National Data and the Applicability to Understanding Rural and Remote Substance Use

Area of Science:

• Public Health
• Epidemiology
• Substance Abuse Research

Background:

• Accurate data are crucial for local public health experts to combat rising overdose, addiction, and substance misuse.
• National datasets, such as the National Survey on Drug Use and Health (NSDUH) and Treatment Episode Data Set (TEDS), are commonly used for state-level planning.
• The applicability of these national data sources for local-level addiction prevention and program planning remains a critical question.

Purpose of the Study:

• To evaluate the suitability of national data sources (NSDUH and TEDS) for local addiction prevention and program planning in Alaska.
• To assess the reliability of NSDUH prevalence estimates for understanding substance use patterns in specific regions.
• To determine if national data accurately reflect local substance use trends and inform effective interventions.

Main Methods:

• Applied NSDUH prevalence estimates (2015-2019) to Alaska's state population to estimate the number of substance users.
• Compared estimated prevalence over time with population data and treatment admissions to assess data efficacy.
• Analyzed the covariance between prevalence estimates, population changes, and treatment-seeking trends.

Main Results:

• NSDUH data showed annual variances in estimated heroin and methamphetamine users (1777 and 2143 persons, respectively) that did not correlate with population changes or treatment admission trends.
• Fentanyl, a primary driver of fatal overdoses in Alaska, was not assessed in the analyzed national datasets.
• NSDUH data collection methods exclude approximately 20% of Alaska's population, predominantly Native individuals in rural and remote areas, limiting its representativeness.

Conclusions:

• The findings do not support the use of NSDUH data for addiction prevention and program planning in Alaska, particularly in rural and remote areas.
• Significant data gaps, including the exclusion of key demographics and the omission of critical substances like fentanyl, hinder the utility of national datasets for local public health efforts.
• Alternative data collection methods and sources are needed to accurately assess substance use and inform targeted interventions in diverse and geographically challenging regions.