Highlights

Treatment Completion
Median Length of Stay (LOS)
Client Characteristics
Client Characteristics Associated with Treatment Completion or Transfer to Further Treatment

This report presents results from the Treatment Episode Data Set (TEDS) for clients discharged from substance abuse treatment in 2005. The report provides information on treatment completion, length of stay in treatment, and demographic and substance abuse characteristics of approximately 1.5 million discharges from alcohol or drug treatment in facilities that report to individual State administrative data systems.

The TEDS Discharge Data System was designed to enable TEDS to collect information on entire treatment episodes. States are asked to submit data for all discharges from substance abuse treatment. Discharge data, when linked to admissions data, represent treatment episodes that enable analyses of questions that cannot be answered with admissions data alone (e.g., the proportion of discharges who completed treatment and the average length of stay of treatment completers).

TEDS is an admission-based system, and TEDS admissions do not represent individuals. Thus, for example, an individual admitted to treatment twice within a calendar year would be counted as two admissions.

TEDS does not include all admissions to substance abuse treatment. It includes data from facilities that are licensed or certified by the State substance abuse agency to provide substance abuse treatment (or are administratively tracked for other reasons). In general, facilities reporting TEDS data are those that receive State alcohol and/or drug agency funds (including Federal Block Grant funds) for the provision of alcohol and/or drug treatment services.

• A total of 1,519,415 records for clients discharged in 2005 were submitted by 34 States. Ninety-six percent of these records (n = 1,454,768) could be linked to a TEDS admission record from 2002, 2003, 2004, or 2005 [Tables 2.2a and 2.2b].
• The linked records for clients discharged in 2005 were similar demographically, by service type, and by primary substance to records for all clients admitted in 2005 [Table 2.1b].
  
• Alcohol was the primary substance reported at treatment admission for 38 percent of the linked 2005 discharges. Nineteen
  percent reported opiates, 15 percent reported marijuana, 14 percent reported cocaine, 10 percent reported stimulants, and 4 percent reported other substances [Table 2.1b].
  
• Treatment was completed by 41 percent of the linked 2005 discharges. Thirteen percent were transferred to further treatment, 24 percent dropped out of treatment, 8 percent had treatment terminated by the facility, 2 percent had treatment terminated because of incarceration, less than 1 percent died, and 7 percent failed to complete treatment for other reasons. The reason for discharge was unknown for 6 percent of discharges [Table 2.4b].*
• Of the 1,370,716 discharges who reported reason for discharge, 43 percent were discharged from outpatient treatment, 23 percent from detoxification, 10 percent from intensive outpatient treatment, 9 percent each from short-term residential treatment and long-term residential treatment, 6 percent from opioid replacement therapy, and 1 percent from hospital residential treatment [Table 2.5 and Figure 2.1].*
• Of the 75,682 opioid replacement therapy clients who reported reason for discharge, 65 percent were discharged from outpatient opioid replacement therapy, 31 percent from opioid replacement detoxification, 2 percent each from long-term residential treatment and short-term residential treatment, and less than 1 percent from hospital residential treatment [Table 2.6].
  

• The treatment completion rate (44 percent for all discharges) was highest among clients discharged from hospital residential treatment (67 percent), detoxification (65 percent), and short-term residential treatment (56 percent). In longer-term and less structured settings, the treatment completion rate was lower—39 percent from long-term residential treatment and 36 percent from intensive outpatient treatment and outpatient treatment. The completion rate was lowest (19 percent) among discharges from opioid replacement therapy [Table 2.5 and Figure 2.2].
  
• In opioid replacement therapy, the treatment completion rate (19 percent overall) was 11 percent from outpatient opioid replacement therapy and 35 percent from opioid replacement detoxification [Table 2.6].
  

• Among discharges not receiving opioid replacement therapy, the median LOS in treatment was greatest for discharges from outpatient treatment (76 days), followed by long-term residential treatment (53 days) and intensive outpatient treatment (46 days). The median LOS from short-term residential treatment was 21 days; from hospital residential treatment, 16 days; and from detoxification, 3 days [Table 2.5].
  
• Among discharges not receiving opioid replacement therapy, the median LOS in treatment was longest (117 days) among discharges who completed outpatient treatment. This was followed by 90 days among discharges completing long-term residential treatment, intensive outpatient treatment (59 days), short-term residential treatment (25 days), hospital residential treatment (19 days), and detoxification (4 days) [Table 2.5 and Figure 2.3].
  
• Among opioid replacement therapy discharges, the median LOS was longest (128 days) among outpatient opioid replacement therapy discharges. The median LOS was 9 days among opioid replacement detoxification discharges, and was between 8 days and 69 days for opioid replacement therapy discharges from the other service types [Table 2.6].
  
• Among opioid replacement therapy discharges completing treatment, the median LOS was longest (180 days) among clients completing outpatient opioid replacement therapy. The median LOS was 7 days among clients completing opioid replacement detoxification, and was between 5 days and 108 days for clients completing other opioid replacement therapy service types [Table 2.6].
  

Client Characteristics

The most common characteristics among all discharges combined were:

• Sixty-eight percent of discharges were male.
• Fifty-six percent were non-Hispanic White.
• The largest age groups were 31 to 40 years (29 percent), 21 to 30 years (26 percent), and 41 to 50 years (25 percent). Fourteen percent were under age 21, and 9 percent were over age 50.
• Alcohol was the most common primary substance, reported by 39 percent.
• Forty-three percent of discharges reported daily use of their primary substance.
• The most common age group for initiating use of the primary substance was between 15 and 17 years.
• Forty-five percent of discharges had never been in treatment before.
• Thirty-five percent of discharges were referred to treatment by the criminal justice system; 34 percent were self- or individually referred.
• Forty-four percent of all discharges were not in the labor force.
• Forty-four percent reported completing 12 years of education or a GED [Table 2.7].

Client Characteristics Associated with Treatment Completion or Transfer to Further Treatment

Two of the Reason for discharge categories, treatment completion and transfer to further substance abuse treatment, represent positive conclusions to a treatment episode. To examine the client characteristics associated with treatment completion or transfer to further treatment, univariate logistic regression and multiple conditional logistic regression analyses were conducted [footnote, Chapter 2].

Univariate analyses of discharges from all service types combined identified client characteristics that were significantly associated with treatment completion or transfer to further treatment [Table 2.8a].

All of the client characteristics that were significantly associated with treatment completion or transfer to further treatment in the univariate analyses remained significantly associated the multivariate analysis. However, the association was weakened for most client characteristics when adjusted for the presence of the other client characteristics in the model [Table 2.8b and Figure 2.5]:

For all discharges combined, the strongest predictor of treatment completion or transfer to further treatment was the use of alcohol rather than other drugs. Clients discharged from all types of service combined were 82 percent more likely to complete treatment or to transfer to further treatment if their primary substance was alcohol, after taking into account all other characteristics associated with that outcome.

Alcohol use as a predictor of treatment completion or transfer to further treatment was followed by daily substance use (21 percent), being over 40 at admission (19 percent), having 12 or more years of education (14 percent), being White (13 percent), referral to treatment by the criminal justice system (9 percent), being employed (7 percent), and being male (5 percent).

* Percentages do not sum to 100 percent because of rounding.


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