Description of the Treatment Episode Data Set (TEDS)
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Limitations of TEDS
Interpretation of the Data
This report presents results from the Treatment Episode Data
Set (TEDS) for 2002, and trend data for 1992 to 2002. The report provides
information on the demographic and substance abuse characteristics of the 1.9
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 (OAS), 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 that include:
The Supplemental Data Set includes 15 items that include
psychiatric, social, and economic measures.
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 methadone
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. A separate TEDS 2002
Discharge Report will be issued later in the year.
Definitions and classifications used in the Admissions Minimum and
Supplemental Data Sets 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
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:
Considerations specific to this report 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.
- The report includes admissions records for calendar
years 1992-2002 that were received and processed by SAMHSA through March 01,
2004. 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:
- 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 2002 may increase by 5 percent or more as submissions of 2002
data continue. However, additional submissions are unlikely to have a
significant effect on the percentage distributions that are the basis of
- 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, those records are excluded from tabulations of that variable. The
total number of admissions on which a percentage distribution is based is
reported in each table.
- 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 each
- 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.
- Methamphetamine/amphetamine 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 95 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 2.3-2.8 and 4.5 and Figures 3-8 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), Kentucky (1992-1996), Mississippi (1992-1994), West Virginia
(1994 and 1997-1998), and Wyoming (1995-1996).
In four States, significant changes in the clients or facilities reported
to TEDS from 1992-2002 resulted in changes in the number of admissions large
enough to influence trends. For these States, rates are not indicated on
Figures 3-8 for the years affected: Ohio (1999-2002), Texas (1992-1995),
Virginia (1996-1999), and West Virginia (1996, 2000, and 2002). The actual
data reported, however, are included in all tables.