Chapter 4
Client Characteristics

Contents

Clients by Facility Ownership/Operation and Primary Focus

Clients by Type of Care

Clients by Substance Abuse Problem Treated

Clients Under Age 18

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This chapter describes key characteristics of clients in substance abuse treatment on March 29, 2002. Clients in treatment were defined as: 1) hospital inpatient and residential
clients receiving treatment (and not discharged) on the reference date, and 2) outpatient clients who received treatment during the prior 30 days and were still enrolled on the reference date. The major breakdowns used in this chapter are the two facility descriptors, ownership/operation and primary
focus. Ownership/operation indicates the type of entity responsible for the operation of the facility: private for-profit; private non-profit; or government (Federal, State, local, or tribal). Primary focus
indicates the services the facility primarily provides: substance abuse treatment services; mental health services; general health care; a mix of both mental health and substance abuse treatment services; or other.

Clients by Facility Ownership/Operation and Primary Focus

Table 4.1. Fifty-six percent of all clients in treatment on March 29, 2002, were in private non-profit facilities. Private for-profit facilities accounted for 26 percent of substance abuse treatment clients. The remaining 18 percent of clients were in government-operated facilities; slightly more than half of these clients were in facilities operated by local governments.

About two-thirds (68 percent) of all clients in treatment on March 29, 2002, were in a facility focused on the provision of substance abuse treatment
services. An additional 23 percent were in a facility whose focus was a mix of both mental health and substance abuse treatment services. Four percent of clients were in facilities with a primarily focus on mental health services, and 3 percent were in facilities with a general health care focus.

Clients by Type of Care

Tables 4.2a, 4.2b, and 4.2c. The 2002 N-SSATS requested data on clients in treatment on March 29, 2002, who received:

The majority of clients in treatment on March 29, 2002, (90 percent) were enrolled in some type of outpatient care: regular outpatient care (54 percent); methadone/LAAM maintenance (19 percent); intensive outpatient care (12 percent); day treatment/partial hospitalization (3 percent); or outpatient detoxification (2 percent). Some 8 percent of clients were in residential rehabilitation, and less than 1 percent were in hospital inpatient rehabilitation. Residential detoxification and hospital inpatient detoxification each accounted for less than 1 percent of clients.

There was considerable variation by both facility ownership/operation and primary focus in the distribution of clients in treatment across the types of care. In facilities operated by Federal, State, local, or tribal governments, between 60 percent and 75 percent of clients were in regular outpatient care. In private for-profit facilities, 48 percent of clients were in regular outpatient care and 33 percent were in outpatient methadone/LAAM maintenance. In private non-profit facilities, 54 percent of clients were in regular outpatient care and 12 percent were in residential rehabilitation.

In facilities whose focus was the provision of mental health services or a mix of mental health and substance abuse treatment services, 73 percent of all clients were in regular outpatient care. In facilities focused on the provision of substance abuse treatment, 47 percent of clients were in regular outpatient care, 26 percent were in outpatient methadone/LAAM maintenance, and 12 percent were in intensive outpatient care. In facilities focused on the provision of general health care services, 48 percent of clients were in regular outpatient care, 17 percent were in outpatient methadone/LAAM maintenance, and 16 percent were in intensive outpatient care.

Clients by Substance Abuse Problem Treated

Table 4.3. On March 29, 2002, nearly half (48 percent) of all clients were in treatment for both alcohol and drug abuse. Thirty-one percent were in treatment for drug abuse only, while the
remaining 21 percent were in treatment for alcohol abuse only.

Private for-profit facilities had the smallest proportion of clients in treatment for both alcohol and drug abuse (39 percent), and the highest proportion in treatment for drug abuse alone (39 percent). Clients in treatment for abuse of alcohol alone were found disproportionately in Federal government-operated facilities (37 percent overall and 66 percent in Department of Defense-operated facilities).

Generally, about half of clients were in treatment for both alcohol and drug abuse, regardless of the facility's primary focus. Facilities focused on substance abuse treatment had the highest proportion of clients in treatment for abuse of drugs alone (35 percent), compared with less than 25 percent each in facilities whose focus was mental health services, general health care, or a mix of mental health and substance abuse treatment services. Conversely, facilities focused on the provision of substance abuse treatment services had a smaller proportion of clients in treatment for abuse of alcohol alone (18 percent) than did facilities focused on provision of other services (26 percent to 30 percent).

Clients Under Age 18

Table 4.4. Clients under age 18 in substance abuse treatment on March 29, 2002, were more likely to be in private non-profit facilities than the total client population (65 percent and 56 percent, respectively; see Table 4.1). Private for-profit facilities accounted for 26 percent of all client admissions, but for 17 percent of clients under age 18.

Nearly 60 percent of clients under age 18 were in facilities focused on the provision of substance abuse treatment services, compared to 68 percent of all clients. Almost one third (31 percent) of clients under age 18 were in facilities whose focus was a mix of mental health and substance abuse services, compared to 23 percent of the total client population.

Table 4.5. Adolescents received types of care broadly similar to the total treatment population (see Table 4.2b). Most (88 percent) received outpatient treatment, 11 percent received residential treatment, and 1 percent received hospital inpatient treatment.

Table 4.6. Clients under age 18 made up 8 percent of all clients in treatment on March 29, 2002. This proportion varied according to facility ownership/operation, primary focus, and type of care. For example, 5 percent of clients in private for-profit facilities were under age 18. However, in private for-profit residential facilities, adolescents made up 20 percent of clients.

Tables