10,050,069	98,180	1.0	62,398	0.6	214,656	2.1	35,026	0.3
Colorado	1,052,116	15,429	1.5	6,458	0.6	40,654	3.9	4,607	0.4
Connecticut	713,934	26,859	3.8	9,671	1.4	39,438	5.5	8,133	1.1
Delaware	179,030	6,685	3.7	2,425	1.4	8,161	4.6	1,841	1.0
District of Columbia	200,116	5,036	2.5	1,763	0.9	10,463	5.2	2,270	1.1
Florida	2,410,115	35,198	1.5	11,592	0.5	93,714	3.9	17,269	0.7
Georgia	1,110,320	14,641	1.3	6,855	0.6	43,458	3.9	6,709	0.6
Hawaii	307,278	4,581	1.5	4,158	1.4	10,150	3.3	1,675	0.5
Idaho	161,110	1,992	1.2	774	0.5	7,384	4.6	666	0.4
Illinois	311,088	4,587	1.5	1,795	0.6	9,310	3.0	1,538	0.5
Indiana	1,097,727	25,029	2.3	10,269	0.9	54,645	5.0	10,317	0.9
Iowa	627,465	14,109	2.2	9,249	1.5	32,420	5.2	3,739	0.6
Kansas	249,801	4,989	2.0	3,369	1.3	12,778	5.1	1,710	0.7
Kentucky	1,115,633	34,312	3.1	13,336	1.2	84,338	7.6	15,084	1.4
Louisiana	594,525	9,933	1.7	4,823	0.8	26,972	4.5	4,755	0.8
Maine	169,150	4,054	2.4	539	0.3	9,966	5.9	1,633	1.0
Maryland	980,899	27,394	2.8	2,024	0.2	19,692	2.0	3,759	0.4
Massachusetts	1,429,779	59,950	4.2	18,388	1.3	98,221	6.9	22,861	1.6
Michigan	2,050,490	43,800	2.1	13,363	0.7	117,272	5.7	12,278	0.6
Minnesota	905,247	28,475	3.1	16,568	1.8	54,734	6.0	9,158	1.0
Mississippi	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Missouri	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Montana	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nebraska	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nevada	528,501	11,719	2.2	7,666	1.5	21,871	4.1	4,507	0.9
New Hampshire	165,862	3,229	1.9	764	0.5	5,232	3.2	1,277	0.8
New Jersey	1,358,106	22,680	1.7	5,271	0.4	45,213	3.3	9,714	0.7
New Mexico	255,223	4,945	1.9	2,426	1.0	7,081	2.8	2,082	0.8
New York	4,814,854	134,717	2.8	52,139	1.1	247,821	5.1	45,698	0.9
North Carolina	1,106,940	25,575	2.3	9,204	0.8	72,237	6.5	9,846	0.9
North Dakota	35,353	837	2.4	409	1.2	2,028	5.7	302	0.9
Ohio	2,459,666	109,703	4.5	34,773	1.4	241,912	9.8	34,569	1.4
Oklahoma	438,682	9,076	2.1	4,392	1.0	28,603	6.5	4,199	1.0
Oregon	844,280	26,834	3.2	17,247	2.0	45,455	5.4	5,285	0.6
Pennsylvania	2,336,316	80,338	3.4	29,990	1.3	141,967	6.1	30,536	1.3
Puerto Rico	2,548,531	2,569	0.1	1,802	0.1	4,328	0.2	1,786	0.1
Rhode Island	267,077	3,141	1.2	1,235	0.5	3,167	1.2	917	0.3
South Carolina	620,945	10,389	1.7	4,215	0.7	29,003	4.7	3,543	0.6
South Dakota	71,413	1,444	2.0	405	0.6	3,806	5.3	417	0.6
Tennessee	1,066,003	22,424	2.1	8,804	0.8	62,450	5.9	11,421	1.1
Texas	2,500,164	25,757	1.0	12,940	0.5	73,004	2.9	13,726	0.5
Utah	198,617	2,579	1.3	1,256	0.6	6,150	3.1	1,127	0.6
Vermont	143,771	5,392	3.8	1,226	0.9	8,154	5.7	1,265	0.9
Virginia	671,301	10,287	1.5	2,842	0.4	32,882	4.9	3,716	0.6
Washington	1,442,574	43,704	3.0	25,360	1.8	64,398	4.5	12,778	0.9
West Virginia	459,782	11,005	2.4	3,120	0.7	23,479	5.1	5,061	1.1
Wisconsin	724,820	19,569	2.7	7,214	1.0	45,824	6.3	6,607	0.9
Wyoming	43,711	829	1.9	354	0.8	2,455	5.6	243	0.6
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table A.1.ii. (Produced based on the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020. NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. A polysubstance use disorder involves a diagnosis in which there are 2 or more SUDs or a polysubstance diagnosis code. The Othercategory includes treatment for caffeine; hallucinogens; sedatives, hypnotics, and anxiolytics; inhalants; and unspecified or unknown SUD. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

Table A.11.a. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Type^a
State	Total Number of Medicaid Beneficiaries	Case Management		Community Support		Consultation		Counseling		Detoxification
State	Total Number of Medicaid Beneficiaries	Number	Percent	Number	Percent	Number	Percent	Number	Percent	Number	Percent
Total	4,084,089	185,050	4.5	70,447	1.7	246,794	6.0	990,714	24.3	148,643	3.6
Alabama	51,300	0	0.0	251	0.5	4,320	8.4	5,448	10.6	1,379	2.7
Alaska	18,048	1,489	8.3	3,648	20.2	426	2.4	2,501	13.9	682	3.8
Arizona	108,967	40,963	37.6	2,611	2.4	8,418	7.7	31,451	28.9	3,508	3.2
Arkansas	12,265	67	0.5	600	4.9	750	6.1	1,775	14.5	104	0.8
California	422,080	10,458	2.5	3,862	0.9	36,070	8.5	81,550	19.3	5,947	1.4
Colorado	67,997	1,021	1.5	506	0.7	68	0.1	6,754	9.9	643	0.9
Connecticut	87,004	351	0.4	277	0.3	18,192	20.9	25,076	28.8	2,424	2.8
Delaware	18,528	0	0.0	87	0.5	146	0.8	6,891	37.2	984	5.3
District of Columbia	15,642	313	2.0	48	0.3	1,800	11.5	2,492	15.9	432	2.8
Florida	136,441	865	0.6	10,395	7.6	11,692	8.6	10,832	7.9	2,249	1.6
Georgia	63,803	878	1.4	2,033	3.2	1,477	2.3	7,239	11.3	1,314	2.1
Hawaii	18,200	65	0.4	107	0.6	433	2.4	3,564	19.6	35	0.2
Idaho	10,416	0	0.0	DS	DS	1,167	11.2	118	1.1	83	0.8
Illinois	15,377	130	0.8	110	0.7	2,515	16.4	1,199	7.8	666	4.3
Indiana	94,721	4,325	4.6	47	0.0	960	1.0	22,958	24.2	5,567	5.9
Iowa	51,123	270	0.5	781	1.5	4,792	9.4	13,074	25.6	1,107	2.2
Kansas	20,250	560	2.8	343	1.7	DS	DS	4,274	21.1	184	0.9
Kentucky	137,127	7,206	5.3	715	0.5	4,388	3.2	37,000	27.0	2,418	1.8
Louisiana	39,945	0	0.0	660	1.7	1,954	4.9	4,478	11.2	813	2.0
Maine	20,830	166	0.8	335	1.6	2,741	13.2	6,486	31.1	202	1.0
Maryland	117,863	DS	DS	57	0.0	5,282	4.5	48,499	41.1	3,405	2.9
Massachusetts	180,056	35	0.0	7,807	4.3	11,183	6.2	46,294	25.7	13,425	7.5
Michigan	190,471	10,684	5.6	6,767	3.6	5,596	2.9	56,102	29.5	11,019	5.8
Minnesota	100,405	1,717	1.7	1,615	1.6	3,523	3.5	14,459	14.4	2,061	2.1
Mississippi	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Missouri	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Montana	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nebraska	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nevada	41,400	690	1.7	162	0.4	966	2.3	4,746	11.5	1,736	4.2
New Hampshire	13,430	859	6.4	516	3.8	1,828	13.6	3,274	24.4	609	4.5
New Jersey	81,928	1,152	1.4	602	0.7	3,385	4.1	23,594	28.8	5,596	6.8
New Mexico	19,153	86	0.4	569	3.0	773	4.0	4,901	25.6	194	1.0
New York	412,492	34	0.0	271	0.1	4,534	1.1	110,895	26.9	19,712	4.8
North Carolina	109,346	14	0.0	927	0.8	7,242	6.6	21,822	20.0	929	0.8
North Dakota	3,072	193	6.3	15	0.5	0	0.0	605	19.7	17	0.6
Ohio	362,088	60,818	16.8	620	0.2	36,856	10.2	122,959	34.0	12,734	3.5
Oklahoma	42,095	2,541	6.0	2,563	6.1	1,247	3.0	7,107	16.9	318	0.8
Oregon	90,062	9,602	10.7	582	0.6	56	0.1	39,068	43.4	5,630	6.3
Pennsylvania	278,008	6,660	2.4	5,678	2.0	34,780	12.5	76,364	27.5	20,576	7.4
Puerto Rico	15,227	0	0.0	209	1.4	1,026	6.7	4,557	29.9	0	0.0
Rhode Island	17,881	1,410	7.9	79	0.4	470	2.6	7,782	43.5	525	2.9
South Carolina	42,561	663	1.6	866	2.0	1,506	3.5	8,151	19.2	874	2.1
South Dakota	5,875	0	0.0	109	1.9	72	1.2	712	12.1	16	0.3
Tennessee	89,695	1,524	1.7	261	0.3	1,332	1.5	15,046	16.8	3,000	3.3
Texas	113,195	3,111	2.7	2,275	2.0	4,358	3.8	12,711	11.2	2,222	2.0
Utah	11,367	148	1.3	703	6.2	105	0.9	1,319	11.6	311	2.7
Vermont	19,100	1,487	7.8	876	4.6	308	1.6	5,564	29.1	1,153	6.0
Virginia	50,330	355	0.7	136	0.3	197	0.4	6,005	11.9	786	1.6
Washington	137,886	9,769	7.1	6,595	4.8	9,579	6.9	40,732	29.5	6,547	4.7
West Virginia	45,593	1,494	3.3	82	0.2	3,676	8.1	16,884	37.0	561	1.2
Wisconsin	79,303	507	0.6	1,323	1.7	4,234	5.3	14,748	18.6	3,930	5.0
Wyoming	4,143	370	8.9	766	18.5	371	9.0	654	15.8	16	0.4
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table C.1.i. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020. NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Service types were determined based on National Drug Codes, procedure codes, and revenue codes. The sum of the percentages across service categories (Table A.11.a, Table A.11.b and Table A.11.c) within each state is not 100 because many Medicaid beneficiaries treated for a SUD received more than 1 treatment. See Report to Congress: T-MSIS SUD Data Book, page 39, for a description of the service categories. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

Table A.11.b. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Type^a
State	Total Number of Medicaid Beneficiaries	Emergency Services		Inpatient Care		Intervention		MAT		Medication Management		Observation Care		Other
State	Total Number of Medicaid Beneficiaries	Number	Percent	Number	Percent	Number	Percent	Number	Percent	Number	Percent	Number	Percent	Number	Percent
Total	4,084,089	1,914,223	46.9	1,688,293	41.3	164,150	4.0	951,891	23.3	30,584	0.7	200,889	4.9	215,824	5.3
Alabama	51,300	34,798	67.8	25,970	50.6	325	0.6	6,483	12.6	1,276	2.5	1,535	3.0	2,448	4.8
Alaska	18,048	7,469	41.4	7,107	39.4	856	4.7	4,091	22.7	426	2.4	798	4.4	4,694	26.0
Arizona	108,967	49,461	45.4	48,745	44.7	13,254	12.2	19,388	17.8	6,763	6.2	9,074	8.3	23,663	21.7
Arkansas	12,265	5,444	44.4	6,876	56.1	162	1.3	956	7.8	DS	DS	494	4.0	181	1.5
California	422,080	217,364	51.5	182,171	43.2	5,533	1.3	94,906	22.5	2,739	0.6	9,421	2.2	4,221	1.0
Colorado	67,997	41,442	60.9	28,498	41.9	2,125	3.1	14,470	21.3	DS	DS	6,671	9.8	904	1.3
Connecticut	87,004	30,513	35.1	26,037	29.9	1,512	1.7	33,107	38.1	21	0.0	3,561	4.1	2,882	3.3
Delaware	18,528	7,731	41.7	7,877	42.5	379	2.0	7,083	38.2	20	0.1	737	4.0	679	3.7
District of Columbia	15,642	10,222	65.3	8,155	52.1	493	3.2	2,810	18.0	52	0.3	847	5.4	516	3.3
Florida	136,441	82,423	60.4	83,088	60.9	1,836	1.3	19,576	14.3	1,578	1.2	13,325	9.8	9,977	7.3
Georgia	63,803	32,762	51.3	38,574	60.5	563	0.9	4,896	7.7	160	0.3	3,764	5.9	4,265	6.7
Hawaii	18,200	9,972	54.8	8,078	44.4	233	1.3	2,704	14.9	DS	DS	1,313	7.2	61	0.3
Idaho	10,416	3,166	30.4	4,789	46.0	48	0.5	1,523	14.6	12	0.1	147	1.4	96	0.9
Illinois	15,377	4,289	27.9	9,447	61.4	260	1.7	1,626	10.6	53	0.3	686	4.5	248	1.6
Indiana	94,721	28,799	30.4	48,045	50.7	1,847	1.9	26,916	28.4	1,508	1.6	4,575	4.8	3,955	4.2
Iowa	51,123	21,780	42.6	24,217	47.4	322	0.6	5,866	11.5	14	0.0	2,364	4.6	818	1.6
Kansas	20,250	4,469	22.1	8,699	43.0	595	2.9	2,534	12.5	DS	DS	614	3.0	434	2.1
Kentucky	137,127	53,435	39.0	52,662	38.4	3,971	2.9	42,430	30.9	41	0.0	3,118	2.3	5,157	3.8
Louisiana	39,945	22,686	56.8	19,683	49.3	231	0.6	5,369	13.4	29	0.1	1,751	4.4	458	1.1
Maine	20,830	6,359	30.5	3,763	18.1	793	3.8	8,721	41.9	1,784	8.6	470	2.3	226	1.1
Maryland	117,863	50,437	42.8	38,605	32.8	1,103	0.9	50,865	43.2	0	0.0	9,515	8.1	9,142	7.8
Massachusetts	180,056	79,799	44.3	66,069	36.7	15,508	8.6	69,402	38.5	391	0.2	11,773	6.5	3,547	2.0
Michigan	190,471	91,519	48.0	68,033	35.7	10,167	5.3	40,499	21.3	468	0.2	7,872	4.1	7,273	3.8
Minnesota	100,405	43,878	43.7	36,251	36.1	2,387	2.4	21,748	21.7	99	0.1	5,021	5.0	6,183	6.2
Mississippi	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Missouri	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Montana	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nebraska	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nevada	41,400	10,065	24.3	12,756	30.8	745	1.8	5,262	12.7	564	1.4	996	2.4	2,295	5.5
New Hampshire	13,430	4,577	34.1	3,761	28.0	661	4.9	5,963	44.4	90	0.7	547	4.1	89	0.7
New Jersey	81,928	40,327	49.2	32,860	40.1	1,289	1.6	20,087	24.5	204	0.2	5,233	6.4	1,656	2.0
New Mexico	19,153	7,368	38.5	7,600	39.7	246	1.3	4,661	24.3	227	1.2	749	3.9	2,490	13.0
New York	412,492	184,903	44.8	172,159	41.7	16,430	4.0	84,147	20.4	3,344	0.8	13,409	3.3	3,121	0.8
North Carolina	109,346	56,780	51.9	55,364	50.6	3,169	2.9	14,974	13.7	DS	DS	7,231	6.6	2,452	2.2
North Dakota	3,072	1,093	35.6	1,896	61.7	24	0.8	172	5.6	DS	DS	189	6.2	87	2.8
Ohio	362,088	209,279	57.8	126,578	35.0	14,552	4.0	87,496	24.2	71	0.0	25,614	7.1	45,238	12.5
Oklahoma	42,095	15,364	36.5	22,148	52.6	353	0.8	4,830	11.5	107	0.3	1,102	2.6	3,205	7.6
Oregon	90,062	37,907	42.1	24,612	27.3	3,121	3.5	22,000	24.4	553	0.6	2,546	2.8	6,935	7.7
Pennsylvania	278,008	120,552	43.4	106,937	38.5	5,216	1.9	76,827	27.6	5,764	2.1	12,236	4.4	8,485	3.1
Puerto Rico	15,227	1,297	8.5	4,427	29.1	974	6.4	3,343	22.0	0	0.0	500	3.3	52	0.3
Rhode Island	17,881	5,733	32.1	3,782	21.2	855	4.8	9,866	55.2	DS	DS	350	2.0	1,457	8.1
South Carolina	42,561	22,972	54.0	20,967	49.3	689	1.6	4,975	11.7	29	0.1	2,060	4.8	6,670	15.7
South Dakota	5,875	2,479	42.2	3,899	66.4	30	0.5	368	6.3	DS	DS	246	4.2	100	1.7
Tennessee	89,695	37,854	42.2	43,803	48.8	2,787	3.1	11,775	13.1	452	0.5	3,988	4.4	825	0.9
Texas	113,195	60,325	53.3	66,473	58.7	1,435	1.3	13,830	12.2	1,461	1.3	9,994	8.8	5,794	5.1
Utah	11,367	3,326	29.3	3,152	27.7	DS	DS	2,424	21.3	DS	DS	81	0.7	403	3.5
Vermont	19,100	6,458	33.8	5,653	29.6	829	4.3	9,007	47.2	18	0.1	456	2.4	292	1.5
Virginia	50,330	24,110	47.9	24,176	48.0	111	0.2	8,761	17.4	17	0.0	1,828	3.6	471	0.9
Washington	137,886	63,605	46.1	43,279	31.4	31,585	22.9	33,952	24.6	171	0.1	4,506	3.3	27,023	19.6
West Virginia	45,593	18,327	40.2	17,606	38.6	1,299	2.8	15,485	34.0	DS	DS	2,458	5.4	2,057	4.5
Wisconsin	79,303	37,573	47.4	31,016	39.1	13,224	16.7	23,245	29.3	11	0.0	4,936	6.2	2,134	2.7
Wyoming	4,143	1,732	41.8	1,950	47.1	23	0.6	472	11.4	67	1.6	188	4.5	465	11.2
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table C.1.ii. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020. NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Service types were determined based on National Drug Codes, procedure codes, and revenue codes. The sum of the percentages across service categories (Table A.11.a, Table A.11.b and Table A.11.c) within each state is not 100 because many Medicaid beneficiaries treated for a SUD received more than 1 treatment. See Report to Congress: T-MSIS SUD Data Book, page 39, for a description of the service categories. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

Table A.11.c. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Type^a
State	Total Number of Medicaid Beneficiaries	Partial Hospitalization		Peer Support		Physician Services		Pharmacotherapy		Screening/Assessment		Treatment Program
State	Total Number of Medicaid Beneficiaries	Number	Percent	Number	Percent	Number	Percent	Number	Percent	Number	Percent	Number	Percent
Total	4,084,089	9,768	0.2	32,264	0.8	1,254,769	30.7	185,480	4.5	733,495	18.0	258,427	6.3
Alabama	51,300	29	0.1	0	0.0	13,683	26.7	3,323	6.5	4,239	8.3	145	0.3
Alaska	18,048	0	0.0	83	0.5	8,623	47.8	1,616	9.0	4,670	25.9	88	0.5
Arizona	108,967	DS	DS	12,020	11.0	28,244	25.9	4,980	4.6	35,925	33.0	6,640	6.1
Arkansas	12,265	DS	DS	0	0.0	2,189	17.8	292	2.4	979	8.0	61	0.5
California	422,080	DS	DS	0	0.0	93,501	22.2	20,217	4.8	20,074	4.8	11,334	2.7
Colorado	67,997	0	0.0	DS	DS	23,405	34.4	4,264	6.3	6,057	8.9	59	0.1
Connecticut	87,004	905	1.0	0	0.0	21,159	24.3	1,269	1.5	20,347	23.4	9,177	10.5
Delaware	18,528	715	3.9	659	3.6	8,663	46.8	585	3.2	2,943	15.9	1,072	5.8
District of Columbia	15,642	0	0.0	DS	DS	4,701	30.1	445	2.8	2,087	13.3	17	0.1
Florida	136,441	DS	DS	14	0.0	22,075	16.2	4,842	3.5	13,028	9.5	57	0.0
Georgia	63,803	248	0.4	229	0.4	17,222	27	852	1.3	7,608	11.9	272	0.4
Hawaii	18,200	38	0.2	DS	DS	6,651	36.5	966	5.3	2,758	15.2	411	2.3
Idaho	10,416	0	0.0	0	0.0	2,756	26.5	91	0.9	584	5.6	0	0.0
Illinois	15,377	0	0.0	0	0.0	3,007	19.6	53	0.3	1,634	10.6	0	0.0
Indiana	94,721	371	0.4	102	0.1	28,037	29.6	2,239	2.4	17,794	18.8	1,310	1.4
Iowa	51,123	669	1.3	51	0.1	17,376	34	3,617	7.1	14,395	28.2	4,109	8.0
Kansas	20,250	0	0.0	904	4.5	5,154	25.5	246	1.2	3,904	19.3	1,856	9.2
Kentucky	137,127	110	0.1	3,505	2.6	56,415	41.1	10,446	7.6	23,962	17.5	8,122	5.9
Louisiana	39,945	0	0.0	DS	DS	10,028	25.1	2,738	6.9	5,357	13.4	3,419	8.6
Maine	20,830	0	0.0	0	0.0	10,736	51.5	765	3.7	8,381	40.2	1,254	6.0
Maryland	117,863	22	0.0	0	0.0	43,502	36.9	1,066	0.9	41,185	34.9	15,407	13.1
Massachusetts	180,056	1,174	0.7	37	0.0	81,430	45.2	7,652	4.2	31,890	17.7	17,511	9.7
Michigan	190,471	22	0.0	6,486	3.4	70,065	36.8	16,269	8.5	48,833	25.6	17,905	9.4
Minnesota	100,405	129	0.1	54	0.1	38,716	38.6	6,056	6.0	32,433	32.3	27,619	27.5
Mississippi	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Missouri	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Montana	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nebraska	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nevada	41,400	DS	DS	249	0.6	5,000	12.1	1,573	3.8	4,009	9.7	574	1.4
New Hampshire	13,430	0	0.0	50	0.4	5,480	40.8	480	3.6	2,626	19.6	1,309	9.7
New Jersey	81,928	1,700	2.1	0	0.0	23,804	29.1	3,354	4.1	18,512	22.6	4,223	5.2
New Mexico	19,153	80	0.4	0	0.0	6,264	32.7	1,206	6.3	4,454	23.3	643	3.4
New York	412,492	612	0.1	DS	DS	116,914	28.3	2,723	0.7	30,080	7.3	6,597	1.6
North Carolina	109,346	18	0.0	958	0.9	34,144	31.2	6,819	6.2	14,455	13.2	7,875	7.2
North Dakota	3,072	35	1.1	0	0.0	872	28.4	64	2.1	512	16.7	315	10.3
Ohio	362,088	569	0.2	DS	DS	125,547	34.7	45,023	12.4	111,994	30.9	25,535	7.1
Oklahoma	42,095	DS	DS	0	0.0	10,917	25.9	2,455	5.8	3,324	7.9	14	0.0
Oregon	90,062	0	0.0	4,078	4.5	33,788	37.5	5,839	6.5	28,220	31.3	5,777	6.4
Pennsylvania	278,008	251	0.1	224	0.1	78,262	28.2	1,996	0.7	53,943	19.4	53,131	19.1
Puerto Rico	15,227	67	0.4	0	0.0	7,438	48.8	41	0.3	3,395	22.3	17	0.1
Rhode Island	17,881	317	1.8	445	2.5	5,690	31.8	211	1.2	4,594	25.7	1,075	6.0
South Carolina	42,561	0	0.0	108	0.3	9,179	21.6	338	0.8	7,972	18.7	1,791	4.2
South Dakota	5,875	0	0.0	0	0.0	991	16.9	190	3.2	577	9.8	438	7.5
Tennessee	89,695	935	1.0	23	0.0	30,756	34.3	3,021	3.4	10,635	11.9	6,351	7.1
Texas	113,195	713	0.6	DS	DS	26,390	23.3	2,144	1.9	9,184	8.1	2,844	2.5
Utah	11,367	DS	DS	46	0.4	1,109	9.8	225	2.0	1,023	9.0	88	0.8
Vermont	19,100	0	0.0	0	0.0	5,308	27.8	109	0.6	3,619	18.9	1,708	8.9
Virginia	50,330	20	0.0	0	0.0	10,463	20.8	1,627	3.2	2,848	5.7	291	0.6
Washington	137,886	0	0.0	1,886	1.4	46,446	33.7	7,523	5.5	39,356	28.5	8,139	5.9
West Virginia	45,593	19	0.0	0	0.0	22,237	48.8	2,111	4.6	10,007	21.9	637	1.4
Wisconsin	79,303	DS	DS	0	0.0	29,228	36.9	1,323	1.7	16,371	20.6	1,210	1.5
Wyoming	4,143	0	0.0	53	1.3	1,204	29.1	196	4.7	718	17.3	DS	DS
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table C.1.iii. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020. NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Service types were determined based on National Drug Codes, procedure codes, and revenue codes. The sum of the percentages across service categories (Table A.11.a, Table A.11.b and Table A.11.c) within each state is not 100 because many Medicaid beneficiaries treated for a SUD received more than 1 treatment. See Report to Congress: T-MSIS SUD Data Book, page 39, for a description of the service categories. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

Table A.12. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Setting^a
State	Total Number of Medicaid Beneficiaries	Treated in an Inpatient Setting		Treated in an Outpatient Setting		Treated in a Residential Setting		Treated in a Home-Based Setting		Treated in a Community-Based Setting		Treated in an Unknown Setting
State	Total Number of Medicaid Beneficiaries	Number	Percent	Number	Percent	Number	Percent	Number	Percent	Number	Percent	Number	Percent
Total	4,084,089	1,774,756	43.5	3,074,191	75.3	166,070	4.1	75,535	1.8	46,838	1.1	457,639	11.2
Alabama	51,300	26,352	51.4	39,787	77.6	1,234	2.4	509	1.0	228	0.4	69	0.1
Alaska	18,048	7,135	39.5	14,209	78.7	1,589	8.8	260	1.4	3,565	19.8	435	2.4
Arizona	108,967	49,905	45.8	83,584	76.7	4,433	4.1	6,891	6.3	873	0.8	27,930	25.6
Arkansas	12,265	6,594	53.8	4,121	33.6	780	6.4	61	0.5	89	0.7	5,674	46.3
California	422,080	183,473	43.5	298,264	70.7	35,686	8.5	2,801	0.7	2,637	0.6	59,149	14.0
Colorado	67,997	28,633	42.1	46,856	68.9	253	0.4	293	0.4	309	0.5	35,078	51.6
Connecticut	87,004	28,102	32.3	75,531	86.8	1,739	2.0	2,032	2.3	118	0.1	2,978	3.4
Delaware	18,528	6,699	36.2	15,365	82.9	2,836	15.3	142	0.8	44	0.2	184	1.0
District of Columbia	15,642	8,082	51.7	11,618	74.3	922	5.9	90	0.6	15	0.1	94	0.6
Florida	136,441	87,887	64.4	80,391	58.9	2,301	1.7	2,443	1.8	9,332	6.8	523	0.4
Georgia	63,803	39,493	61.9	39,091	61.3	970	1.5	992	1.6	1,639	2.6	1,178	1.8
Hawaii	18,200	8,557	47.0	13,475	74.0	324	1.8	43	0.2	102	0.6	99	0.5
Idaho	10,416	5,464	52.5	7,164	68.8	275	2.6	57	0.5	DS	DS	491	4.7
Illinois	15,377	9,972	64.9	7,287	47.4	457	3.0	68	0.4	106	0.7	2,898	18.8
Indiana	94,721	49,449	52.2	64,859	68.5	1,538	1.6	808	0.9	45	0.0	1,288	1.4
Iowa	51,123	24,889	48.7	38,593	75.5	2,268	4.4	419	0.8	485	0.9	588	1.2
Kansas	20,250	11,669	57.6	12,193	60.2	1,864	9.2	505	2.5	191	0.9	619	3.1
Kentucky	137,127	54,447	39.7	111,752	81.5	7,327	5.3	888	0.6	701	0.5	1,213	0.9
Louisiana	39,945	18,890	47.3	28,037	70.2	6,348	15.9	351	0.9	50	0.1	2,686	6.7
Maine	20,830	4,006	19.2	19,220	92.3	236	1.1	187	0.9	252	1.2	603	2.9
Maryland	117,863	39,882	33.8	101,915	86.5	6,019	5.1	965	0.8	46	0.0	8,461	7.2
Massachusetts	180,056	79,983	44.4	152,372	84.6	10,570	5.9	4,140	2.3	7,191	4.0	16,056	8.9
Michigan	190,471	68,048	35.7	100,150	52.6	1,981	1.0	578	0.3	160	0.1	129,437	68.0
Minnesota	100,405	36,641	36.5	85,110	84.8	2,357	2.3	7,496	7.5	673	0.7	6,156	6.1
Mississippi	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Missouri	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Montana	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nebraska	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nevada	41,400	21,461	51.8	30,331	73.3	1,256	3.0	751	1.8	78	0.2	932	2.3
New Hampshire	13,430	3,921	29.2	11,281	84.0	1,148	8.5	434	3.2	183	1.4	1,253	9.3
New Jersey	81,928	36,444	44.5	62,820	76.7	1,505	1.8	2,439	3.0	562	0.7	635	0.8
New Mexico	19,153	7,409	38.7	15,472	80.8	897	4.7	259	1.4	517	2.7	118	0.6
New York	412,492	184,041	44.6	331,943	80.5	7,472	1.8	2,272	0.6	202	0.0	9,173	2.2
North Carolina	109,346	57,504	52.6	76,404	69.9	3,301	3.0	2,674	2.4	566	0.5	2,312	2.1
North Dakota	3,072	1,810	58.9	1,784	58.1	302	9.8	59	1.9	DS	DS	588	19.1
Ohio	362,088	131,318	36.3	308,936	85.3	12,812	3.5	10,028	2.8	574	0.2	42,670	11.8
Oklahoma	42,095	22,524	53.5	27,756	65.9	1,132	2.7	969	2.3	2,322	5.5	781	1.9
Oregon	90,062	25,180	28.0	78,084	86.7	8,256	9.2	1,219	1.4	509	0.6	2,963	3.3
Pennsylvania	278,008	112,866	40.6	208,307	74.9	3,873	1.4	11,784	4.2	629	0.2	73,539	26.5
Puerto Rico	15,227	5,105	33.5	12,053	79.2	25	0.2	70	0.5	207	1.4	DS	DS
Rhode Island	17,881	3,884	21.7	16,235	90.8	389	2.2	163	0.9	75	0.4	776	4.3
South Carolina	42,561	21,840	51.3	28,936	68.0	971	2.3	282	0.7	822	1.9	2,588	6.1
South Dakota	5,875	3,894	66.3	3,369	57.3	348	5.9	DS	DS	108	1.8	162	2.8
Tennessee	89,695	47,511	53.0	65,613	73.2	990	1.1	1,472	1.6	172	0.2	1,219	1.4
Texas	113,195	66,021	58.3	70,922	62.7	6,598	5.8	3,458	3.1	1,748	1.5	1,687	1.5
Utah	11,367	6,818	60.0	5,762	50.7	2,124	18.7	46	0.4	422	3.7	406	3.6
Vermont	19,100	5,746	30.1	16,351	85.6	124	0.6	172	0.9	136	0.7	3,815	20.0
Virginia	50,330	27,750	55.1	32,635	64.8	762	1.5	240	0.5	75	0.1	202	0.4
Washington	137,886	43,652	31.7	115,581	83.8	14,951	10.8	1,794	1.3	6,232	4.5	5,127	3.7
West Virginia	45,593	19,746	43.3	34,199	75.0	1,266	2.8	943	2.1	19	0.0	453	1.0
Wisconsin	79,303	32,116	40.5	65,710	82.9	985	1.2	952	1.2	1,200	1.5	1,990	2.5
Wyoming	4,143	1,943	46.9	2,763	66.7	276	6.7	36	0.9	629	15.2	363	8.8
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table C.2. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020. NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Service types were determined based on National Drug Codes, procedure codes, and revenue codes. Setting was defined as unknownwhen there was not enough information on the claim to categorize the service by setting. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

Table A.13. Days of Service Provided to Medicaid Beneficiaries Who Received Each Service Type in 2017^a
State	Inpatient Care			MAT			Observation Care			Partial Hospitalization
State	Number of Beneficiaries Receiving Service	Total Number of Days	Average Number of Days Per Beneficiary	Number of Beneficiaries Receiving Service	Total Number of Days	Average Number of Days Per Beneficiary	Number of Beneficiaries Receiving Service	Total Number of Days	Average Number of Days Per Beneficiary	Number of Beneficiaries Receiving Service	Total Number of Days	Average Number of Days Per Beneficiary
Total	1,688,293	15,309,087	9.1	951,891	12,309,275	129.3	200,889	684,463	3.4	9,768	163,769	16.8
Alabama	25,970	325,139	12.5	6,483	1,210,702	186.8	1,535	5,719	3.7	29	617	21.3
Alaska	7,107	62,559	8.8	4,091	436,878	106.8	798	3,169	4.0	0	0	0.0
Arizona	48,745	437,937	9.0	19,388	1,615,477	83.3	9,074	38,240	4.2	DS	DS	DS
Arkansas	6,876	50,346	7.3	956	49,370	51.6	494	1,551	3.1	DS	DS	DS
California	182,171	1,444,319	7.9	94,906	15,553,357	163.9	9,421	30,330	3.2	DS	DS	DS
Colorado	28,498	210,822	7.4	14,470	1,206,850	83.4	6,671	26,282	3.9	0	0	0.0
Connecticut	26,037	324,848	12.5	33,107	2,948,667	89.1	3,561	8,422	2.4	905	7,913	8.7
Delaware	7,877	93,441	11.9	7,083	1,102,713	155.7	737	2,870	3.9	715	11,745	16.4
District of Columbia	8,155	90,449	11.1	2,810	480,725	171.1	847	3,393	4.0	0	0	0.0
Florida	83,088	694,301	8.4	19,576	1,451,475	74.1	13,325	60,370	4.5	DS	DS	DS
Georgia	38,574	368,400	9.6	4,896	572,117	116.9	3,764	14,596	3.9	248	2,216	8.9
Hawaii	8,078	57,746	7.1	2,704	413,147	152.8	1,313	4,732	3.6	38	379	10.0
Idaho	4,789	19,233	4.0	1,523	192,132	126.2	147	184	1.3	0	0	0.0
Illinois	9,447	63,228	6.7	1,626	97,922	60.2	686	1,827	2.7	0	0	0.0
Indiana	48,045	398,821	8.3	26,916	2,707,429	100.6	4,575	16,486	3.6	371	5,654	15.2
Iowa	24,217	173,578	7.2	5,866	509,422	86.8	2,364	7,420	3.1	669	12,502	18.7
Kansas	8,699	94,629	10.9	2,534	196,963	77.7	614	1,851	3.0	0	0	0.0
Kentucky	52,662	401,796	7.6	42,430	5,927,602	139.7	3,118	8,018	2.6	110	2,338	21.3
Louisiana	19,683	167,708	8.5	5,369	694,161	129.3	1,751	7,313	4.2	0	0	0.0
Maine	3,763	27,851	7.4	8,721	1,829,467	209.8	470	840	1.8	0	0	0.0
Maryland	38,605	340,179	8.8	50,865	4,839,198	95.1	9,515	36,795	3.9	22	195	8.9
Massachusetts	66,069	755,227	11.4	69,402	12,545,064	180.8	11,773	26,932	2.3	1,174	9,423	8.0
Michigan	68,033	478,647	7.0	40,499	4,837,859	119.5	7,872	24,732	3.1	22	153	7.0
Minnesota	36,251	428,021	11.8	21,748	2,813,253	129.4	5,021	19,608	3.9	129	1,217	9.4
Mississippi	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Missouri	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Montana	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nebraska	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ	DQ
Nevada	12,756	132,583	10.4	5,262	473,295	89.9	996	3,086	3.1	DS	DS	DS
New Hampshire	3,761	26,833	7.1	5,963	821,284	137.7	547	980	1.8	0	0	0.0
New Jersey	32,860	322,164	9.8	20,087	2,080,304	103.6	5,233	20,167	3.9	1,700	58,002	34.1
New Mexico	7,600	51,613	6.8	4,661	922,417	197.9	749	953	1.3	80	302	3.8
New York	172,159	2,185,283	12.7	84,147	10,224,380	121.5	13,409	52,603	3.9	612	10,958	17.9
North Carolina	55,364	442,362	8.0	14,974	1,355,091	90.5	7,231	29,731	4.1	18	189	10.5
North Dakota	1,896	17,278	9.1	172	15,218	88.5	189	361	1.9	35	455	13.0
Ohio	126,578	809,181	6.4	87,496	11,230,010	128.3	25,614	53,960	2.1	569	12,486	21.9
Oklahoma	22,148	220,120	9.9	4,830	514,156	106.5	1,102	3,837	3.5	DS	DS	DS
Oregon	24,612	199,177	8.1	22,000	2,836,702	128.9	2,546	10,177	4.0	0	0	0.0
Pennsylvania	106,937	1,039,712	9.7	76,827	10,818,977	140.8	12,236	36,637	3.0	251	3,718	14.8
Puerto Rico	4,427	37,549	8.5	3,343	445,514	133.3	500	1,197	2.4	67	299	4.5
Rhode Island	3,782	33,115	8.8	9,866	1,433,020	145.2	350	909	2.6	317	2,535	8.0
South Carolina	20,967	165,161	7.9	4,975	567,963	114.2	2,060	9,541	4.6	0	0	0.0
South Dakota	3,899	53,522	13.7	368	35,488	96.4	246	926	3.8	0	0	0.0
Tennessee	43,803	374,649	8.6	11,775	862,624	73.3	3,988	13,002	3.3	935	13,327	14.3
Texas	66,473	590,800	8.9	13,830	1,439,370	104.1	9,994	42,888	4.3	713	6,771	9.5
Utah	3,152	22,995	7.3	2,424	339,351	140.0	81	181	2.2	DS	DS	DS
Vermont	5,653	55,881	9.9	9,007	1,965,471	218.2	456	1,967	4.3	0	0	0.0
Virginia	24,176	216,313	8.9	8,761	1,164,446	132.9	1,828	6,100	3.3	20	275	13.8
Washington	43,279	412,010	9.5	33,952	4,201,106	123.7	4,506	19,143	4.2	0	0	0.0
West Virginia	17,606	121,508	6.9	15,485	2,281,120	147.3	2,458	7,761	3.2	19	100	5.3
Wisconsin	31,016	252,663	8.1	23,245	2,798,161	120.4	4,936	16,438	3.3	DS	DS	DS
Wyoming	1,950	17,390	8.9	472	35,339	74.9	188	238	1.3	0	0	0.0
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table D.1.ii. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020. NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

Table A.14. Percent of Persons 12 and Older Needing SUD Treatment Who Perceived a Need for Treatment and Made an Effort to get Treatment, 2015-2018^a
	2015	2016	2017	2018
Illicit drug use disorder
Perceived need for treatment	7.5	6.4	8.2	6.4
Made effort to get treatment	2.9	3.3	3.3	3.0
Made no effort to get treatment	4.7	3.0	4.9	3.4
Did not perceive need for treatment	92.5	93.6	91.8	93.6
Alcohol use disorder
Perceived need for treatment	2.9	3.2	4.4	3.9
Made effort to get treatment	0.9	1.4	2.2	1.6
Made no effort to get treatment	2.0	1.8	2.2	2.3
Did not perceive need for treatment	97.1	96.8	95.6	96.1
Drugs or alcohol use disorder
Perceived need for treatment	4.6	4.5	5.7	5.1
Made effort to get treatment	1.6	1.9	2.7	2.1
Made no effort to get treatment	2.9	2.5	3.0	3.0
Did not perceive need for treatment	95.4	95.5	94.3	94.9
SOURCE: Estimates from 2018 NSDUH: Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for illicit drug use disorder are from Table 7.62B. Estimates for alcohol are from Table 7.63B. Estimates for illicit drugs and alcohol are from Table 7.64B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020. NOTE: The population in this table is survey respondents classified as needing substance use treatment based on meeting the criteria in the DSM-IV for an illicit drug or alcohol use disorder or received treatment for illicit drug or alcohol use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or MH center). Respondents were classified as not perceiving a need for treatment if they responded to the survey that, at the time of their disorder, they did not think they needed treatment. Respondents were classified as making an effort to get treatment if they responded affirmatively to the survey question, "During the past 12 months, did you make an effort to get treatment or counseling for your use of [substance for which individual had associated SUD]?" For each row in this table the difference between the 2018 estimate and the estimates for each of the other years was tested for statistical significance at the 0.05 level. None of these differences is statistically significant at the 0.05 level.

Table A.15. Percentage of Population Needing but not Receiving SUD Treatment in the Past Year, by Age Group and State, 2017-2018^a
State	Illicit Drug Use Disorder			Alcohol Use Disorder			Drug or Alcohol Use Disorder
State	12-17	18-25	26 and Older	12-17	18-25	26 and Older	12-17	18-25	26 and Older
Total	2.7	6.9	1.8	1.7	9.7	4.8	3.6	14.1	6.0
Alabama	2.5	7.7	1.8	1.6	7.7	4.4	3.4	13.1	5.8
Alaska	3.2	7.7	2.2	1.9	11.6	6.0	4.3	15.6	7.7
Arizona	2.7	6.6	1.6	1.8	9.8	4.7	3.8	13.5	5.9
Arkansas	2.7	7.0	1.8	2.0	9.1	4.7	3.7	13.8	6.0
California	3.1	7.0	2.0	1.8	9.9	5.5	3.9	14.1	6.8
Colorado	3.7	12.3	3.0	2.1	14.3	7.5	4.7	22.2	9.5
Connecticut	2.6	8.7	2.1	1.8	11.3	5.0	3.5	18.3	6.2
Delaware	3.1	7.6	2.1	1.5	10.2	5.7	3.7	14.7	6.8
District of Columbia	3.7	8.7	3.4	1.7	13.0	8.8	5.4	17.5	10.2
Florida	3.2	7.0	1.8	1.6	8.1	4.2	4.1	12.9	5.4
Georgia	2.4	7.2	1.7	1.4	7.5	4.1	3.0	12.3	5.4
Hawaii	2.8	5.8	1.7	2.1	11.4	4.7	4.0	14.6	5.6
Idaho	2.6	4.9	1.4	1.7	9.6	5.0	3.8	12.1	6.1
Illinois	2.7	7.1	1.8	1.9	10.9	5.4	3.8	15.0	6.4
Indiana	2.5	7.3	1.9	1.5	9.6	4.2	3.2	14.1	5.5
Iowa	2.4	6.4	1.8	2.1	14.0	5.7	4.0	17.2	6.7
Kansas	2.3	5.4	1.5	1.9	10.6	4.7	3.6	13.4	5.6
Kentucky	2.7	6.0	1.8	1.6	8.2	4.4	3.6	12.0	5.6
Louisiana	2.1	6.4	1.9	1.7	9.8	5.8	3.2	14.5	6.8
Maine	3.0	9.4	2.2	2.3	11.4	5.5	4.4	18.3	7.3
Maryland	2.5	7.2	1.7	1.3	8.6	4.3	3.2	12.9	5.3
Massachusetts	2.6	7.3	2.4	1.9	12.8	5.3	3.7	17.7	6.7
Michigan	2.5	6.9	1.7	1.6	9.1	4.7	3.4	13.5	5.8
Minnesota	2.9	6.6	2.0	1.5	10.5	4.5	3.8	13.7	5.7
Mississippi	2.3	5.8	1.7	1.3	6.9	4.0	3.1	10.9	5.2
Missouri	2.5	6.3	1.8	1.6	8.3	4.6	3.5	12.7	5.9
Montana	3.3	8.3	2.0	2.9	13.0	6.7	4.8	17.0	7.5
Nebraska	2.4	7.0	1.7	1.8	12.3	5.0	3.6	16.4	5.8
Nevada	3.5	10.8	2.4	1.7	9.8	4.9	4.4	17.1	7.0
New Hampshire	2.9	7.0	1.8	2.0	14.3	5.7	4.2	18.3	7.1
New Jersey	2.5	6.3	1.7	1.5	10.2	4.3	3.4	14.3	5.7
New Mexico	3.7	7.4	1.8	1.7	9.1	4.5	4.5	14.3	5.6
New York	2.4	7.2	1.9	1.5	8.7	4.9	3.3	13.7	5.9
North Carolina	2.8	7.1	1.8	1.6	8.0	4.3	3.5	12.5	5.5
North Dakota	2.5	6.4	1.7	2.1	13.0	5.6	4.1	16.3	6.5
Ohio	2.9	7.5	2.0	1.6	9.5	4.4	3.7	13.9	5.8
Oklahoma	2.9	7.0	1.6	1.7	10.0	5.3	3.9	14.6	6.5
Oregon	3.2	8.4	2.2	2.3	12.5	6.8	4.3	17.6	8.0
Pennsylvania	2.3	5.8	1.8	1.6	10.7	4.3	3.2	14.1	5.3
Rhode Island	2.9	7.9	2.0	1.8	11.8	5.4	3.8	16.6	6.5
South Carolina	2.7	6.5	1.6	1.6	10.5	4.8	3.6	15.4	5.7
South Dakota	2.8	7.4	1.8	2.3	13.8	5.8	4.6	18.0	6.6
Tennessee	2.7	6.1	1.8	1.7	8.2	4.2	3.6	12.2	5.4
Texas	2.2	5.6	1.3	1.3	8.2	4.0	3.0	11.9	5.0
Utah	2.2	5.2	1.5	1.5	8.1	3.9	3.0	10.8	4.8
Vermont	3.8	9.4	2.4	2.7	13.8	6.1	4.9	19.9	7.6
Virginia	2.4	6.6	1.5	1.6	10.3	4.7	3.4	14.3	5.8
Washington	3.5	8.4	2.3	2.3	11.0	5.1	4.7	15.7	6.7
West Virginia	2.7	6.1	1.7	1.6	8.3	3.8	3.9	12.4	5.2
Wisconsin	2.6	6.2	1.8	2.0	13.8	5.8	3.9	16.9	6.4
Wyoming	2.8	5.8	1.4	2.3	10.3	4.9	4.2	12.6	5.5
SOURCE: Estimates from 2017-2018 NSDUH: Model-Based Prevalence Estimates, Center for Behavioral Health Statistics and Quality, 2019. Estimates for illicit drugs, alcohol, and illicit drugs or alcohol are from Tables 24, 25, and 26, respectively. Available at https://www.samhsa.gov/data/sites/default/files/reports/rpt23235/2k18SAEExcelTabs/NSDUHsaeExcelTabs2018.xlsx. Accessed December 16, 2019. NOTE: Survey respondents were classified as needing substance use treatment if they met the criteria for an illicit drug or alcohol use disorder as defined in the DSM-IV or received treatment for illicit drug or alcohol use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or MH center). Needing but not receiving SUD treatment refers to respondents who are classified as needing illicit drug or alcohol treatment, but who did not receive such treatment at a specialty facility. Illicit drug use includes the misuse of prescription psychotherapeutics or the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Misuse of prescription psychotherapeutics is defined as use in any way not directed by a doctor, including use without a prescription of one's own; use in greater amounts, more often, or longer than prescribed; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. Differences among estimates reported here may not be statistically significant. Significance tests were not conducted for this table. Confidence intervals for the estimates reported here are included in the source document.

Table A.16. Number of Residential and Inpatient Beds Designated for SUD Treatment and Their Utilization Rates, by State, 2013, 2015, and 2017^a
	Number of Designated Beds						Utilization Rate
	Residential			Inpatient Hospital			Residential			Inpatient Hospital
	2013	2015	2017	2013	2015	2017	2013	2015	2017	2013	2015	2017
Total	100,417	104,012	91,601	12,213	15,415	12,707	97.0	105.5	93.9	96.6	108.6	98.3
Alabama	1,212	1,031	1,073	252	52	64	92.1	95.2	85.7	95.6	53.8	45.3
Alaska	383	347	382	NA	0	32	89.0	109.2	74.6	NA	0.0	41.0
Arizona	1,853	2,235	1,562	210	297	416	97.4	120.0	101.2	129.0	116.8	108.2
Arkansas	798	686	563	83	46	96	85.8	350.0	128.8	94.0	63.0	65.6
California	13,688	13,390	13,180	750	477	594	94.2	95.5	93.6	102.0	95.0	95.1
Colorado	1,446	1,162	1,265	172	184	111	97.9	92.5	79.7	80.2	72.8	64.0
Connecticut	1,766	1,491	1,333	290	219	226	100.2	100.5	123.1	98.3	111.4	108.8
Delaware	184	262	78	NA	30	35	92.4	1450.4	147.4	NA	106.7	57.1
District of Columbia	428	396	482	NA	12	0	97.9	108.8	90.7	NA	8.3	0.0
Florida	6,020	6,363	6,110	641	843	1,040	120.2	100.5	86.1	93.9	127.9	131.6
Georgia	1,934	1,933	1,612	284	413	350	98.0	83.2	94.5	90.5	110.4	114.6
Hawaii	456	466	409	0	48	0	84.4	94.6	93.4	0.0	91.7	0.0
Idaho	162	144	191	NA	15	68	69.8	97.2	81.7	NA	93.3	63.2
Illinois	3,099	2,885	2,785	328	253	356	87.1	100.2	99.8	59.5	64.8	53.1
Indiana	541	618	737	237	552	424	81.5	129.9	105.4	74.7	92.4	76.2
Iowa	815	935	737	NA	30	34	80.0	72.9	88.3	NA	80.0	44.1
Kansas	765	720	725	NA	29	20	85.5	95.7	74.8	NA	79.3	90.0
Kentucky	1,798	2,264	2,228	291	329	427	102.4	94.3	121.6	79.7	126.1	70.0
Louisiana	1,615	1,785	1,551	199	270	374	83.0	91.5	83.8	80.9	74.1	51.3
Maine	296	257	216	112	118	52	106.8	90.7	98.6	108.0	39.0	75.0
Maryland	2,074	2,063	1,660	709	344	189	70.2	85.6	78.5	56.7	74.7	69.3
Massachusetts	3,211	3,292	3,348	595	811	1,037	94.9	104.9	96.6	106.2	120.8	103.1
Michigan	2,985	2,996	3,111	180	173	109	163.4	88.0	78.9	185.6	44.5	54.1
Minnesota	3,862	3,593	3,482	63	95	63	96.3	92.8	105.1	92.1	75.8	88.9
Mississippi	1,133	968	791	259	148	162	71.5	69.1	63.0	129.0	128.4	113.6
Missouri	1,107	1,215	1,222	55	73	116	88.0	174.8	99.2	194.5	76.7	168.1
Montana	258	222	231	24	78	114	177.1	84.2	104.3	529.2	117.9	77.2
Nebraska	812	748	816	0	0	29	82.0	98.4	97.4	0.0	0.0	7.0
Nevada	455	543	615	113	143	184	93.4	89.7	80.8	131.0	132.9	56.0
New Hampshire	368	390	278	NA	15	15	89.7	89.7	99.6	NA	26.7	66.7
New Jersey	2,541	2,837	2,324	365	307	494	105.0	117.7	87.4	95.3	130.6	90.1
New Mexico	481	483	602	137	125	34	353.4	83.0	93.5	72.3	90.4	82.4
New York	10,531	10,125	8,003	2,067	1,741	1,779	91.2	97.4	92.3	79.1	95.0	106.5
North Carolina	2,655	2,591	2,042	429	368	461	92.5	112.3	97.5	128.7	72.6	87.2
North Dakota	378	440	259	94	83	118	111.4	84.1	146.7	56.4	71.1	18.6
Ohio	1,758	1,955	1,992	586	561	355	99.2	102.3	93.5	84.5	87.7	96.9
Oklahoma	1,570	1,206	1,258	131	113	75	75.9	96.5	81.8	85.5	68.1	58.7
Oregon	1,260	1,268	970	83	52	17	84.9	97.5	133.7	74.7	184.6	82.4
Pennsylvania	5,756	5,570	6,591	529	392	351	91.0	95.0	94.5	82.6	61.7	92.6
Puerto Rico	3,027	2,553	1,303	178	198	170	75.3	108.7	119.8	250.6	177.8	232.4
Rhode Island	348	1,721	284	NA	3,543	58	92.8	100.1	94.7	NA	99.9	108.6
South Carolina	471	692	546	301	209	182	117.2	88.7	95.4	115.6	536.8	130.2
South Dakota	543	623	285	87	98	169	114.7	92.9	109.5	86.2	69.4	79.3
Tennessee	1,848	1,913	1,738	142	129	156	86.0	92.7	81.4	279.6	95.3	211.5
Texas	5,448	4,809	4,460	375	404	711	87.1	122.1	91.4	88.5	138.4	121.8
Utah	896	928	1,287	NA	49	51	109.4	90.5	87.1	NA	71.4	102.0
Vermont	245	213	123	112	116	120	403.7	77.0	106.5	82.1	587.1	48.3
Virginia	801	1,060	728	109	277	152	71.8	94.6	90.5	152.3	112.6	105.9
Washington	2,417	5,729	2,464	189	192	242	86.5	116.9	90.3	72.5	76.6	72.3
West Virginia	433	552	437	NA	74	69	91.2	92.6	91.3	NA	55.4	136.2
Wisconsin	1,114	904	840	130	261	188	73.7	86.0	95.6	101.5	68.2	88.8
Wyoming	316	388	224	0	16	18	103.2	83.0	87.1	0.0	31.3	16.7
US territories	56	52	68	0	10	NA	89.3	82.7	92.6	0.0	240.0	0.0
SOURCE: N-SSATS 2013, Questions 28d and 29d, and N-SSATS 2015 and 2017, Questions 29d and 30d, indicate hospital- and residential-designated beds. NOTE: The utilization rate is calculated by dividing the number of clients in care on the single day covered by the survey by the total number of designated beds. Significance tests were not conducted for these estimates because N-SSATS surveys the universe of specialty SUD treatment facilities.

Table A.17. Number of DATA-Waived Providers, September 2019^a
State	Total		Waivered to Treat up to 30 Patients		Waivered to Treat up to 100 Patients		Waivered to Treat up to 275 Patients
State	Physicians	Other Practitioners^b	Physicians	Other Practitioners^b	Physicians	Other Practitioners^b	Physicians	Other Practitioners^b
Total	88,061	23,098	65,517	18,287	17,008	4,312	5,536	497
Alabama	1,324	91	812	73	348	15	164	3
Alaska	385	178	327	154	47	22	11	2
Arizona	1,655	1006	1,345	846	235	147	75	13
Arkansas	372	120	266	95	82	23	24	2
California	8,903	1471	7,325	1,273	1307	192	271	6
Colorado	1,485	707	1,190	605	229	98	66	4
Connecticut	1,610	543	1,203	420	324	111	83	12
Delaware	296	97	207	70	62	22	27	5
District of Columbia	308	111	256	101	46	10	6	0
Florida	4,504	770	3,162	620	1,033	138	309	12
Georgia	1,556	216	1,115	186	342	29	99	1
Hawaii	271	65	234	59	31	6	6	0
Idaho	330	168	266	139	48	27	16	2
Illinois	2,077	456	1,676	388	319	64	82	4
Indiana	1,437	628	943	433	349	168	145	27
Iowa	261	105	219	92	35	13	7	0
Kansas	358	72	291	61	53	10	14	1
Kentucky	1,825	658	1,064	425	526	197	235	36
Louisiana	1,113	254	695	188	300	59	118	7
Maine	1,098	411	786	316	256	80	56	15
Maryland	2,389	1097	1,750	836	499	220	140	41
Massachusetts	5,225	1283	4,005	1,002	929	247	291	34
Michigan	2,500	455	1,801	355	555	88	144	12
Minnesota	1,121	369	880	297	192	65	49	7
Mississippi	499	94	304	73	139	20	56	1
Missouri	1,198	198	911	146	209	48	78	4
Montana	201	130	161	102	33	23	7	5
Nebraska	176	60	139	53	27	7	10	0
Nevada	531	191	394	154	111	36	26	1
New Hampshire	699	326	504	254	144	69	51	3
New Jersey	2,705	558	2,016	453	522	99	167	6
New Mexico	936	326	736	264	165	61	35	1
New York	7,973	1,854	6,357	1,534	1,264	289	352	31
North Carolina	2,305	920	1668	698	454	201	183	21
North Dakota	97	87	67	62	21	22	9	3
Ohio	4,237	1,583	2,890	1,175	938	358	409	50
Oklahoma	803	190	589	156	151	33	63	1
Oregon	1,404	489	1,124	405	221	73	59	11
Pennsylvania	5,409	1,080	3,701	799	1,195	229	513	52
Puerto Rico	726	0	598	0	117	0	11	0
Rhode Island	773	166	575	135	142	29	56	2
South Carolina	995	314	723	231	198	77	74	6
South Dakota	101	49	91	44	7	5	3	0
Tennessee	2,046	6	1,181	6	590	0	275	0
Texas	3,027	545	2,237	472	614	71	176	2
Utah	1,025	331	788	266	192	63	45	2
Vermont	573	143	444	116	100	24	29	3
Virginia	1,643	403	1,155	320	366	74	122	9
Washington	3,255	1,078	2,726	844	425	214	104	20
West Virginia	837	314	494	229	233	73	110	12
Wisconsin	1,371	268	1,044	208	258	55	69	5
Wyoming	102	63	72	53	24	10	6	0
US territories	11	1	10	1	1	0	0	0
SOURCE: SAMHSA. Number of DATA-waived Practitioners: Waiver Totals by State. Available at https://www.samhsa.gov/medication-assisted-treatment/practitioner-resources/DATA-program-data. Accessed February 22, 2020. NOTE: On October 17, 2000, Congress passed the Drug Addiction Treatment Act (DATA), which permitted qualified physicians to apply for a waiver to treat narcotic dependence with schedules III, IV, and V controlled narcotic substances that have been approved by the Food and Drug Administration for that use. On July 22, 2016, the Comprehensive Addiction and Recovery Act (CARA) of 2016 became law, expanding the individuals permitted to apply for these waivers to nurse practitioners, physician assistants, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives. Waivers limit practitioners to treating 30, 100, or 275 patients, depending on the practitioner's request and qualifications. Significance tests were not conducted because the data used to develop this table includes all DATA-waivered practitioners. Other practitioners encompasses all nonphysician practitioners eligible for DATA waivers (that is, nurse practitioners, physician assistants, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives).

Table A.18. Mean Rate of IET-AD for Members of Health Plans Participating in NCQA's State of Health Care Quality Report, 2005-2018^a
Calendar Year	Initiation of Alcohol and Other Drug Treatment (%)					Engagement in Alcohol or Other Drug Treatment (%)
	Commercial		Medicaid	Medicare		Commercial		Medicaid	Medicare
	HMO	PPO	HMO	HMO	PPO	HMO	PPO	HMO	HMO	PPO
2018	35.4	36.2	42.8	33.5	33.9	12.2	13.8	14.0	4.5	3.9
2017	36.6	36.7	42.3	33.9	36.1	12.5	14.3	13.5	4.4	3.6
2016	33.5	33.9	40.8	32.7	36.5	11.3	12.9	12.5	3.6	3.4
2015	33.3	34.5	38.2	32.7	35.2	11.8	13.5	10.2	3.2	2.9
2014	34.7	36.1	38.3	32.5	35.1	12.8	14.2	11.3	3.3	3.5
2013	37.6	40.3	38.2	33.7	37.8	13.7	14.8	10.6	3.2	3.5
2012	39.1	41.2	39.4	38.8	43.3	13.6	14.6	10.8	3.1	3.0
2011	40.2	40.6	39.2	41.0	47.6	15.2	16.0	11.9	3.7	3.8
2010	42.7	40.8	42.9	44.6	57.4	15.6	16.0	14.2	3.7	3.8
2009	42.7	46.0	45.6	46.2	57.4	16.1	15.7	12.3	4.6	4.2
2008	42.4	42.6	44.5	45.9	49.1	16.2	16.2	12.4	4.3	9.4
2007	44.5	46.0	45.6	50.3	56.5	15.2	15.2	14.4	4.5	6.3
2006	43.2	49.0	43.3	50.3	50.0	13.8	16.0	11.7	4.5	7.0
2005	44.5	45.8	40.7	50.9	52.3	14.1	15.3	9.7	4.7	3.2
SOURCE: NCQA. State of Health Care Quality Report. Available at https://www.ncqa.org/hedis/measures/initiation-and-engagement-of-alcohol-and-other-drug-abuse-or-dependence-treatment/. Accessed on February 22, 2020. NOTE: Initiation of Alcohol or Other Drug Abuse or Dependence Treatment measures the percentage of adolescents and adults who within 14 days of a SUD diagnosis initiated treatment in any of the following types of care: inpatient stay, outpatient visit, intensive outpatient or partial hospitalization service, telehealth, or MAT. Engagement in Alcohol or Other Drug Abuse or Dependence Treatment measures the percentage of adolescents and adults who within 34 days of initiating treatment received 2 or more additional alcohol or other drug abuse or dependence treatment services. Specifications for these measures are updated annually. These updates may affect the comparability of estimates across years. Estimates represent the average rate for the reporting health plans. More than 1,000 health plans that voluntarily submitted data are represented in these estimates. Significance testing was not conducted for these estimates.

Table A.19.a. Rate of IET-AD for Medicaid and/or CHIP Beneficiaries, by state, FFY 2018^a
State	Population	Number of Beneficiaries with SUD Diagnoses	Initiation (%)	Engagement (%)
States reporting ages 18 to 64
Alabama	Medicaid	3,505	39.9	3.8
Arizona	Medicaid, dual eligibles	6,173	57.2	21.0
California	Medicaid	81,814	28.2	5.3
Delaware	Medicaid, dual eligibles	1,137	42.1	15.0
Illinois	Medicaid, CHIP	35,457	32.4	8.9
Iowa	Medicaid	11,388	34.9	20.2
Louisiana	Medicaid, CHIP	12,053	38.6	10.6
Maryland	Medicaid, CHIP	22,834	29.4	18.8
Massachusetts	Medicaid, dual eligibles	15,816	40.9	14.2
Mississippi	Medicaid	1,967	44.0	4.3
Missouri	Medicaid, CHIP	6,014	40.1	11.4
Nevada	Medicaid	4,532	39.2	9.3
New Hampshire	Medicaid	797	38.9	13.8
New York	Medicaid	59,308	41.7	15.8
North Carolina	Medicaid	12,146	38.3	11.7
Oklahoma	Medicaid, dual eligibles	3,219	35.6	5.5
Oregon	Medicaid, dual eligibles	4,358	39.0	14.8
Pennsylvania	Medicaid	20,146	30.8	22.3
South Carolina	Medicaid, CHIP	3,919	35.4	9.4
South Dakota	Medicaid, CHIP, dual eligibles	1,074	38.6	4.4
Vermont	Medicaid, CHIP	2,408	38.3	16.6
Washington	Medicaid, dual eligibles	20,137	27.9	6.4
West Virginia	Medicaid, dual eligibles	7,560	36.9	15.6
Wisconsin	Medicaid	7,084	39.9	14.4
States reporting other age groups
Connecticut	Medicaid, CHIP	13,859	44.7	26.1
Florida	Medicaid	13,262	44.7	4.8
Kansas	Medicaid, dual eligibles	2,258	37.9	8.8
Kentucky	Medicaid, dual eligibles	11,580	37.7	10.3
New Mexico	Medicaid	11,517	37.9	12.3
Ohio	Medicaid, CHIP	31,177	47.4	13.1
Tennessee	Medicaid	8,780	45.3	11.1
Texas	Medicaid	12,062	41.2	6.5
SOURCE: Centers for Medicare & Medicaid Services. Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020. NOTE: Initiation of Alcohol and Other Drug Abuse or Dependence Treatment indicates the percentage of adults who within 14 days of a SUD diagnosis initiated treatment in any of the following types of care: inpatient stay, outpatient visit, intensive outpatient or partial hospitalization service, telehealth, or MAT. Engagement in Alcohol or Other Drug Abuse or Dependence Treatment indicates the percentage of adults who within 34 days of initiating treatment received 2 or more additional alcohol or other drug abuse or dependence treatment services. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs. Significance testing was not conducted for these estimates.

Table A.19.b. Rate of FUA-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018^a
State	Population	Number of Beneficiaries with SUD ED Visit	7-day Follow-up (%)	30-day Follow-up (%)
States reporting ages 21 to 64
Alabama	Medicaid	1,570	9.7	11.4
Arizona	Medicaid	1,912	24.3	31.5
Arkansas	Medicaid, CHIP, dual eligibles	948	3.9	5.2
California	Medicaid	59,217	6.4	10.7
Delaware	Medicaid, dual eligibles	680	10.1	17.4
Iowa	Medicaid	4,448	40.7	44.7
Louisiana	Medicaid, CHIP	8,267	7.4	12.2
Massachusetts	Medicaid	12,943	24.3	33.9
Minnesota	Medicaid, CHIP, dual eligibles	10,728	17.5	28.4
Mississippi	Medicaid	920	5.5	8.2
Missouri	Medicaid, CHIP	4,295	4.7	5.0
Nebraska	Medicaid, CHIP, dual eligibles	664	5.4	9.8
Nevada	Medicaid	4,238	9.2	13.0
New Hampshire	Medicaid	638	22.7	34.6
New York	Medicaid	41,168	21.0	27.5
Oklahoma	Medicaid, dual eligibles	1,901	35.5	43.9
Pennsylvania	Medicaid	17,993	15.3	23.2
South Carolina	Medicaid, CHIP	2,422	8.4	13.3
Tennessee	Medicaid	4,060	3.9	6.1
Vermont	Medicaid, CHIP	1,024	17.9	27.1
West Virginia	Medicaid, dual eligibles	4,057	8.1	15.9
States reporting other age groups
Connecticut	Medicaid	12,049	21.4	31.5
District of Columbia	Medicaid, CHIP, dual eligibles	439	13.7	15.9
Florida	Medicaid	7,797	6.0	8.7
Hawaii	Medicaid, dual eligibles	2,367	13.8	21.7
Kentucky	Medicaid, dual eligibles	10,841	13.2	19.8
New Mexico	Medicaid	9,166	9.4	16.7
Ohio	Medicaid, CHIP	18,235	16.9	24.3
Rhode Island	Medicaid, CHIP	3,228	14.1	21.7
Texas	Medicaid	6,246	3.7	5.9
SOURCE: Centers for Medicare & Medicaid Services. Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020. NOTE: The 7-day and 30-day follow-up rates measure the percentage of adults who had an ED visit for an alcohol or other drug use diagnosis with a follow-up visit with a principal diagnosis of alcohol or other drug abuse or dependence within the stated number of days. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs. Significance testing was not conducted for these estimates.

Table A.20. Continuity of Care for Medicaid Beneficiaries Treated for a SUD Who Received Services in an Inpatient or a Residential Setting in 2017, by State^a
State	Number of Beneficiaries with a SUD Who Received Services in an Inpatient or a Residential Setting	Received at Least 1 Outpatient or Home or Community-Based SUD Service within 30 Days of Discharge		Received More than 1 Outpatient or Home or Community-Based Service within 30 days of Discharge
State		Number	Percentage	Number	Percentage
Total	1,750,767	424,875	24.3	280,369	16.0
Alabama	25,161	6,063	24.1	2,957	11.8
Alaska	7,696	2,293	29.8	1,537	20.0
Arizona	49,236	14,191	28.8	10,374	21.1
Arkansas	6,582	307	4.7	70	1.1
California	191,981	35,218	18.3	22,458	11.7
Colorado	26,685	3,605	13.5	1,546	5.8
Connecticut	26,811	9,777	36.5	7,251	27.0
Delaware	8,060	3,049	37.8	2,198	27.3
District of Columbia	7,993	1,815	22.7	1,076	13.5
Florida	83,424	12,854	15.4	6,483	7.8
Georgia	37,545	5,211	13.9	2,537	6.8
Hawaii	8,152	1,830	22.4	964	11.8
Idaho	5,357	916	17.1	424	7.9
Illinois	9,069	1,436	15.8	647	7.1
Indiana	46,628	8,840	19.0	5,679	12.2
Iowa	24,171	6,045	25.0	3,856	16.0
Kansas	12,058	2,011	16.7	1,096	9.1
Kentucky	54,497	12,852	23.6	7,337	13.5
Louisiana	20,618	3,482	16.9	2,236	10.8
Maine	3,872	1,376	35.5	1,040	26.9
Maryland	40,681	13,704	33.7	10,500	25.8
Massachusetts	78,810	34,298	43.5	27,076	34.4
Michigan	64,680	5,771	8.9	1,942	3.0
Minnesota	34,987	11,572	33.1	8,099	23.1
Mississippi	DQ	DQ	DQ	DQ	DQ
Missouri	DQ	DQ	DQ	DQ	DQ
Montana	DQ	DQ	DQ	DQ	DQ
Nebraska	DQ	DQ	DQ	DQ	DQ
Nevada	20,712	5,140	24.8	3,055	14.7
New Hampshire	4,482	1,451	32.4	966	21.6
New Jersey	34,966	8,604	24.6	6,582	18.8
New Mexico	7,479	2,015	26.9	1,197	16.0
New York	176,942	59,995	33.9	45,281	25.6
North Carolina	55,508	9,363	16.9	4,827	8.7
North Dakota	1,800	258	14.3	128	7.1
Ohio	129,417	41,369	32.0	27,988	21.6
Oklahoma	21,632	2,913	13.5	1,309	6.1
Oregon	29,492	10,542	35.7	7,555	25.6
Pennsylvania	108,026	23,154	21.4	14,498	13.4
Puerto Rico	4,714	897	19.0	481	10.2
Rhode Island	3,853	1,593	41.3	1,280	33.2
South Carolina	21,028	3,208	15.3	1,838	8.7
South Dakota	3,895	650	16.7	322	8.3
Tennessee	44,953	9,765	21.7	5,140	11.4
Texas	65,920	10,187	15.5	5,347	8.1
Utah	7,520	1,253	16.7	668	8.9
Vermont	5,424	1,667	30.7	1,070	19.7
Virginia	26,752	3,235	12.1	1,664	6.2
Washington	50,514	16,507	32.7	11,800	23.4
West Virginia	18,614	3,276	17.6	1,927	10.4
Wisconsin	30,363	8,990	29.6	5,888	19.4
Wyoming	2,007	327	16.3	175	8.7
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table F.1.(Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020. NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Significance testing was not conducted for these estimates.

B. MENTAL HEALTH TREATMENT DEMAND AND CAPACITY

Table B.1. Number of Persons with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, 2008-2018 (in thousands)
	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Any mental illness
18 and older	39,826^a	41,195^a	41,417^a	41,381^a	43,714^a	43,846^a	43,553^a	43,421^a	44,652^a	46,632	47,635
18 to 25	6,099^a	6,043^a	6,151^a	6,356^a	6,774^a	6,754^a	7,014^a	7,574^a	7,635^a	8,849	8,944
26 to 49	20,697^a	21,455^a	20,648^a	19,936^a	20,777^a	21,061^a	20,007^a	20,589^a	20,903^a	22,256	22,721
50 and older	13,030^a	13,698^a	14,618	15,089	16,163	16,031	16,531	15,257	16,114	15,527	15,969
Serious mental illness
18 and older	8,331^a	8,383^a	9,334^a	9,011^a	9,570^a	10,018^a	9,822^a	9,765^a	10,360^a	11,190	11,373
18 to 25	1,236^a	1,124^a	1,334^a	1,296^a	1,423^a	1,468^a	1,681^a	1,756^a	2,035^a	2,566	2,619
26 to 49	4,763^a	4,858^a	5,132^a	4,951^a	5,065^a	5,193^a	4,807^a	4,896^a	5,279^a	5,580	5,907
50 and older	2,332	2,401	2,868	2,764	3,082	3,356	3,335	3,113	3,047	3,044	2,848
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Numbers for any mental illness are from Table 10.1A, and numbers for any serious mental illness are from Table 10.3A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. NOTE: Any mental illness and serious mental illness align with the criteria in the DSM-IV and were defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental disorder or SUD. Estimates of serious mental illness are a subset of estimates of any mental illness because serious mental illness is limited to persons with any mental illness that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are therefore not direct measures of diagnostic status. NSDUH does not produce estimates of any mental illness or serious mental illness for persons younger than age 18. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table B.2. Percentage of Population with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, by Age Group, 2008-2018
	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Any mental illness
18 and older	17.7^a	18.1^a	18.1^a	17.8^a	18.6	18.5	18.1^a	17.9^a	18.3^a	18.9	19.1
18 to 25	18.5^a	18.0^a	18.1^a	18.5^a	19.6^a	19.4^a	20.1^a	21.7^a	22.1^a	25.8	26.3
26 to 49	20.7^a	21.6	20.9^a	20.3^a	21.2^a	21.5	20.4^a	20.9^a	21.1^a	22.2	22.5
50 and older	14.1	14.5	15.1	15.0	15.8^a	15.3	15.4^a	14.0	14.5	13.8	14.0
Serious mental illness
18 and older	3.7^a	3.7^a	4.1^a	3.9^a	4.1^a	4.2	4.1^a	4.0^a	4.2^a	4.5	4.6
18 to 25	3.8^a	3.3^a	3.9^a	3.8^a	4.1^a	4.2^a	4.8^a	5.0^a	5.9^a	7.5	7.7
26 to 49	4.8^a	4.9^a	5.2^a	5.0^a	5.2^a	5.3	4.9^a	5.0^a	5.3^a	5.6	5.9
50 and older	2.5	2.5	3.0	2.8	3.0	3.2^a	3.1^a	2.8	2.7	2.7	2.5
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Numbers for any mental illness are from Table 10.1B, and numbers for any serious mental illness are from Table 10.3B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. NOTE: Any mental illness and serious mental illness align with the criteria in the DSM-IV and were defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental disorder or SUD. Estimates of serious mental illness are a subset of estimates of any mental illness because serious mental illness is limited to persons with any mental illness that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are therefore not direct measures of diagnostic status. NSDUH does not produce estimates of any mental illness or serious mental illness for persons younger than age 18. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table B.3. Number of Persons with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, by Insurance Status, 2008-2018 (in thousands)
	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Any mental illness
Private	23,775^a	24,949^a	23,693^a	22,565^a	23,589^a	25,011^a	24,456^a	24,972^a	26,307^a	27,933	28,245
Medicaid/CHIP	5,287^a	5,767^a	6,084^a	6,664^a	7,085^a	7,282^a	8,776^a	9,147^a	9,845	10,090	10,410
Medicare or other	8,227^a	8,587^a	9,815^a	9,727^a	11,458	10,796	11,620	10,971	10,990	10,845	11,142
No coverage	7,751^a	7,446^a	7,863^a	8,095^a	8,423^a	7,725^a	6,206^a	5,235	4,636^a	4,901	5,371
Serious mental illness
Private	4,502^a	4,099^a	4,765^a	3,967^a	4,106^a	4,767^a	4,656^a	5,093^a	5,334^a	5,813	5,977
Medicaid/CHIP	1,438^a	1,680^a	1,694^a	2,033^a	1,965^a	1,988^a	2,434^a	2,436^a	2,831	2,978	2,978
Medicare or other	1,706^a	1,799^a	2,204	1,941	2,569	2,499	2,572	2,622	2,226	2,533	2,338
No coverage	1,678	1,710	1,909^a	1,972^a	2,290^a	2,208^a	1,556	1,202^a	1,298	1,369	1,524
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for any mental illness are from Table 10.2A, and estimates for serious mental illness are from Table 10.4A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. NOTE: Any mental illness and serious mental illness align with the criteria in the DSM-IV were defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental disorder or SUD. Estimates of serious mental illness are a subset of estimates of any mental illness because serious mental illness is limited to persons with any mental illness that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic status. Insurance status was self-reported. Individuals could report more than 1 type of insurance. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table B.4.a. Number of Persons with a MDE or Suicidal Thoughts in the Past Year, by Age Group, 2008-2018 (in thousands)
	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Major depressive episode
12 to 17	2,027^a	1,954^a	1,911^a	2,011^a	2,213^a	2,587^a	2,751^a	3,031^a	3,089^a	3,214^a	3,482
18 and older	14,462^a	14,836^a	15,556^a	15,153^a	16,026^a	15,670^a	15,655^a	16,079^a	16,225^a	17,297	17,720
18 to 25	2,742^a	2,677^a	2,796^a	2,826^a	3,051^a	3,007^a	3,200^a	3,554^a	3,705^a	4,416	4,609
26 to 49	7,377	7,546	7,361	7,536	7,370	7,336	6,970^a	7,329^a	7,236^a	7,635	7,990
50 and older	4,343	4,613	5,400	4,790	5,606	5,327	5,485	5,196	5,284	5,245	5,121
Suicidal thoughts
12 to 17	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
18 and older	8,335^a	8,467^a	8,724^a	8,540^a	9,031^a	9,292^a	9,436^a	9,767^a	9,829^a	10,642	10,744
18 to 25	2,227^a	2,027^a	2,257^a	2,329^a	2,489^a	2,568^a	2,586^a	2,878^a	3,022^a	3,555	3,709
26 to 49	3,951^a	4,290	4,006^a	3,587^a	4,064^a	3,875^a	3,953^a	4,072^a	4,173^a	4,292	4,657
50 and older	2,157	2,150	2,461	2,624	2,478	2,849	2,897	2,817	2,634	2,795	2,379
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for adult MDEs are from Table 10.32A, and estimates for adult suicidal thoughts are from Table 10.36A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. Estimates for adolescent MDEs are from Table 11.2A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect11pe2018.htm. Accessed on February 22, 2020. NOTE: The definition used for MDE is consistent with the DSM-V. Individuals were defined as having a past-year MDE if in the past 12 months they reported at least 5 or more of the following 9 symptoms nearly every day (except where noted) in the same 2-week period, and at least 1 of the symptoms was a depressed mood or loss of interest or pleasure in daily activities: (1) depressed mood most of the day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day; (3) significant weight loss when not dieting, or weight gain, or decrease or increase in appetite; (4) insomnia or hypersomnia; (5) psychomotor agitation or retardation; (6) fatigue or loss of energy; (7) feelings of worthlessness; (8) diminished ability to think or concentrate, or indecisiveness; and (9) recurrent thoughts of death or recurrent suicide ideation. Recurrent thoughts of death or suicidal ideation did not need to occur nearly every day. Consistent with the DSM-V criteria, the NSDUH does not exclude MDEs that occurred exclusively in the context of bereavement. Respondents were classified as having suicidal thoughts based on self-reporting of suicidal thoughts in the past 12 months. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table B.4.b. Percentage of Population with a MDE or Suicidal Thoughts in the Past Year, by Age Group, 2008-2018
	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Major depressive episode
12 to 17	8.3^a	8.1^a	8.0^a	8.2^a	9.1^a	10.7^a	11.4^a	12.5^a	12.8^a	13.3^a	14.4
18 and older	6.5^a	6.6^a	6.8	6.6^a	6.9	6.7^a	6.6^a	6.7^a	6.7^a	7.1	7.2
18 to 25	8.4^a	8.0^a	8.3^a	8.3^a	8.9^a	8.7^a	9.3^a	10.3^a	10.9^a	13.1	13.8
26 to 49	7.4	7.6	7.5	7.7	7.6	7.6	7.2^a	7.5	7.4^a	7.7	8.0
50 and older	4.8	4.9	5.6^a	4.8	5.5^a	5.1	5.2	4.8	4.8	4.7	4.5
Suicidal thoughts
12 to 17	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
18 and older	3.7^a	3.7^a	3.8^a	3.7^a	3.9^a	3.9^a	3.9^a	4.0	4.0	4.3	4.3
18 to 25	6.8^a	6.1^a	6.7^a	6.8^a	7.2^a	7.4^a	7.5^a	8.3^a	8.8^a	10.5	11.0
26 to 49	4.0^a	4.3	4.1^a	3.7^a	4.2	4.0^a	4.0^a	4.1^a	4.2	4.3	4.7
50 and older	2.3	2.3	2.6	2.6	2.4	2.7^a	2.7^a	2.6	2.4	2.5	2.1
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for adult MDEs are from Table 10.32B. Estimates for adult suicidal thoughts are from Table 10.36B. Both are available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. Estimates for adolescent MDEs are from Table 11.2B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect11pe2018.htm. Accessed on February 22, 2020. NOTE: The definition used for MDE is consistent with the DSM-V. Individuals were defined as having had a past-year MDE if in the past 12 months they reported at least 5 or more of the following 9 symptoms nearly every day (except where noted) in the same 2-week period, and at least 1 of the symptoms was a depressed mood or loss of interest or pleasure in daily activities: (1) depressed mood most of the day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day; (3) significant weight loss when not dieting, or weight gain, or decrease or increase in appetite; (4) insomnia or hypersomnia; (5) psychomotor agitation or retardation; (6) fatigue or loss of energy; (7) feelings of worthlessness; (8) diminished ability to think or concentrate, or indecisiveness; and (9) recurrent thoughts of death or recurrent suicide ideation. Recurrent thoughts of death or suicidal ideation did not need to occur nearly every day. Consistent with the DSM-V criteria, the NSDUH does not exclude MDEs that occurred exclusively in the context of bereavement. Respondents were classified as having suicidal thoughts based on self-reporting of these thoughts in the past 12 months. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table B.5. Number of Persons Receiving Any MH Services in the Past Year, by Age and Insurance Status, 2008-2018 (in thousands)
	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Adults 18 and older
Age group
18 and older	30,201^a	30,341^a	31,490^a	31,642^a	34,122^a	34,644^a	35,498^a	34,243^a	34,982^a	36,416	37,101
18 to 25	3,612^a	3,740^a	3,717^a	3,899^a	4,120^a	4,221^a	4,135^a	4,044^a	4,423^a	5,073	5,120
26 to 49	14,030^a	14,481^a	14,627^a	14,543^a	14,811^a	15,101^a	14,930^a	15,057^a	15,154^a	15,695	16,113
50 and older	12,559^a	12,120^a	13,146^a	13,200^a	15,191	15,322	16,432	15,142	15,404	15,647	15,868
Insurance status
Private	20,564^a	19,691^a	20,324^a	19,879^a	21,618^a	22,294^a	22,033^a	22,805^a	22,660^a	23,813	24,849
Medicaid/CHIP	4,036^a	4,520^a	4,567^a	5,133^a	4,936^a	5,510^a	6,717	6,288	7,295	7,597^a	6,834
Medicare or other	7,811^a	7,384^a	8,079^a	8,128^a	9,604	9,452	11,296	10,186	9,866	10,027	10,363
No coverage	3,102^a	3,307^a	3,540^a	3,334^a	3,906^a	3,747^a	2,842^a	1,787	1,816	1,916	1,985
Adolescents 12 to 17
Specialty services	3,129^a	2,925^a	2,920^a	3,101^a	3,118^a	3,341^a	3,369^a	3,253^a	3,598^a	3,646^a	3,901
Nonspecialty services	NA	3,430^a	3,465^a	3,463^a	3,649^a	3,634^a	3,736	3,691^a	3,732^a	3,810	3,977
SOURCE: NSDUH, 2008-2018. Estimates for adult MH services by age group are from Table 10.7A. Estimates for adult MH services by insurance status are from Table 10.8A. Both are available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. Estimates for adolescent MDEs are from Table 11.1A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect11pe2018.htm. Accessed on February 22, 2020. NOTE: Specialty MH settings include outpatient, inpatient, or residential MH settings. The outpatient settings include: (1) private therapists, psychologists, psychiatrists, social workers, or counselors; (2) MH clinics or centers; (3) partial day hospitals or day treatment programs; and (4) In-home therapists, counselors, or family preservation workers. The inpatient settings include: (1) hospitals; and (2) residential treatment centers. Adolescents were defined as having received specialty MH services if they reported receiving treatment or counseling in any of these settings for emotional or behavioral problems. Nonspecialty settings include the education, general medical, juvenile justice, and child welfare settings. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table B.6. Number of Clients Receiving Specialty MH Treatment in the Past Year, by State and Service Setting, in 2014, 2016, and 2018^a
State	Total (across other columns)			Outpatient (1-month count)			Residential (1-day count)			Inpatient (1-day count)
State	2014	2016	2018	2014	2016	2018	2014	2016	2018	2014	2016	2018
Total	3,971,758	4,332,881	4,125,284	3,801,558	4,161,697	3,937,407	68,849	65,324	58,762	101,351	105,860	129,115
Alabama	59,743	60,595	59,887	57,014	57,607	57,167	1,613	1,166	1,070	1,116	1,822	1,650
Alaska	11,991	16,556	11,132	11,214	15,128	10,359	534	451	487	243	977	286
Arizona	122,249	135,147	145,182	119,373	131,688	135,673	1,478	1,646	1,468	1,398	1,813	8,041
Arkansas	67,449	61,641	65,279	65,034	59,852	62,516	1,249	599	1,307	1,166	1,190	1,456
California	248,474	270,009	246,757	230,332	256,013	228,138	4,824	6,407	5,462	13,318	7,589	13,157
Colorado	68,144	72,927	91,810	65,914	68,328	84,241	1,008	1,170	987	1,222	3,429	6,582
Connecticut	76,959	68,673	66,870	74,167	66,111	61,865	1,099	1,296	2,898	1,693	1,266	2,107
Delaware	8,028	10,056	8,597	7,511	5,285	8,149	124	120	71	393	4,651	377
District of Columbia	17,158	15,558	14,564	16,408	15,118	14,202	300	0	12	450	440	350
Florida	160,192	183,368	228,525	150,254	175,463	210,619	3,988	2,681	2,914	5,950	5,224	14,992
Georgia	69,620	178,142	77,784	67,016	174,875	74,591	1,197	1,215	1,187	1,407	2,052	2,006
Hawaii	11,333	7,187	5,374	10,626	6,739	4,938	386	223	92	321	225	344
Idaho	38,651	188,084	24,382	37,938	187,521	23,923	251	150	107	462	413	352
Illinois	130,408	113,605	111,463	123,905	106,952	105,732	2,538	2,338	1,769	3,965	4,315	3,962
Indiana	81,509	106,911	119,948	76,191	102,546	116,067	1,933	2,238	1,801	3,385	2,127	2,080
Iowa	55,307	46,729	52,721	53,613	45,367	51,371	1,023	740	587	671	622	763
Kansas	44,581	48,217	52,601	41,953	43,720	50,654	1,635	1,364	825	993	3,133	1,122
Kentucky	66,968	53,638	68,818	64,725	50,941	66,124	1,127	1,135	1,371	1,116	1,562	1,323
Louisiana	38,762	40,483	42,046	36,666	38,163	35,892	125	241	265	1,971	2,079	5,889
Maine	40,966	39,407	27,922	39,991	37,899	27,104	564	1,095	396	411	413	422
Maryland	94,155	94,620	73,089	90,264	91,489	70,528	1,831	1,326	953	2,060	1,805	1,608
Massachusetts	145,551	144,486	144,052	140,889	138,531	139,916	2,257	2,344	1,888	2,405	3,611	2,248
Michigan	158,326	198,900	162,966	154,441	193,776	158,692	1,444	2,344	1,295	2,441	2,780	2,979
Minnesota	80,624	82,006	62,254	77,978	79,692	59,307	1,201	1,207	1,637	1,445	1,107	1,310
Mississippi	44,301	53,726	56,225	41,810	51,153	53,980	1,139	1,226	1,093	1,352	1,347	1,152
Missouri	72,812	80,934	86,374	68,087	76,601	79,834	1,663	1,410	1,477	3,062	2,923	5,063
Montana	17,155	18,386	14,584	15,482	16,676	13,564	787	736	444	886	974	576
Nebraska	22,742	32,058	28,557	21,540	31,050	27,424	570	522	534	632	486	599
Nevada	15,536	16,928	21,695	14,746	16,094	20,945	64	159	191	726	675	559
New Hampshire	23,410	22,262	19,692	22,609	21,531	19,091	493	416	324	308	315	277
New Jersey	92,646	82,110	76,697	87,564	77,149	71,774	1,585	1,258	1,172	3,497	3,703	3,751
New Mexico	19,005	20,422	24,107	17,942	19,297	23,151	472	660	286	591	465	670
New York	352,232	334,794	319,034	336,171	323,683	306,696	6,517	3,815	4,032	9,544	7,296	8,306
North Carolina	56,141	63,149	71,346	52,427	59,019	67,732	1,312	1,108	987	2,402	3,022	2,627
North Dakota	8,239	12,664	12,902	7,936	11,798	12,440	187	368	169	116	498	293
Ohio	245,426	260,754	288,731	240,595	255,945	283,238	2,384	1,805	2,123	2,447	3,004	3,370
Oklahoma	36,974	46,692	46,404	34,826	45,273	45,226	694	564	334	1,454	855	844
Oregon	42,396	47,397	59,703	39,895	44,969	57,700	1,613	1,395	937	888	1,033	1,066
Pennsylvania	228,208	206,337	225,921	220,380	198,249	218,826	2,852	2,666	2,517	4,976	5,422	4,578
Puerto Rico	0	22,498	39,987	0	21,551	38,930	0	523	327	0	424	730
Rhode Island	25,893	20,097	20,348	25,040	19,397	19,606	368	291	304	485	409	438
South Carolina	61,011	50,321	65,799	59,015	48,358	63,938	722	798	510	1,274	1,165	1,351
South Dakota	13,538	10,053	15,813	12,900	9,545	15,272	533	398	372	105	110	169
Tennessee	120,380	121,734	126,870	116,958	117,993	123,392	1,649	1,877	1,585	1,773	1,864	1,893
Texas	122,741	128,313	126,091	114,300	118,795	116,659	2,750	2,578	2,281	5,691	6,940	7,151
Utah	28,931	33,523	45,479	27,239	30,796	43,583	1,112	1,125	984	580	1,602	912
Vermont	16,696	20,918	16,231	15,997	20,302	15,732	545	346	306	154	270	193
Virginia	82,156	89,970	82,561	78,748	84,494	77,988	1,327	2,447	1,792	2,081	3,029	2,781
Washington	101,368	112,603	112,867	98,253	110,465	109,864	1,272	1,173	1,120	1,843	965	1,883
West Virginia	41,278	26,573	31,440	40,100	24,964	29,985	360	751	633	818	858	822
Wisconsin	121,558	144,136	113,697	118,974	141,715	111,454	1,071	1,159	825	1,513	1,262	1,418
Wyoming	11,907	14,804	10,151	11,444	14,342	9,685	276	230	254	187	232	212
U.S. territories	49,930	1,780	1,955	47,163	1,689	1,930	803	24	0	1,964	67	25
SOURCE: N-MHSS, 2014, 2016, and 2018. NOTE: Counts include clients who received services at the MH treatment facilities that responded to the survey. Surveyed facilities included the following types of facilities: (1) psychiatric hospitals; (2) general hospitals with a separate inpatient psychiatric unit; (3) Veterans Affairs medical centers; (4) partial hospitalization or day treatment MH facilities; (5) outpatient MH facilities; (6) residential treatment centers for children; (7) residential treatment centers for adults; (8) multi-setting MH facilities; (9) community MH centers; and (10) other types of outpatient, residential, and inpatient treatment facilities that provide programs focused on the treatment of mental illness. Estimates were not adjusted for survey nonresponse. The survey response rates were 88%, 91%, and 90% in 2014, 2016, and 2018, respectively. Significance tests were not conducted for these estimates because N-MHSS surveys the universe of specialty MH facilities.

Table B.7. Number of Residential and Inpatient Beds Designated for MH Treatment and Utilization Rates, by State, in 2014, 2016, and 2018^a
	Number of Designated Beds						Utilization Rate
	Residential			Inpatient Hospital			Residential			Inpatient Hospital
	2014	2016	2018	2014	2016	2018	2014	2016	2018	2014	2016	2018
Total	76,280	67,560	62,253	106,236	106,486	109,241	90.3	96.7	94.4	95.4	99.4	118.2
Alabama	1,781	1,097	1,344	1,442	1,716	1,429	90.6	106.3	79.6	77.4	106.2	115.5
Alaska	583	496	569	278	310	342	91.6	90.9	85.6	87.4	315.2	83.6
Arizona	1,627	1,667	1,625	1,651	1,817	1,958	90.8	98.7	90.3	84.7	99.8	410.7
Arkansas	1,292	646	1,481	1,344	1,543	1,746	96.7	92.7	88.3	86.8	77.1	83.4
California	5,467	6,275	6,331	9,086	8,516	10,993	88.2	102.1	86.3	146.6	89.1	119.7
Colorado	1,075	1,072	901	1,217	1,149	1,447	93.8	109.1	109.5	100.4	298.4	454.9
Connecticut	1,127	1,145	1,005	1,530	1,330	1,462	97.5	113.2	288.4	110.7	95.2	144.1
Delaware	130	124	37	430	469	421	95.4	96.8	191.9	91.4	991.7	89.5
District of Columbia	249	0	12	490	518	391	120.5	0.0	100.0	91.8	84.9	89.5
Florida	4,176	2,935	3,255	6,745	6,238	6,227	95.5	91.3	89.5	88.2	83.7	240.8
Georgia	1,231	1,208	1,282	1,918	2,492	2,076	97.2	100.6	92.6	73.4	82.3	96.6
Hawaii	749	403	113	381	361	386	51.5	55.3	81.4	84.3	62.3	89.1
Idaho	375	312	226	580	560	451	66.9	48.1	47.3	79.7	73.8	78.0
Illinois	2,215	2,045	2,044	4,361	4,743	4,467	114.6	114.3	86.5	90.9	91.0	88.7
Indiana	2,156	2,243	1,803	2,818	2,818	2,680	89.7	99.8	99.9	120.1	75.5	77.6
Iowa	1,217	902	772	814	657	817	84.1	82.0	76.0	82.4	94.7	93.4
Kansas	2,721	1,617	946	1,156	1,409	1,228	60.1	84.4	87.2	85.9	222.4	91.4
Kentucky	1,160	1,524	1,304	1,665	2,040	1,832	97.2	74.5	105.1	67.0	76.6	72.2
Louisiana	126	243	282	2,204	2,380	2,862	99.2	99.2	94.0	89.4	87.4	205.8
Maine	681	537	431	537	475	486	82.8	203.9	91.9	76.5	86.9	86.8
Maryland	1,717	1,614	1,117	2,293	2,065	2,087	106.6	82.2	85.3	89.8	87.4	77.0
Massachusetts	2,424	2,364	2,049	2,463	3,147	2,271	93.1	99.2	92.1	97.6	114.7	99.0
Michigan	1,500	1,754	1,357	2,652	2,650	2,734	96.3	133.6	95.4	92.0	104.9	109.0
Minnesota	1,570	1,338	1,779	1,347	1,198	1,017	76.5	90.2	92.0	107.3	92.4	128.8
Mississippi	1,136	1,303	680	1,651	1,624	1,555	100.3	94.1	160.7	81.9	82.9	74.1
Missouri	1,783	1,601	1,623	3,606	3,508	5,254	93.3	88.1	91.0	84.9	83.3	96.4
Montana	667	713	638	390	501	738	118.0	103.2	69.6	227.2	194.4	78.0
Nebraska	613	523	668	797	532	771	93.0	99.8	79.9	79.3	91.4	77.7
Nevada	76	234	246	663	866	760	84.2	67.9	77.6	109.5	77.9	73.6
New Hampshire	624	497	354	398	369	315	79.0	83.7	91.5	77.4	85.4	87.9
New Jersey	1,556	1,367	1,239	3,856	3,942	3,599	101.9	92.0	94.6	90.7	93.9	104.2
New Mexico	525	584	402	787	668	728	89.9	113.0	71.1	75.1	69.6	92.0
New York	7,002	4,321	3,784	10,906	8,399	7,909	93.1	88.3	106.6	87.5	86.9	105.0
North Carolina	1,544	1,276	1,127	2,651	2,715	3,015	85.0	86.8	87.6	90.6	111.3	87.1
North Dakota	154	410	173	199	547	334	121.4	89.8	97.7	58.3	91.0	87.7
Ohio	2,402	2,102	1,843	2,938	3,484	3,108	99.3	85.9	115.2	83.3	86.2	108.4
Oklahoma	811	619	416	1,747	1,187	1,060	85.6	91.1	80.3	83.2	72.0	79.6
Oregon	1,753	1,279	1,087	964	1,080	1,136	92.0	109.1	86.2	92.1	95.6	93.8
Pennsylvania	3,290	2,930	2,950	5,650	5,680	5,111	86.7	91.0	85.3	88.1	95.5	89.6
Puerto Rico	NA	608	372	NA	561	756	NA	86.0	87.9	NA	75.6	96.6
Rhode Island	350	334	328	545	483	352	105.1	87.1	92.7	89.0	84.7	124.4
South Carolina	916	806	548	1,440	1,348	1,578	78.8	99.0	93.1	88.5	86.4	85.6
South Dakota	548	349	375	136	136	192	97.3	114.0	99.2	77.2	80.9	88.0
Tennessee	1,873	2,150	1,917	2,239	2,393	2,400	88.0	87.3	82.7	79.2	77.9	78.9
Texas	3,077	2,816	2,822	6,310	7,148	7,868	89.4	91.5	80.8	90.2	97.1	90.9
Utah	1,559	1,394	1,286	750	1,127	880	71.3	80.7	76.5	77.3	142.1	103.6
Vermont	568	405	358	169	161	221	96.0	85.4	85.5	91.1	167.7	87.3
Virginia	1,650	2,077	1,923	2,570	3,299	2,749	80.4	117.8	93.2	81.0	91.8	101.2
Washington	1,192	1,061	1,160	1,922	989	2,072	106.7	110.6	96.6	95.9	97.6	90.9
West Virginia	593	680	640	931	1,040	1,095	60.7	110.4	98.9	87.9	82.5	75.1
Wisconsin	1,594	1,237	824	1,218	1,679	1,491	67.2	93.7	100.1	124.2	75.2	95.1
Wyoming	309	299	405	214	323	336	89.3	76.9	62.7	87.4	71.8	63.1
U.S. territories	766	24	0	1,187	96	48	104.8	100.0	0.0	165.5	69.8	52.1
SOURCE: N-MHSS 2014, 2016, and 2018. NOTE: The utilization rate was calculated by dividing the number of clients in care on a particular day, as assessed by the survey, by the total number of designated beds. Estimates were not adjusted for survey nonresponse. The survey response rates were 88%, 91%, and 90% in 2014, 2016, and 2018, respectively. Significance tests were not conducted for these estimates because N-MHSS surveys the universe of specialty MH facilities.

Table B.8. MH Quality MeasureS from NCQA's State of Health Care Quality Report, 2018 (average percentage of applicable health plan beneficiaries)^a
	Commercial		Medicaid	Medicare
	HMO	PPO	HMO	HMO	PPO
Diabetes monitoring for people with both schizophrenia and diabetes^b	NA	NA	70.5	NA	NA
Cardiovascular disease monitoring for people with both schizophrenia and cardiovascular disease^c	NA	NA	76.9	NA	NA
AMM-AD^d
Effective acute phase treatment	69.2	69.2	53.5	72.3	74.6
Effective continuation phase treatment	52.9	53.7	37.9	56.3	60.1
Follow-Up After Hospitalization for Mental Illness^e
Follow-up within 7-days post-discharge	45.6	43.0	35.8	27.7	27.3
Follow-up within 30-days post-discharge	66.6	64.9	56.8	48.1	49.2
SAA-AD^f	NA	NA	59.8	NA	NA
Follow-up after ED visit for mental illness^g
Follow-up within 7-days post-ED visit	45.6	44.6	40.3	32.2	29.3
Follow-up within 30-days post-ED visit	60.1	59.5	54.8	48.5	44.5
Follow-up care for children prescribed medication for ADHD^h
Follow-up care after initiation of treatment	40.6	39.6	44.2	NA	NA
Follow-up care during continuation and maintenance of treatment	49.7	46.8	54.6	NA	NA
Metabolic monitoring of children and adolescents on antipsychoticsⁱ	37.2	33.1	35.3	NA	NA
Use of first-line psychosocial care for children and adolescents on antipsychotics^j	55.4	54.9	57.6	NA	NA
SOURCE: NCQA�s State of Health Care Quality Report. Available at https://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality-report/. Accessed January 2, 2020. Significance testing was not conducted for these estimates. Percentage with both an LDL-C test and an HbA1c test during the measurement year. Percentage with LDL-C test during the measurement year. Effective acute phase treatment indicates the percentage of adults on antidepressant medication who remained on the medication for at least 12 weeks. Effective continuation phase treatment indicates the percentage of adults on antidepressant medications who remained on the medications for at least 6 months. Percentage of adults and children ages 6 and older who were hospitalized for treatment of mental illness or intentional self-harm who had a follow-up outpatient or intensive outpatient treatment service visit with a MH practitioner within the specified number of days following discharge. Percentage of adults ages 19-64 with a schizophrenia diagnosis who were dispensed and remained on an antipsychotic medication for at least 80% of their treatment period. Percentage of ED visits for adults and children ages 6 and older with a mental illness diagnosis who had a follow-up visit for mental illness within the specified number of days following discharge. For the initiation phase, the percentage of children between ages 6 and 12 who were diagnosed with ADHD and who had a follow-up visit with a practitioner who can prescribe within 30 days of their first prescription for ADHD medication. For the continuation and maintenance phase, the percentage of children between ages 6 and 12 who had a prescription for ADHD medication, remained on the medication for at least 210 days, and had at least 2 follow-up visits with the practitioner in the 9 months after the initial prescription. Percentage of children and adolescents taking antipsychotic medication on an ongoing basis for whom metabolic testing was conducted during the year. Percentage of children and adolescents with an initial prescription for antipsychotic medication for whom documentation indicated psychosocial care was provided as the first line of treatment.

Table B.9.a. Rate of AMM-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018^a
State	Population	Denominator	Acute Phase Treatment	Continuation Phase Treatment
States reporting ages 18 to 64
Alabama	Medicaid	4,135	45.4	31.0
California	Medicaid	1,693	46.7	26.1
Delaware	Medicaid, dual eligibles	26	47.9	33.4
Illinois	Medicaid, CHIP	618	41.7	23.1
Iowa	Medicaid	2	29.6	21.4
Louisiana	Medicaid, CHIP	128	52.3	38.4
Massachusetts	Medicaid, dual eligibles	1,060	50.3	35.6
Michigan	Medicaid	14	47.0	27.0
Minnesota	Medicaid, dual eligibles	26,872	53.0	38.7
Mississippi	Medicaid	4,686	37.3	21.5
Missouri	Medicaid, CHIP	89	43.7	26.7
New Hampshire	Medicaid	1,270	57.1	41.0
New York	Medicaid	1,267	52.0	37.6
North Carolina	Medicaid	22,854	46.5	31.2
South Carolina	Medicaid, CHIP	8,448	40.6	25.5
Vermont	Medicaid, CHIP	3,472	73.5	59.3
Washington	Medicaid	24,766	51.6	35.9
West Virginia	Medicaid, dual eligibles	19	57.3	39.9
Wisconsin	Medicaid	10,523	62.0	45.9
States reporting ages 18 and older
Connecticut	Medicaid, CHIP	13,524	61.3	44.6
District of Columbia	Medicaid, CHIP, dual eligibles	1,489	52.7	36.3
Florida	Medicaid	22,671	52.6	37.2
Hawaii	Medicaid, dual eligibles	3,734	50.3	34.5
Kansas	Medicaid, dual eligibles	5,023	50.7	33.8
Kentucky	Medicaid, dual eligibles	29,102	52.9	38.6
New Mexico	Medicaid	12,307	48.7	33.2
Ohio	Medicaid, CHIP	52,508	49.7	34.0
Pennsylvania	Medicaid	42,840	51.4	37.1
Rhode Island	Medicaid, CHIP	6,047	50.8	36.2
Tennessee	Medicaid	25,351	47.1	30.6
Texas	Medicaid	25,711	49.6	34.8
Utah	Medicaid, dual eligibles	472	47.2	29.2
Virginia	Medicaid, CHIP	NR	50.2	35.2
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020. NOTES: This measure identifies the percentage of adults age 18 and older diagnosed with major depression who were treated with antidepressant medication and remained on antidepressant medication treatment for the 12-week acute phase and the 6-month continuation phase. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs. Significance testing was not conducted for these estimates.

Table B.9.b. FUH-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018^a
	Population	Denominator	7-day Follow-up	30-day Follow-up
States reporting ages 21 to 64
Alabama	Medicaid	4,361	38.5	55.3
Arizona	Medicaid	8,352	41.4	61.7
Arkansas	Medicaid, CHIP, dual eligibles	2,474	31.7	53.3
California	Medicaid	27,690	54.4	67.0
Delaware	Medicaid, dual eligibles	1,206	30.5	47.3
District of Columbia	Medicaid, CHIP, dual eligibles	3,005	57.6	73.3
Georgia	Medicaid	8,131	31.9	51.5
Illinois	Medicaid, CHIP	24,055	26.4	42.5
Iowa	Medicaid	4,676	32.8	59.8
Louisiana	Medicaid, CHIP	13,879	17.3	39.3
Maryland	Medicaid, CHIP	4,898	38.4	60.3
Massachusetts	Medicaid, dual eligibles	8,975	52.7	74.0
Michigan	Medicaid	13,590	43.8	65.6
Minnesota	Medicaid, CHIP, dual eligibles	9,937	35.0	62.9
Mississippi	Medicaid	5,795	33.6	59.4
Missouri	Medicaid, CHIP	9,228	22.7	37.9
Nebraska	Medicaid, CHIP, dual eligibles	2,336	47.4	72.5
New Hampshire	Medicaid	1,633	53.6	71.7
New York	Medicaid	31,105	44.7	61.4
North Carolina	Medicaid	12,886	25.4	46.1
Oklahoma	Medicaid, dual eligibles	3,521	18.9	39.5
Oregon	Medicaid, dual eligibles	2,583	85.3	NR
Pennsylvania	Medicaid	30,453	34.9	56.0
South Carolina	Medicaid, CHIP	1,880	29.0	52.4
South Dakota	Medicaid, CHIP, dual eligibles	614	32.6	56.8
Vermont	Medicaid, CHIP, dual eligibles	1,305	51.0	69.8
Washington	Medicaid, dual eligibles	6,238	66.5	82.1
West Virginia	Medicaid, dual eligibles	3,847	10.0	33.7
Wisconsin	Medicaid	6,225	42.7	66.2
Wyoming	Medicaid, dual eligibles	128	39.8	57.8
States reporting other ages
Connecticut	Medicaid	8,049	51.0	70.4
Florida	Medicaid	39,041	30.5	51.1
Hawaii	Medicaid, dual eligibles	1,371	38.4	55.4
Kansas	Medicaid	5,031	59.0	76.5
Kentucky	Medicaid, dual eligibles	10,509	34.3	56.6
Nevada	Medicaid	4,896	32.7	49.8
New Jersey	Medicaid, CHIP	695	15.5	32.4
New Mexico	Medicaid	5,981	38.0	61.6
Ohio	Medicaid, CHIP	26,635	44.0	65.3
Rhode Island	Medicaid, CHIP	3,690	55.4	74.9
Tennessee	Medicaid	13,261	35.1	57.2
Texas	Medicaid	15,457	20.7	38.9
Utah	Medicaid, dual eligibles	1,416	61.3	75.9
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020. NOTES: Percentage of discharges for adults ages 21 and older who were hospitalized for treatment of selected mental illness diagnoses who received a follow-up visit with a MH practitioner within 7 days and 30 days after discharge. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs. Significance testing was not conducted for these estimates.

Table B.9.c. SAA-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018^a
State	Population	Denominator	Rate
Alabama	Medicaid	1,606	53.9
Arkansas	Medicaid, CHIP, dual eligibles	2,485	57.2
California	Medicaid	56,934	56.7
Connecticut	Medicaid, CHIP	4,446	68.1
Delaware	Medicaid, CHIP	463	52.7
District of Columbia	Medicaid, CHIP, dual eligibles	304	40.1
Florida	Medicaid	15,711	62.7
Hawaii	Medicaid	1,118	65.9
Illinois	Medicaid, CHIP	9,772	54.7
Iowa	Medicaid	929	37.5
Kentucky	Medicaid, dual eligibles	4,386	58.2
Louisiana	Medicaid, CHIP	9,533	47.4
Massachusetts	Medicaid	6,010	68.5
Michigan	Medicaid	14,307	59.1
Mississippi	Medicaid	3,288	57.4
Missouri	Medicaid, CHIP	7,532	64.9
Nebraska	Medicaid, CHIP, dual eligibles	981	54.4
Nevada	Medicaid	1,614	40.1
New Hampshire	Medicaid	428	79.7
New Mexico	Medicaid	2,912	54.3
New York	Medicaid	38,429	63.1
North Carolina	Medicaid	10,212	57.7
Ohio	Medicaid, CHIP	11,617	54.4
Pennsylvania	Medicaid	15,369	69.0
Rhode Island	Medicaid	1,333	66.2
South Carolina	Medicaid, CHIP	3,186	58.0
Tennessee	Medicaid	8,205	59.6
Texas	Medicaid	21,366	55.8
Utah	Medicaid	121	57.0
Vermont	Medicaid, CHIP	284	79.2
Virginia	Medicaid, CHIP	NR	67.0
Washington	Medicaid	3,677	64.2
West Virginia	Medicaid, dual eligibles	1,965	47.1
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement-performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020. NOTE: This measure identifies the percentage of adults ages 19-64 with schizophrenia who were dispensed and remained on an antipsychotic medication for at least 80% of their treatment period during the measurement year. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs. Significance testing was not conducted for these estimates.

Table B.9.d. SSD-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018^a
State	Population	Denominator	Rate
Alabama	Medicaid	7,103	77.1
Arkansas	Medicaid, CHIP, dual eligibles	4,618	76.9
California	Medicaid	89,764	75.3
Connecticut	Medicaid, CHIP	10,263	79.0
Delaware	Medicaid, CHIP	1,543	71.4
District of Columbia	Medicaid, CHIP, dual eligibles	859	69.0
Florida	Medicaid	23,697	80.8
Hawaii	Medicaid	3,320	72.1
Illinois	Medicaid, CHIP	17,664	91.5
Iowa	Medicaid	2,075	80.8
Kentucky	Medicaid, dual eligibles	12,013	83.1
Louisiana	Medicaid, CHIP	18,462	82.5
Massachusetts	Medicaid	14,552	80.6
Michigan	Medicaid	31,164	79.9
Mississippi	Medicaid	4,374	70.8
Missouri	Medicaid, CHIP	14,294	84.3
Nevada	Medicaid	3,781	79.4
New Hampshire	Medicaid	905	81.9
New Mexico	Medicaid	6,369	76.9
New York	Medicaid	60,518	79.6
North Carolina	Medicaid	19,177	76.3
Ohio	Medicaid, CHIP	29,641	80.2
Pennsylvania	Medicaid	15,568	88.1
Rhode Island	Medicaid, CHIP	3,118	79.6
South Carolina	Medicaid, CHIP	4,834	72.5
Tennessee	Medicaid	17,344	83.5
Texas	Medicaid	31,941	80.9
Utah	Medicaid	203	90.1
Vermont	Medicaid, CHIP	882	77.8
Virginia	Medicaid, CHIP	NR	82.2
Washington	Medicaid	8,724	85.2
West Virginia	Medicaid, dual eligibles	6,605	81.5
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020. NOTES: This measure identifies the percentage of adults ages 18-64 with schizophrenia or bipolar disorder who were dispensed an antipsychotic medication and who were screened for diabetes during the measurement year. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs. Significance testing was not conducted for these estimates.

Table B.9.e. Percentage of Children Ages 6-20 Hospitalized for Treatment of Mental Illness Who Received a FUH-CH for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018^a
State	Population	Denominator	7-day Follow-up	30-day Follow-up
Alabama	Medicaid	4,054	45.9	68.6
Alabama	CHIP	285	34.7	56.8
Alaska	Medicaid, CHIP	410	10.0	31.2
Arizona	Medicaid	4,358	61.2	77.7
Arkansas	Medicaid, CHIP	6,109	45.5	69.0
California	Medicaid, CHIP	13,826	67.8	80.4
Connecticut	Medicaid, CHIP	2,721	62.7	79.6
Delaware	Medicaid, CHIP	104	36.5	48.1
District of Columbia	Medicaid, CHIP	570	48.8	74.2
Florida	Medicaid, CHIP	40,165	30.6	51.2
Georgia	Medicaid, CHIP	6,585	38.3	64.7
Hawaii	Medicaid, CHIP	1,371	38.4	55.4
Illinois	Medicaid, CHIP	12,138	48.4	68.0
Indiana	Medicaid, CHIP	3,989	50.7	73.8
Iowa	Medicaid	3,763	40.6	67.5
Iowa	CHIP	384	50.5	82.6
Kansas	Medicaid, CHIP	5,031	59.0	76.5
Kentucky	Medicaid, CHIP	10,509	34.3	56.6
Louisiana	Medicaid, CHIP	6,076	40.3	63.0
Maine	Medicaid, CHIP	1,153	50.1	76.7
Massachusetts	Medicaid, CHIP	2,219	57.0	78.5
Michigan	Medicaid	4,202	55.0	74.5
Minnesota	Medicaid, CHIP	4,330	44.7	70.3
Mississippi	CHIP	268	37.7	66.0
Missouri	Medicaid, CHIP	4,203	34.5	56.4
Montana	CHIP	137	57.7	77.4
Nebraska	Medicaid, CHIP	1,506	29.7	63.9
Nevada	Medicaid	4,896	32.7	49.8
Nevada	CHIP	73	58.9	72.6
New Hampshire	Medicaid, CHIP	764	61.1	78.0
New Jersey	Medicaid, CHIP	695	15.5	32.4
New Mexico	Medicaid, CHIP	5,981	38.0	61.6
New York	Medicaid, CHIP	6,620	70.4	85.1
North Carolina	CHIP	425	39.3	63.5
Ohio	Medicaid, CHIP	26,635	44.0	65.3
Oklahoma	Medicaid, CHIP	6,058	27.2	51.2
Oregon	Medicaid, CHIP	474	81.4	NR
Pennsylvania	Medicaid, CHIP	11,944	51.3	74.2
Rhode Island	Medicaid, CHIP	3,690	55.4	74.9
South Carolina	Medicaid, CHIP	1,297	42.2	62.3
South Dakota	Medicaid, CHIP	1,071	23.3	42.7
Tennessee	Medicaid	13,261	35.1	57.2
Tennessee	CHIP	277	49.1	71.8
Texas	Medicaid	23,239	33.6	56.5
Texas	CHIP	1,379	34.7	55.6
Utah	Medicaid	1,416	61.3	75.9
Utah	CHIP	58	32.8	46.6
Vermont	Medicaid, CHIP	299	59.2	79.6
Virginia	Medicaid	NR	52.9	66.7
West Virginia	Medicaid	2,211	9.7	39.6
West Virginia	CHIP	93	21.5	55.9
Wyoming	Medicaid	398	53.3	76.4
Wyoming	CHIP	18	*	*
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-child-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020. NOTES: This measure identifies the percentage of children ages 6 to 20 hospitalized for treatment of selected mental illness diagnoses who received a follow-up visit with a MH practitioner within 7 days and 30 days after discharge. Dual eligibles = individuals enrolled in both the Medicaid and Medicare programs. Significance testing was not conducted for these estimates. * Rate not reported because denominator is less than 30.

C. CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

Table C.1. Mean Hourly Wage for Occupations Providing Behavioral Health Treatment, 2008-2018 (in dollars)^a
Occupation	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
All occupations	20.32	20.90	21.35	21.74	22.01	22.33	22.71	23.23	23.86	24.34	24.98
Substance abuse and behavioral disorder counselor^a	19.07	19.43	19.62	19.73	19.67	19.75	20.13	20.64	21.23	22.38^b	23.04^b
MH counselor^a	19.36	20.05	19.88	20.48	20.81	21.01	21.15	21.67	22.14	22.38^b	23.04^b
MH and substance abuse social worker	19.05	19.88	20.13	20.50	20.84	21.36	22.03	22.69	23.02	22.99	23.86
Marriage and family therapist	22.56	23.57	22.85	23.42	23.69	24.85	24.87	25.73	26.00	25.89	26.03
Psychiatrist	74.06	78.68	80.58	83.73	85.35	87.82	87.84	93.12	93.63	103.89	105.95
Psychiatric technician	15.48	14.77	15.15	15.08	15.93	16.09	16.91	17.44	14.89	17.34	18.15
Psychiatric aide	13.10	13.19	12.84	13.11	12.83	12.98	13.67	13.55	12.85	14.10	14.95
Clinical, counseling, and school psychologist	33.74	34.77	34.87	35.14	34.72	34.96	35.59	36.56	37.83	39.10	41.03
Industrial-organizational psychologist	41.57	49.31	54.82	59.69	47.50	42.29	43.30	44.38	39.79	49.29	52.42
Psychologist, all other	43.49	40.49	41.59	41.27	41.53	42.50	43.18	44.73	46.02	44.92	45.97
SOURCE: Bureau of Labor Statistics, Occupational Employment Statistics for May 2008-2018. Available at https://www.bls.gov/oes/tables.htm. Accessed on February 22, 2020. NOTE: The OES is a semiannual survey that assesses occupational employment and wage rates for wage and salary workers in nonfarm establishments in the United States. The OES survey draws its sample from state unemployment insurance files. Significance testing was not conducted for these estimates. The occupations for substance abuse and behavioral disorder counselor versus MH counselor were reported separately from 2008 to 2016 but together in 2017 and 2018.

Table C.2. Total Employment for Occupations Providing Behavioral Health Treatment, 2008-2018^a
Occupation	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Substance abuse and behavioral disorder counselor^a	79,180	78,470	77,940	76,600	80,130	83,120	85,180	87,090	91,040	241,930^b	267,730^b
MH counselor^a	104,650	106,920	110,300	114,180	115,080	115,580	120,010	128,200	139,820	241,930^b	267,730^b
MH and substance abuse social worker	131,010	127,140	119,960	115,390	109,920	110,010	109,460	110,070	114,040	112,040	116,750
Marriage and family therapist	24,520	26,450	33,050	33,990	34,270	29,060	30,150	32,070	36,960	42,880	48,520
Psychiatrist	22,140	22,210	22,690	23,140	24,210	25,040	25,080	24,060	24,820	25,250	25,630
Psychiatric technician	54,800	70,730	72,650	69,840	67,760	66,760	64,540	58,450	61,720	66,930	71,360
Psychiatric aide	59,050	62,610	64,730	71,570	77,880	75,340	72,860	69,550	67,410	65,770	56,910
Clinical, counseling, and school psychologist	97,880	98,330	100,700	100,850	103,590	104,480	104,730	105,600	107,980	108,060	110,490
Industrial-organizational psychologist	1,460	1,710	1,420	1,230	1,030	1,040	1,110	990	1,020	920	780
Psychologist, all other	9,870	10,260	10,690	10,580	10,350	10,870	11,980	12,400	13,310	12,880	13,480
SOURCE: Bureau of Labor Statistics, Occupational Employment Statistics for May 2008-2018. Available at https://www.bls.gov/oes/tables.htm. Accessed on February 22, 2020. NOTE: The OES is a semiannual survey that measures occupational employment and wage rates for wage and salary workers in nonfarm establishments in the United States. The OES survey draws its sample from state unemployment insurance files. The estimated total employment was rounded to the nearest 10 and excluded self-employed workers. Significance testing was not conducted for these estimates. The occupations for substance abuse and behavioral disorder counselor versus MH counselor were reported separately from 2008 to 2016 but together in 2017 and 2018.

Table C.3. Number and Percentage of Persons with Both a MDE in the Past Year and Either Marijuana Use in the Past Year or Alcohol Use in the Past Month Among Persons Ages 12-17, 2008-2018
	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Number (in thousands)
MDE in past year	2,027^a	1,954^a	1,911^a	2,011^a	2,213^a	2,587^a	2,751^a	3,031^a	3,089^a	3,214^a	3,482
MDE and marijuana use	485^a	472^a	481^a	523^a	547^a	664^a	664^a	675^a	751^a	724^a	878
MDE and alcohol use	509	473	460^a	482	503	490	556	524	508	524	558
MDE and binge alcohol use	NA	NA	NA	NA	NA	NA	NA	288	268	293	295
Percentage of persons age 12 to 17 with an MDE
MDE and marijuana use	23.9	24.2	25.2	26.0	24.7	25.7	24.1	22.3	24.3	22.5	25.2
MDE and alcohol use	25.1	24.2	24.1	24.0	22.7	18.9	20.2	17.3	16.4	16.3	16.0
MDE and binge alcohol use	NA	NA	NA	NA	NA	NA	NA	9.5	8.7	9.1	8.5
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for the number of persons ages 12-17 with an MDE are from Table 11.2A. Estimates for number of persons age 12-17 with MDE and marijuana, alcohol, or binge alcohol use are from Table 11.6A. Percentages for each year and substance use category were calculated by dividing the number of persons with MDE and the use of each substance by the total number with MDE in the past year. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect11pe2018.htm. Accessed February 21, 2020. NOTE: The definition used for MDE is consistent with the DSM-V. Individuals were defined as having had a past-year MDE if in the past 12 months they reported at least 5 or more of the following 9 symptoms nearly every day (except where noted) in the same 2-week period, and at least 1 of the symptoms was a depressed mood or loss of interest or pleasure in daily activities: (1) depressed mood most of the day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day; (3) significant weight loss when not dieting, or weight gain, or decrease or increase in appetite; (4) insomnia or hypersomnia; (5) psychomotor agitation or retardation; (6) fatigue or loss of energy; (7) feelings of worthlessness; (8) diminished ability to think or concentrate, or indecisiveness; and (9) recurrent thoughts of death or recurrent suicide ideation. Recurrent thoughts of death or suicidal ideation did not need to occur nearly every day. Consistent with the DSM-V criteria, the NSDUH does not exclude MDEs that occurred exclusively in the context of bereavement. Binge use of alcohol was defined for females as drinking 4 or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) and for males as drinking 5 or more drinks on the same occasion. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

Table C.4. Number and Percentage of Persons with Mental Illness and a SUD in the Past Year Among Persons Age 18 and Older, by Age Group, 2015-2018
Category	Any Mental Illness				Serious Mental Illness
Category	2015	2016	2017	2018	2015	2016	2017	2018
Mental illness (number in thousands)
Total	43,421^a	44,652^a	46,632	47,635	9,765^a	10,360^a	11,190	11,373
18 to 25	7,574^a	7,635^a	8,849	8,944	1,756^a	2,035^a	2,566	2,619
26 to 49	20,589^a	20,903^a	22,256	22,721	4,896^a	5,279^a	5,580	5,907
50 and older	15,257	16,114	15,527	15,969	3,113	3,047	3,044	2,848
SUD and mental illness (number in thousands)
Total	8,069^a	8,249^a	8,526	9,187	2,323^a	2,627^a	3,092	3,166
18 to 25	2,060^a	2,123^a	2,376	2,447	593^a	711^a	947	879
26 to 49	4,285^a	4,462^a	4,369^a	5,020	1,307^a	1,421^a	1,584	1,726
50 and older	1,725	1,663	1,782	1,720	422	496	562	560
Percentage of those with mental illness who have a SUD
Total	18.6	18.5	18.3	19.3	23.8	25.4	27.6	27.8
18 to 25	27.2	27.8	26.9	27.4	33.8	34.9	36.9	33.6
26 to 49	20.8	21.3	19.6	22.1	26.7	26.9	28.4	29.2
50 and older	11.3	10.3	11.5	10.8	13.6	16.3	18.5	19.7
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for any mental illness are from Table 10.1A and for serious mental illness are from Table 10.3A. Estimates for any mental illness and a SUD and for serious mental illness and a SUD are from Table 10.6A. Percentages were calculated by dividing the number with a SUD and mental illness by the total number with mental illness for each year and age group. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. NOTE: Any mental illness and serious mental illness aligned with the criteria of the DSM-IV were defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental disorder or SUD. Estimates of serious mental illness are a subset of estimates of any mental illness because serious mental illness is limited to persons with any mental illness that resulted in serious functional impairment. These mental illness estimates were based on a predictive model and thus were not direct measures of diagnostic status. For the number with mental illness and the number with a SUD and mental illness, the difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

D. DESCRIPTION OF DATA SOURCES

This appendix briefly describes the five data sources that we used to develop the analyses in this report.

1. National Survey of Substance Abuse Treatment Services (N-SSATS)

The N-SSATS is an important source for analyzing trends in clients who are receiving specialty substance use disorder (SUD) treatment as well as trends in SUD treatment facility characteristics. It is an annual survey of the universe of specialty SUD treatment facilities. Counts of clients in care (on the last working day in March of each survey year) were collected annually through 2013 and biannually thereafter. Key strengths of the survey include its comprehensiveness in terms of the inclusion of facilities and the types of information collected. The N-SSATS, which includes all known specialty SUD treatment facilities in the United States, consistently achieves response rates greater than 90 percent and there is no adjustment for the roughly 10 percent of facilities that do not respond. This allows for detailed analysis of small states or subgroups.

However, N-SSATS data are limited in several ways. Specifically, the N-SSATS excludes nonspecialty providers, solo practitioners, and facilities that serve only criminal justice populations. The exclusion of solo practitioners might be particularly important to analysis of programs such as those implementing hub-and-spoke models, which seek to increase treatment access at nonspecialty providers. The exclusion of facilities that serve only criminal justice populations might limit the potential for analyzing programs for people exiting criminal justice institutions; however, many of these people might be served by facilities included in the N-SSATS. The N-SSATS does include information on whether facilities have programs that focus on criminal justice clients (excluding programs for those convicted of driving under the influence or driving while intoxicated).

The N-SSATS estimates presented in this report were directly extracted from N-SSATS reports and special tabulations.

2. National Mental Health Services Survey (N-MHSS)

The N-MHSS is an annual census of facilities that provide mental health services. This survey collects information on the characteristics of the facilities in the U.S. mental health treatment delivery system and is an important source of data, as it is the only national and state-level survey of public and private facilities that provide mental health services. The data collected by the N-MHSS covers several topics including: what services facilities are providing, the characteristics of the facilities providing services, and the types of clients receiving services. These data allow for comparisons in service availability and utilization across states, facility characteristics, and client characteristics.

The major limitation of the N-MHSS is that it is a survey for a certain point in time, instead of representing annual totals. The survey is for a reference date and provides information based on the mental health treatment delivery system around that time. Additionally, the survey typically achieves responses rates around 90% and there is no adjustment for the roughly 10% of facilities that do not respond.

3. National Survey on Drug Use and Health (NSDUH)

The NSDUH is designed to track the prevalence of SUDs in the United States by type of substance. The NSDUH is an annual survey of the civilian, noninstitutionalized population ages 12 and older in the United States. As a population survey, it provides the most comprehensive information about the number of people who met the diagnostic criteria for a SUD, who misused prescription opioids, and who accessed any SUD treatment service in the past year. The NSDUH includes a sufficient sample of respondents to develop state-level estimates when two years of survey data are combined; however, standard errors for estimates are often quite large for smaller states--which makes it impossible to identify small changes in a disorder's prevalence or treatment use.

There are a number of limitations to the NSDUH survey data. The NSDUH provides limited information on the type of substance use treatment services that respondents received and no information on the intensity of services received. The survey excludes people who are homeless and not in a shelter as well as those who are institutionalized, such as those residing in hospitals, residential treatment settings, jails, or prisons. However, the NSDUH includes individuals who have been released from prison or institutional care. Overall, estimates of the prevalence of alcohol and illicit drug use disorders based on the NSDUH reflect the household population only. Thus, the NSDUH is likely to understate national prevalence because groups with high prevalence are excluded. In addition to the exclusion of subpopulations that have a higher prevalence of SUDs (Office of Applied Studies 2002), the self-reported nature of the data collection likely results in some underreporting (Harrell 1997).

Substance Abuse and Mental Health Services Administration (SAMHSA) redesigned the NSDUH between the 2014 and 2015 surveys. Due to methodological changes associated with the redesign, estimates from 2015 and later years are not comparable to earlier years. Updates to the prescription drug questions were a key component of the redesign (CHBSQ 2015):

Beginning in 2015, questions about prescription drugs were restructured to collect more information on the use and misuse of specific prescription drugs. The definition of misuse was also changed, with respondents being given more specific examples of misuse. In particular, before 2015, the definition of misuse did not include overuse of prescribed medication.
Methamphetamine was included as a prescription stimulant before 2015. However, most methamphetamine that is used in the United States is manufactured illegally, not prescribed. Therefore, beginning in 2015, a new methamphetamine module was added to address both prescription and nonprescription use.
To help respondents categorize substances, the term "Molly" was added to questions about Ecstasy use in the hallucinogens module and the use of felt tip pens and computer keyboard cleaner were added to the inhalants' module.

The redesign also affected the abuse and dependence modules in the following key ways:

The logic for routing individuals to the substance abuse and dependence modules was updated.
Sedative withdrawal was updated to require two or more symptoms of withdrawal instead of one or more.
Dependence and abuse questions were added for methamphetamine.

The NSDUH estimates presented in this report were directly extracted from NSDUH reports prepared by SAMHSA or from summarized data presented in those reports.

4. Treatment Episode Data Set (TEDS)

Relative to the N-SSATS and the NSDUH, the TEDS provides more detailed information on treatment services and the characteristics of clients at admission and discharge. The TEDS aggregates admissions data collected in individual state administrative data systems. States collect these data to monitor their SUD treatment systems. Reporting requirements can vary substantially by state. Generally, facilities that receive public funds or that are licensed or certified by a state substance abuse agency are included in state administrative systems. The universe of their admissions is reported to the TEDS. The scope of facilities that report to the TEDS in each state may change over time.

5. Transformed Medicaid Statistical Information System (T-MSIS) SUD Data Book

The SUD Data Book is a report to Congress that provides useful information related to the prevalence and treatment of SUDs in state Medicaid populations. The SUD Data Book focuses on Medicaid and Children�s Health Insurance Program (CHIP) enrollees age 12 or older who have been diagnosed with a SUD. It includes information on enrollment categories; the types of SUD treatment services received; the setting where services were received; the payment models for services received; the utilization of services; and whether treatments in inpatient or residential settings were followed up in an outpatient, home-based, or community-based setting within 30 days of discharge.

The data in the SUD Data Book comes from the T-MSIS Analytic Files (TAF), which are constructed from monthly data reported by state Medicaid programs to the Centers for Medicare & Medicaid Services on Medicaid and CHIP enrollments, service utilization, payments, providers, and other information. The TAF, and therefore the SUD Data Book, have limitations due to the newness of the T-MSIS reporting system and data quality issues. The quality of the SUD Data Book is expected to improve over time as the T-MSIS reporting improves.

Analyses of Disability, Aging and Long-Term Care Policy and Data

These reports summarize results from BHDAP work examining recent trends in mental health (MH) and substance use disorder (SUD) treatment needs, unmet needs, and system capacity to provide treatment. The reports synthesize data from a variety of existing sources including the National Mental Health Services Survey (N-MHSS), the National Survey of Substance Abuse Treatment Services (N-SSATS), the Treatment Episode Data Set (TEDS), and quality measurement data submitted to the Centers for Medicaid & Medicare Services. Overall, results indicate increasing numbers of individuals with unmet need for MH treatment, very high utilization rates for inpatient and residential MH treatment, and low rates of follow-up for individuals after hospitalization for mental illness. Taken together, these findings suggest that the MH treatment system may not have sufficient capacity to treat current rates of treatment need. The reports also highlight recent increases in the delivery of SUD treatment provided in private doctor’s offices and specialty outpatient settings, and the delivery of medication assisted treatment. Analyses also suggest that SUD prevalence rates have declined among adolescents and young adults, while rates have remained constant, or increased, among adults aged 26 or older. However, rates of unmet need for SUD treatment also remain very high.

Reports Available

Has Treatment for Substance Use Disorders Increased? Issue Brief

Chartbook on Behavioral Health Treatment Demand and Provider Capacity in the United States

Mental Health Treatment Need and Treatment System Capacity Issue Brief

Age Group Differences in Progress toward Reducing Substance Use Disorders, 2015-2018 Issue Brief

To obtain a printed copy of these reports, send the full report title and your mailing information to:

U.S. Department of Health and Human Services
Office of Behavioral Health, Disability, and Aging Policy
Room 424E, H.H. Humphrey Building
200 Independence Avenue, S.W.
Washington, D.C. 20201
FAX: 202-401-7733

Topics

Behavioral Health | Mental Health | Service Delivery & Capacity Building

Location- & Geography-Based Data

National Data

Chartbook on Behavioral Health Treatment Demand and Provider Capacity in the United States

TABLE OF CONTENTS

ACRONYMS

A. SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

B. MENTAL HEALTH TREATMENT DEMAND AND CAPACITY

C. CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

D. DESCRIPTION OF DATA SOURCES

Analyses of Disability, Aging and Long-Term Care Policy and Data

ASPE.hhs.gov

Chartbook on Behavioral Health Treatment Demand and Provider Capacity in the United States

TABLE OF CONTENTS

ACRONYMS

A. SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

B. MENTAL HEALTH TREATMENT DEMAND AND CAPACITY

C. CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

D. DESCRIPTION OF DATA SOURCES

Analyses of Disability, Aging and Long-Term Care Policy and Data

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