Public and Private Financing 

States Considering Parity Legislation

Lawmakers in New Jersey are considering legislation to mandate insurance benefits to cover alcohol, substance abuse and mental health treatment. The bill, SB 807, passed the Senate in December and cleared an Assembly Committee in early May, meaning it could be up for a vote in a matter of weeks. Under the bill, insurance companies must provide treatment for these conditions under the same terms and conditions as all other illnesses. While 46 states currently have some form of parity law, none have the unlimited coverage proposed by the New Jersey bill. Current state law only requires coverage for biological mental illnesses, such as schizophrenia.

In Louisiana, Senator Ben Nevers introduced SB 93, which would have added mental illness treatment to the state’s list of mandated benefits. The state previously had a mandated benefit for substance abuse, but this bill would have required payment from insurance companies for substance abuse and mental health treatment to be on par with those of other covered benefits.  The bill passed the Senate, but failed in the House Insurance Committee.

Criminal Justice Interventions

Criminal Justice Drug Abuse Treatment Studies

The National Institute on Drug Abuse has established the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) as a cooperative research program to explore the issues related to the complex system of offender treatment services. Researchers, criminal justice professionals and drug abuse treatment practitioners joined together to create nine research centers and a coordinating center. Please go to http://www.cjdats.org

Treatment Services

States Considering Needle Exchange Programs

Congress is currently considering action to allow the District of Columbia to establish a needle exchange program. The House Appropriations Subcommittee on Financial Services and General Government recently voted to remove long-standing language from a D.C. appropriations bill that bars the city from using taxpayer money to finance needle exchange programs. The language was added to a federal appropriations bill and signed into law by former President Bill Clinton in 1998. Congress renewed that language in subsequent D.C. appropriations bills. Now Representative Jose Serrano, chairman of the subcommittee, has made removal of the language a priority. The impetus is to help counter the alarming rise in the number of HIV/AIDS cases in D.C. For example, according to the Centers for Disease Control and Prevention, D.C. saw 128 new AIDS cases per 100,000 residents in 2005, compared to the national average of 13.7 cases per 100,000 people. Injection drug use is the second leading cause of new cases among men in the District and accounts for one-third of all new HIV cases. D.C. Mayor Adrian Fenty has already said that he will provide the funds for needle exchanges as soon as Congress acts. Presently, there is one needle exchange program in the District, Prevention Works!. The effort is financed entirely by private donations and reaches approximately one-third of the 9,700 injection drug users in the city. “It's politically obscene to have Congress tell the District of Columbia that it can't use local funds for something like needle-exchange programs, which have been proven to have major effects on fighting a deadly disease,” said Representative Serrano on the House Floor.

At the same time, California has decided it will directly fund needle exchange programs within its borders. The state Office of AIDS will provide $75,000 a year over the next three years to fund 10 different programs throughout the Golden State. Current California law bars the use of state money for the purchase of syringes, so the programs will instead use the funds for operating costs and to expand hours of operation and the number of locations. The Assembly also is currently considering AB 110, which would drop the prohibition of using state funds for clean needles.

Substance Abuse Treatment Research Show Risks for Girls

Although girls ages 12-17 made up less than one-third of adolescent treatment admissions in 2005, they began treatment at a younger age than boys and were more likely to have a co-occurring psychiatric disorder, according to a new report by the Substance Abuse and Mental Health Services Administration.

And while both boys and girls were most often admitted for marijuana treatment, girls were more likely than boys to report alcohol or inhalants as their primary substance of abuse.

Adolescent Treatment Admissions by Gender: 2005 shows that, in 2005, there were about 142,600 admissions of adolescents ages 12-17 to substance abuse treatment programs. About 44,600 (31 percent) of those admissions were for girls, and 98,000 (69 percent) were for boys. Data for the report comes from SAMHSA’s Treatment Episode Data Set, which reports numbers of admissions rather than numbers of individuals, as a person may be admitted to treatment more than once.

Adolescents admitted with a psychiatric problem in addition to a substance abuse problem were counted as having a co-occurring disorder. Girls were more likely to have such co-occurring disorders, which were reported in 23 percent of the female admissions compared with 18 percent of the male admissions.

Marijuana was listed as the primary substance of abuse for 51 percent of female admissions and 72 percent of male admissions. While alcohol and inhalants ranked second and third respectively for both girls and boys, these substances were more likely to be the primary substance of abuse for girls. Alcohol accounted for 23 percent of female admissions vs. 16 percent of male admissions, and inhalants accounted for 12 percent of female admissions vs. 4 percent of male admissions. Cocaine, opiates and other drugs accounted for about 14 percent for girls, compared with 8 percent for boys.

For all substances except inhalants, the number of admissions increased with age for both girls and boys. For most of the adolescent admissions for inhalants, treatment began prior to age 16. Treatment began even younger – prior to age 14 – for nearly a third of the female admissions for inhalants (29 percent) compared with about 21 percent of the male admissions for inhalants.

Girls were more likely than boys to enter treatment before age 16 for alcohol (44 percent of female admissions vs. 30 percent of male admissions) and for marijuana (47 percent vs. 39 percent).

While the most common referral to treatment for both sexes was the criminal justice system, girls were less likely than boys to enter treatment by this route (39 percent vs. 55 percent). Treatment admissions in which the client was referred by an individual person, such as a family member, were more common for girls (21 percent) than boys (16 percent).

TEDS is an annual compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment, primarily at facilities that receive public funding.

Adolescent Treatment Admissions by Gender: 2005 is available on the Web at http://oas.samhsa.gov/2k7/youthTX/youthTX.cfm. Copies may be obtained free of charge by calling SAMHSA’s Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727). Request inventory number DASISRPT07-0524. For related publications and information, visit http://www.samhsa.gov/.

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