Chapter 5

Client Characteristics

This chapter describes key characteristics of the 1,072,251 clients in substance abuse treatment on March 31, 2004. Clients in treatment were defined as: 1) hospital inpatient and non-hospital residential clients receiving substance abuse services on March 31, 2004, and 2) outpatient clients who were seen at the facility for a substance abuse treatment or detoxification service at least once during the month of March 2004, and who were still enrolled in treatment on March 31, 2004. The majority of tables in the report are organized according to facility operation and the primary focus of the facility. Facility operation indicates the type of entity responsible for the operation of the facility: private for profit; private non-profit; or government—local, county, or community; State; Federal; or tribal. Primary focus indicates the services the facility primarily provides: substance abuse treatment services, mental health services, a mix of mental health and substance abuse treatment services, general health care, or other.

Facility Operation and Primary Focus

Table 5.1. Fifty-five percent of the 1,072,251 clients in treatment on March 31, 2004, were in facilities operated by private non-profit organizations. Another 28 percent were in facilities operated by private for-profit organizations. Nine percent of clients were in local government-operated facilities, 4 percent in State government-operated facilities, 3 percent in Federal government-operated facilities, and 1 percent in facilities operated by tribal governments.

Two-thirds (68 percent) of all clients in treatment on March 31, 2004, were in facilities whose primary focus was the provision of substance abuse treatment services. An additional 23 percent were in facilities whose primary focus was a mix of both mental health and substance abuse treatment services. Five percent of clients were in facilities primarily focused on mental health services, and 2 percent were in facilities with a general health care focus.

Type of Care

Tables 5.2a, 5.2b, and 5.2c. The 2004 N-SSATS requested data on clients in treatment on March 31, 2004, who received:

The majority (89 percent) of clients in treatment on March 31, 2004, were enrolled in outpatient treatment. Nine percent were in non-hospital residential treatment, and 1 percent were in hospital inpatient treatment.

Table 5.2b. Of the 1,072,251 clients in treatment on March 31, 2004, 53 percent were in regular outpatient treatment, 21 percent were in outpatient methadone maintenance, 11 percent were in intensive outpatient treatment, 3 percent were in outpatient day treatment or partial hospitalization, and 1 percent were in outpatient detoxification. In addition, 7 percent of all clients were in non-hospital residential long-term treatment, 2 percent were in non-hospital residential short-term treatment, and 1 percent were in non-hospital residential detoxification. Clients in hospital inpatient treatment, both treatment and detoxification, accounted for 1 percent of all clients.

Clients in treatment at local or Federal government-operated facilities were most likely to be in regular outpatient care (68 percent and 61 percent, respectively). Clients in treatment at private non-profit facilities were more likely than clients in facilities operated by other entities to be receiving residential treatment (13 percent) and, more specifically, long-term residential treatment (10 percent).

In facilities focused primarily on providing substance abuse treatment services, 44 percent of clients were in regular outpatient care, 29 percent were in outpatient methadone maintenance, and 11 percent were in intensive outpatient care. In facilities whose focus was the provision of mental health services or a mix of mental health and substance abuse treatment services, 76 percent and 71 percent, respectively, of clients were in regular outpatient care. In facilities focused on the provision of general health care, 55 percent of clients were in regular outpatient care, 13 percent were in outpatient methadone maintenance, and 12 percent were in intensive outpatient care.

Table 5.2c. Clients in outpatient methadone maintenance or outpatient detoxification were most likely to be in private for-profit facilities—48 percent of all outpatient methadone maintenance clients and 47 percent of all outpatient detoxification clients. More than three-quarters (76 percent) of clients in non-hospital residential treatment (and 81 percent of clients in non-hospital residential long-term treatment) were in facilities operated by private non-profit organizations.

Substance Abuse Problem Treated

Table 5.3. On March 31, 2004, nearly half (46 percent) of all clients were in treatment for both alcohol and drug abuse. Thirty-four percent were in treatment for drug abuse only, and 20 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 (37 percent), and the highest proportion in treatment for drug abuse alone (45 percent). Clients in treatment for abuse of alcohol alone were found in the highest proportions in Federal government-operated facilities (38 percent overall and 70 percent in Department of Defense facilities).

Facilities focused on the provision of substance abuse treatment services had the  highest proportion of clients in treatment for abuse of drugs alone (40 percent), compared with a range of 19 percent to 22 percent in facilities focused on provision of other services. In turn, facilities focused on the provision of substance abuse treatment services had the smallest proportion of clients in treatment for abuse of alcohol alone (17 percent), compared with a range of 26 percent to 34 percent in facilities focused on provision of other services.

Clients Under Age 18

There were 91,112 clients under age 18 in substance abuse treatment on March 31, 2004, some 8 percent of the total 1,072,251 clients in treatment on that date.

Table 5.4. Clients under age 18 in substance abuse treatment on March 31, 2004, were more likely to be in private non-profit facilities than were the general client population (66 percent and 55 percent, respectively) [Table 5.1]. Private for-profit facilities accounted for 28 percent of all clients in treatment, but only 17 percent of clients under age 18.

Fifty-eight 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. One third (33 percent) of clients under age 18 were in facilities whose focus was provision of a mix of mental health and substance abuse services, compared to 23 percent of the total client population.

Table 5.5. Adolescents received types of care generally similar to the total treatment population [Table 5.2b]. Most (87 percent) were in outpatient treatment, 12 percent were in non-hospital residential treatment, and 1 percent were in hospital inpatient treatment.

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