Over 1 million Americans are seeking treatment for substance use disorder—here's how it breaks down in Hawaii

In 2020, more than 41 million Americans were classified as needing treatment for substance use, including 28 million with alcohol use disorder, 18 million with an illicit drug use disorder, and 6.5 million with both, according to the Substance Abuse and Mental Health Services Administration.

Over 97% of those 41 million did not believe that treatment was necessary. Perhaps this is, in part, why on a given day in 2020, just 2.7% of people were receiving treatment, including hospital inpatients, non-hospital residential clients, and outpatient clients who were seen at a facility for a substance use treatment, detoxification, or methadone or buprenorphine maintenance, or naltrexone treatment.

Citing one-day census data from the National Survey of Substance Abuse Treatment Services and state population data from the U.S. Census Bureau, Zinnia Health identified the total number who received treatment—1,090,357 people (328.5 per 100,000) nationally, including 39,271 patients under 18— in each state and Washington D.C. This survey was taken on March 31, 2020, amid the start of COVID-19-related shutdowns. This is likely a contributing factor for states that saw significant decreases in people seeking treatment.

Those suffering from substance use disorders (SUD) have been severely impacted by the pandemic. According to the National Council for Behavioral Health, 54% of facilities that offered SUD services were shut down in September 2020, and 65% of those that remained open had to disrupt vital, often life-saving, services due to financial and operational hardships. From alcohol to opioids, substance use was both a way to cope with, and a behavior exacerbated by, the pandemic. In March 2020, opioid overdoses jumped 18% compared to the same period the previous year. Overdose deaths involving any drug rose by 30% in the first year of the pandemic.

Since the 1990s, opioids have been at the forefront of the substance use crisis in America—a deadly problem so pervasive that it is lowering the average life expectancy of Americans at a rate not previously seen since the country simultaneously faced World War I and the 1918 influenza pandemic. In the past 22 years, more than 1 million people have died of a drug overdose, according to the National Center for Health Statistics.

Opioids began as an imperfect solution to pain management, followed by a period of negligent, profit-driven practices of false marketing and over-prescribing by physicians and pharmaceutical companies like Purdue Pharma. When newly imposed regulations made prescription painkillers too expensive or too difficult to get, heroin use—and related deaths—increased.

While statistics around SUDs are often grim, the most important statistic is a positive one. Recent studies have shown that 75% of people with a SUD eventually enter recovery. Read on to see how the rates of people seeking treatment and the number of facilities providing SUD services have changed over the decade in your state, or check out the national story here.

Hawaii by the numbers

- Patients seeking treatment: 3,354 (-24.9% change since 2011)
--- Patients seeking treatment per 100k residents: 230.5 (-29.8% lower than national average)
- Patients under 18 seeking treatment: 494 (-63.7% change since 2011)
- Total facilities: 161 (+35.3% change since 2011)

Today, America finds itself in a third wave, or iteration, of the opioid epidemic. This wave is characterized by a rise in usage and overdose deaths from deadlier synthetic opioids like fentanyl—a substance 50 times stronger than heroin. From 2013 to 2019, the synthetic opioid-involved death rate jumped by more than 1,000%. That’s an increase from 3,105 to 36,359 lives lost. Since 1999, more than half a million people have died from overdoses involving opioids.

There is rising awareness of opioid use and in some states, Narcan vending machines dispense drugs to treat opioid overdose. The share of all facilities that offered medication-assisted treatment, such as drugs to curb withdrawal symptoms and drugs to block opioid-induced highs, increased from 9% in 2010 to 36% in 2020—indicative of the severity and prevalence of the country’s drug epidemic. Private for-profit facilities increased from 30% to 41% in the same timeframe. It is estimated that treatment and rehabilitation centers were a $42 billion industry in the U.S in 2020 alone.

Keep reading to see how treatment rates for SUDs have changed in other states near you.

California by the numbers

- Patients seeking treatment: 70,034 (-47.2% change since 2011)
--- Patients seeking treatment per 100k residents: 177.1 (-46.1% lower than national average)
- Patients under 18 seeking treatment: 2,287 (-82.1% change since 2011)
- Total facilities: 1,734 (+5.8% change since 2011)

Oregon by the numbers

- Patients seeking treatment: 20,268 (-12.5% change since 2011)
--- Patients seeking treatment per 100k residents: 478.3 (45.6% greater than national average)
- Patients under 18 seeking treatment: 841 (-49.1% change since 2011)
- Total facilities: 247 (+5.1% change since 2011)