Description of the Treatment Episode Data Set (TEDS)
Limitations of TEDS
Interpretation of the Data
This report presents results from the Treatment Episode Data Set (TEDS) for 2001, and
trend data for 1992-2001. The report provides
information on the demographic and substance abuse characteristics of the 1.7 million annual
admissions to treatment for abuse of alcohol and drugs in
facilities that report to individual State administrative
data systems. The Office of Applied Studies,
Substance Abuse and Mental Health Services
Administration (SAMHSA), coordinates and manages
collection of TEDS data from the States. (Additional
information on TEDS, its history, and its relationship
to SAMHSA's other data collection activities can
be found in Appendix A.)
The TEDS system is comprised of two major components, the Admissions Data System and
the Discharge Data System. The TEDS Admissions Data System is an established program that
has been operational for over 10 years. It includes
data on treatment admissions that are routinely
collected by States to monitor their individual substance
abuse treatment systems. The TEDS Discharge Data
System is relatively new. For both data systems, selected data items from the individual State
data files are converted to a standardized format
consistent across States. These standardized data constitute TEDS.
The TEDS Admissions Data System consists of a Minimum Data Set collected by all States, and
a Supplemental Data Set collected by some States. The Minimum Data Set consists of 19 items
- Demographic information
- Primary, secondary, and tertiary substances
and their route of administration, frequency of
use, and age at first use
- Source of referral to treatment
- Number of prior treatment episodes
- Service type, including planned use of
The Supplemental Data Set includes 15 items
that include psychiatric, social, and economic measures.
The TEDS Discharge Data System was designed to enable TEDS to collect information on
entire treatment episodes. Discharge data, when
linked to admissions data, represent treatment
episodes that enable analyses of questions that cannot be
answered with admissions data alone. Currently about 25 States are submitting discharge data
or are actively preparing to submit data. Enlistment
of States into the system is ongoing, with
participation by all States that collect discharge data
expected within 12 months.
Definitions and classifications used in the
Admissions Minimum and Supplemental Data Sets and the Discharge Data Set are detailed in Appendix B.
Limitations of TEDS
TEDS, while comprising a significant proportion
of all admissions to substance abuse treatment,
does not include all such admissions. TEDS is a
compilation of facility data from State
administrative systems. The scope of facilities included in TEDS
is affected by differences in State licensure,
certification, accreditation, and disbursement of public
funds. For example, some State substance abuse
agencies regulate private facilities and
individual practitioners, while others do not. In some
States, hospital-based substance abuse treatment
facilities are not licensed through the State substance
abuse agency. Some State substance abuse agencies
track correctional facilities (State prisons and local
jails), while others do not.
In general, facilities reporting TEDS data
receive State alcohol and/or drug agency funds
(including Federal Block Grant funds) for the provision of
alcohol and/or drug treatment services. (See
Chapter 4.) Most States are able to report all admissions
to all eligible facilities, although some report only
admissions financed by public funds. States may report data from facilities that do not receive
public funds, but generally do not because of the
difficulty in obtaining data from these facilities. TEDS
generally does not include data on facilities operated
by Federal agencies, including the Bureau of
Prisons, the Department of Defense, and the Department
of Veterans Affairs. However, some facilities
operated by the Indian Health Service are included.
The primary goal of TEDS is to monitor the characteristics of treatment episodes for
substance abusers. Implicit in the concept of treatment is
a planned, continuing treatment regimen. Thus TEDS does not include early intervention programs
that are considered to be prevention programs.
Crisis intervention facilities such as sobering-up
stations and hospital emergency departments generally
are not included in TEDS.
Interpretation of the Data
TEDS is an exceptionally large and powerful
data set. Like all data sets, however, care must be
taken that interpretation does not extend beyond the
limitations of the data. Limitations fall into two
broad categories: those related to the scope of the
data collection system, and those related to the
difficulties of aggregating data from highly diverse
State data collection systems.
Limitations to be kept in mind while analyzing
TEDS admissions data include:
- 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 attempts to enumerate treatment
episodes by distinguishing the initial admission of a client from his/her subsequent transfer to
a different service type (for example, from residential treatment to outpatient) within a
single continuous treatment episode. However,
States differ greatly in their ability to identify
transfers; some can distinguish transfers within
providers but not across providers. (See Chapter 4
and Table 4.1.) Some admission records in fact may represent transfers, and therefore the
number of admissions reported probably
overestimates the number of treatment episodes.
- The number and client mix of TEDS
admissions do not represent the total national demand
for substance abuse treatment or the prevalence of substance abuse in the general population.
- The primary, secondary, and tertiary
substances of abuse reported to TEDS are those substances that led to the treatment episode,
and not necessarily a complete enumeration of all drugs used at the time of admission.
- States continually review the quality of their
data processing. When systematic errors are identified, States may revise or replace
historical TEDS data files. While this process
represents an improvement in the data system, the
historical statistics in this report will differ slightly
from those in earlier reports.
Considerations specific to this report include:
- The report includes admissions records for
calendar years 1992-2001 that were received and processed by SAMHSA through May
31, 2003. SAMHSA, in reporting national-level TEDS data, must balance timeliness of
reporting and completeness of the data set. This
can result in a time lag in the publication of
annual data because preparation of the report is
delayed until nearly all States have completed their data submission for that year.
Summary statistics for 2002 for those States that
have completed their 2002 submissions are
available on-line at:
(Click on DASIS.)
- States rely on individual facilities to report in
a timely manner so they can in turn report data to SAMHSA at regular intervals. Admissions
from facilities that report late to the States may
appear in a later data submission to SAMHSA. Thus the number of admissions reported
for 2001 may increase by 5 percent or more as submissions of 2001 data continue.
However, additional submissions are unlikely to have
a significant effect on the percentage
distributions that are the basis of this report.
- The report focuses on treatment admissions
for substance abusers. Thus admissions for treatment as a codependent of a substance
abuser are excluded. Records for identifiable
transfers within a single treatment episode are also
- Records with partially complete data have
been retained. Where records include missing or
invalid data for a specific variable, that record is excluded from tabulations of that
variable. The total number of admissions on which a
percentage distribution is based is reported in
- Variables in the Supplemental Data Set
(Tables 3.6-3.9) are not collected by all States.
States that did not collect a specific variable are
excluded from tabulations of that variable. The total number of admissions on which a
percentage distribution is based is reported in
- Primary alcohol admissions are
characterized as alcohol only or alcohol with
secondary drug. Alcohol with secondary
drug indicates a primary alcohol admission with a
specified secondary drug. All other alcohol
admissions are classified as alcohol only.
- Cocaine admissions are classified according
to route of administration as smoked and
other route. Smoked cocaine primarily
represents crack or rock cocaine, but can also
include cocaine hydrochloride (powder cocaine)
when it is free-based. Non-smoked cocaine includes all cocaine admissions where the route of
administration is not smoked, including admissions where the route of administration is
not collected. Thus the TEDS estimate of admissions for smoked cocaine is conservative.
admissions include admissions for both substances, but
are primarily for methamphetamine. Three States (Arkansas, Oregon, and Texas) do not
distinguish between methamphetamine and amphetamine admissions. However, for the States
that make this distinction, methamphetamine
constitutes about 94 percent of combined methamphetamine/amphetamine admissions.
- For this report, secondary and tertiary
substances (see Appendix B) are grouped and
referred to as secondary substances.
- Tables 2.3-2.7 and 4.5 and Figures 3-7
show trends in State admission rates. Data were
not submitted for one or more years in some States or jurisdictions because of changes to their
data collection systems. These States were:
Arizona (1992-1997), the District of Columbia
(1992-1993), Indiana (1997 and 2001), Kentucky (1992-1996), Mississippi (1992-1994),
West Virginia (1994, 1997-1998, and 2000-2001), and Wyoming (1995-1996).
In four States, significant changes in the
clients or facilities reported to TEDS from
1992-2001 resulted in changes in the number of
admissions large enough to influence trends. For
these States, rates are not indicated on Figures
3-7 for the years affected: Ohio (1999-2001),
Texas (1992-1995), Virginia (1996-1999), and West Virginia (1996). The actual data reported,
however, are included in all tables.
- A total of 22 States submitted discharge
data for Year 2001. Therefore the data presented
in this report do not represent all discharges in
all States. As discharge records are added to the data set, a higher proportion of matching
admission records is expected.