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ABOUT THE SURVEY
The Department of Social and Health Services (DSHS), Division of
Alcohol and Substance Abuse (DASA) received a federal grant from the
Substance Abuse and Mental Health Services Administration, Center
for Substance Abuse Treatment to conduct a statewide household
survey to determine the need for substance abuse treatment among
Washington adults. Data were collected from February 2003 through
February 2004. The Research and Data Analysis Division (RDA) of DSHS
conducted the project on behalf of DASA. Telephone interviews were
performed by Washington State University’s Social and Economic
Sciences Research Center. The survey achieved a response rate of 50
percent and a cooperation rate of 69 percent. The sample was
weighted to U.S. Census data to provide direct statewide estimates
of substance use and the need for substance abuse treatment
services. Population Groups for Analysis
Overall prevalence estimates are provided for three primary
populations of interest:
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All adult household residents: Household residents aged 18+,
regardless of income.
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Adults above 200% FPL: Household residents aged 18+ living above
200 percent of the federal poverty level.
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Adults at or below 200% FPL: Household residents aged 18+ living
at or below 200 percent of the federal poverty level.
In Washington State, 24 percent of adult household residents are
at or below 200 percent of the federal poverty level.
Measures of Substance Use
The survey measured use of alcohol, tobacco, and illicit drugs.
Measures of substance use include having: a) ever used a substance
(lifetime use), b) used a substance in the past 12 months, and c)
used a substance in the past 30 days. Need for Treatment
The survey also assessed current need for alcohol or drug treatment.
Respondents were classified as having a current need for treatment
if they met any of the following four conditions:
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Reported symptoms of lifetime Diagnostic and Statistical
Manual of Mental Disorders, 4th Edition (DSM-IV) alcohol or drug
abuse or dependence, reported at least one symptom in the past 12
months, and used alcohol or drugs in the past 12 months. See pages 3-2
and 3-3 in the state report for a description of the DSM-IV
substance abuse and dependence criteria.
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Received professional alcohol or drug treatment
(excluding
detoxification) during the past 12 months.
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Reported having a problem with alcohol or drugs and used alcohol
or drugs regularly during the past 12 months. Regular alcohol use
was defined as having 3 or more drinks at least one day per week.
Regular drug use was defined as using marijuana 34 or more times
in the past 12 months or as using other illicit drugs 8 or more
times in the past 12 months.
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Reported heavy use of alcohol or drugs during the past 12
months. Heavy alcohol use was defined as having 4 or more drinks
per drinking day, 3 or more days per week during the past 12
months. Heavy drug use was defined as using any illicit substance
34 or more times during the past 12 months.
Most respondents (72 percent) determined to need substance
abuse treatment met the first condition.
Measuring
Treatment and Penetration Rates
To measure treatment use and estimate treatment penetration, the
WANAHS data are supplemented by data from DASA’s Treatment
Assessment Report Generation Tool (TARGET), a database of services
provided under DSHS funded programs. Clients used to calculate the
treatment penetration rate were selected based on the following
conditions:
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Eligible treatment was limited to residential, outpatient,
and methadone services. Clients who received detoxification or
transitional housing services were not included.
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Clients had to reside in a personal residence or a
group/foster home. The homeless or institutionalized were not
included in these client counts.
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Treatment had to be funded by DASA. Clients who paid for
services through private funds or had their treatment paid for
by the Department of Corrections or non-DASA state funds were
not counted.
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Clients had to receive treatment services during the 2003
calendar year.
In addition, penetration rates are calculated only for
lower-income adults who are estimated to be eligible for DASA-funded
services. Adults eligible for DASA-funded services include persons at or below 200 percent of the federal poverty level who need
substance abuse treatment and who do not have primary private health
insurance, Basic Health Plan coverage, or military health insurance.
This represents a change from previous reports using 1993-94
household survey data. Previously, all adult household residents
living at or below 200 percent of the federal poverty level who
needed substance abuse treatment were included in the
penetration rate calculation, regardless of their health
insurance coverage status. The net result of this change is that
the 2003 treatment penetration rate estimates will be higher
than earlier estimates.
Race/Ethnicity Categories
The race/ethnicity groups used for most state estimates are
consistent with federal Office of Management and Budget
guidelines. WANAHS respondents were read a list of five races:
White, Black or African American, American Indian or Alaska
Native, Native Hawaiian or Other Pacific Islander, and Asian.
Respondents were asked to indicate whether they considered
themselves to belong to one or more of these groups. In a
separate question, survey respondents were asked “Are you
Hispanic or Latino(a)?” Respondents indicating they were
Hispanic, regardless of whether they indicated other races, were
classified as Hispanic. Non-Hispanic respondents indicating more
than one race were all classified as 2+ Races.
A different race classification system was used
for the county-level estimates and the state treatment
penetration estimates. For these, respondents who indicated they
belonged to more than one race or ethnic group were assigned to
a single category in the following order:
Hispanic
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Black or African American
White
Asian
For example, respondents indicating that they
were both American Indian and Black were categorized as American
Indian. Similarly, respondents indicating they were both
Hispanic and White were classified as Hispanic.
Hispanics were listed first, consistent with
current U.S. Census conventions, and the subsequent ordering was
determined based on an examination of need for treatment
patterns among adults reporting two or more races. It was
necessary to use this simplified race/ethnicity classification
to calculate the treatment penetration rates. This is because
penetration rates are calculated by combining need for treatment
estimates with TARGET treatment data and very few TARGET clients
are identified as belonging to more than one race. Due to the differences in the race groups used to
construct state and county-level population weights, we have
suppressed the state race/ethnicity population counts in the
county supplemental tables. |
