Chapter 3
Trends in Client Characteristics

This chapter presents trends in client characteristics for 2002 to 2006. It should be kept in mind, however, that the facility universe, methods, and survey instrument have changed during this period. These changes are detailed in Appendix A.

Number of Clients

Table 3.1. The number of clients in treatment on the survey reference date was about the same in 2006 (1,130,881) as it had been in 2002 (1,136,287).

Facility Operation

Table 3.1 and Figure 5. The proportion of clients in facilities operated by private non-profit organizations remained constant between 2002 and 2006 at 55 to 56 percent, although the total number of clients in these facilities decreased by 2 percent, from 637,835 in 2002 to 623,604 on March 31, 2006. The number and proportion of clients in private for-profit facilities increased by 13 percent, from 291,122 (26 percent of all clients) in 2002 to 328,763 (29 percent of all clients) on March 31, 2006. The proportion of clients in local government-operated facilities fell 21 percent between 2002 and 2006 from 112,820 (10 percent of all clients) to 89,960 (8 percent of all clients). The number of clients in Federal government-operated facilities fell 10 percent, from 40,637 (4 percent of all clients) to 36,660 (3 percent of all clients). The proportions of clients in State and tribal government-operated facilities remained constant between 2002 and 2006, at 4 percent of all clients and 1 percent of all clients, respectively.

Type of Care Received

Table 3.2 and Figure 6. The proportions of clients in treatment for the major types of care—outpatient, non-hospital residential, and hospital inpatient—were stable between 2002 and 2006. Clients in outpatient treatment made up the majority of clients (89 to 90 percent) between 2002 and 2006. There were 1,008,915 clients (89 percent of all clients) in outpatient treatment on March 31, 2006. The proportion of clients in non-hospital residential treatment ranged from 9 to 10 percent between 2002 and 2006, and there were 107,790 (10 percent of all clients) in non-hospital residential treatment on March 31, 2006. The proportion of clients in hospital inpatient treatment was constant, at 1 percent between 2002 and 2006, and there were 14,176 clients in hospital inpatient treatment on March 31, 2006.

Clients Receiving Methadone

Table 3.2 and Figure 6. The proportion of clients receiving methadone fluctuated between 20 percent and 23 percent in the period 2002 to 2006. There were 258,752 clients (23 percent of all clients) receiving methadone on March 31, 2006. Clients receiving methadone could be in any of the three major types of care—outpatient, non-hospital residential, or hospital inpatient.

Substance Abuse Problem Treated

Table 3.3. Clients in treatment for both drug and alcohol abuse made up just under half of all clients between 2002 and 2006, ranging from 46 to 48 percent. On March 31, 2006, there were 521,067 clients (46 percent of all clients) in treatment for both alcohol and drug abuse. The proportion of clients treated for drug abuse only increased from 31 percent in 2002 to 35 percent in 2006, while the proportion of clients treated for alcohol abuse only declined from 21 percent in 2002 to 18 percent in 2006.

Managed Care

Table 3.4 and Figure 7. In general, the term “managed care” refers to the prepaid health care sector where care is provided under a fixed budget within which costs are “managed.” The trends in the proportion of clients in facilities with agreements or contracts with managed care organizations were grossly similar to those for the proportion of facilities with such agreements or contracts [Table 2.4]. On March 31, 2006, 49 percent of all clients were in facilities with managed care agreements or contracts, and 47 percent of facilities had such agreements or contracts. This represented a decrease from 2002, when 53 percent of all clients were in facilities with managed care agreements or contracts, and 51 percent of facilities had such agreements or contracts. Between 2002 and 2006, the proportion of clients in facilities with managed care agreements or contracts declined for all facility operations except for tribal government, where it increased from 18 percent to 37 percent, and Federal government-operated facilities, where the proportion with managed care agreements or contracts fell from a high of 16 percent in 2003 to 8 percent in 2005, then rebounded to 12 percent in 2006.

Clients under Age 18 in Treatment

Table 3.5 and Figure 8. On March 31, 2006, there were 91,873 clients under age 18 in treatment. These represented 8 percent of all clients, a proportion which was stable from 2002 through 2006.

The majority of clients under age 18 were in treatment facilities offering special programs or groups for adolescents. The proportion in such a group ranged from 91 percent in 2002 (when special programs for adolescents were probably over-reported; see Chapter 2, pages 16-17) to between 83 and 85 percent from 2003 to 2006. On March 31, 2006, there were 76,874 clients under age 18 (84 percent of all clients under age 18) in treatment facilities offering special programs or groups for adolescents.

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