|July 9, 2004|
Discharges from Detoxification: 2000
This report examines discharge data in the Treatment Episode Data Set (TEDS).1 TEDS is comprised of two major components, the Admissions Data System and the Discharge Data System. Both admission and discharge data come primarily from facilities that receive some public funding.
States are asked to submit data for all discharges from substance abuse treatment. In 2000, 18 States2 submitted 347,923 records for clients discharged from treatment. Nearly all of these records (94 percent) could be linked to a TEDS admission record. These 326,750 linked admission/discharge records are referred to as treatment episodes. Of these episodes, over 99 percent (323,156) had a valid response for reason for discharge.
This report presents data on the 23 percent (73,564) of episodes that represent clients who received detoxification services (Table 1). Facilities offering detoxification services care for clients experiencing withdrawal. The large majority of detoxification discharges (95 percent) were from free-standing residential facilities; the remaining discharges were nearly evenly divided between ambulatory (3 percent) and hospital (2 percent) settings.3
Reasons for Discharge
Despite relatively short stays for this kind of service, only about half (52 percent) of detoxification episodes resulted in completion (Figure 1). An additional 8 percent of detoxification discharges transferred to further substance abuse treatment. The remaining detoxification episodes involved clients who left against professional advice (29 percent), whose services were terminated by the facility (9 percent), or who were discharged for other reasons (2 percent).
Primary Substance of Abuse
Alcohol was the most common primary substance of abuse4 in completed detoxification episodes, accounting for nearly half (49 percent) of such episodes (Figure 2).
Opiates were the primary substance in 34 percent of completed detoxification episodes. Among completed detoxification episodes, alcohol and opiates were followed by cocaine (12 percent), stimulants (2 percent), marijuana (2 percent), and other substances (1 percent).
The detoxification completion rate was highest, at 54 percent, for episodes involving alcohol as the primary substance of abuse (Figure 3). Completion rates for episodes involving cocaine, opiates, and stimulants were similar (51, 49, and 49 percent, respectively). Detoxification episodes involving marijuana/hashish as the primary substance were least likely to be completed, at 38 percent. This may in part reflect a higher rate of transfer to further treatment (25 percent) for marijuana than for other substances. Despite their 49 percent completion rate, detoxification episodes involving opiates as the primary substance were substantially more likely to end with the client leaving against medical advice (40 percent of opiate episodes) than was the case for all other substances (24 percent of all other episodes).
Median Length of Stay
Since detoxification services are specifically intended to treat withdrawal, the median length of stay is short. The median length of stay for completed detoxification episodes was 4 days, with the highest median length of stay for opiates (6 days) (Figure 4).
1 For an earlier report on TEDS discharges, see Substance Abuse and Mental Health Services Administration, Office of Applied Studies. The DASIS report: Treatment completion in the Treatment Episode Data Set (TEDS). Rockville, MD. January 30, 2003.
2 States included are CA, GA, HI, IA, IL, MA, MD, ME, MI, MN, MS, MT, NE, NM, OH, OK, UT, and WY.
3 Detoxification includes free-standing residential detoxification, ambulatory detoxification, and hospital detoxification. Residential detoxification facilities provide 24-hour per day services for safe withdrawal and transition to ongoing treatment in a non-hospital setting. Ambulatory detoxification facilities provide safe withdrawal in an ambulatory, i.e., non-24-hour setting. Hospital detoxification facilities provide 24-hour per day medical acute care services for persons with severe medical complications associated with withdrawal in a hospital setting. Because treatment completion rates and lengths of stay vary across modalities or types of treatment, reports on other modalities, including hospital inpatient, outpatient, intensive outpatient, short-term residential, and long-term residential treatment, are being presented in other DASIS reports.
4 The primary substance of abuse is the main substance reported at the time of admission.
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