Chapter 3
Outpatient Treatment Discharges: 2005

Chapter 3 presents data on the reasons for discharge and length of stay (LOS) in treatment for the 592,057 linked admission/discharge records of clients discharged from outpatient treatment in 2005 in 33 States [Table 3.1]. Outpatient treatment in this chapter includes outpatient care other than intensive outpatient treatment (Chapter 4), outpatient detoxification (Chapter 8), and opioid replacement outpatient therapy (Chapter 9).

Table 3.1 and Figure 3.1 present the distribution of reasons for discharge among discharges from outpatient treatment. Overall, 212,078 (36 percent) of outpatient discharges completed treatment, 73,652 (12 percent) were transferred to further treatment, 171,454 (29 percent) dropped out of treatment, 62,556 (11 percent) had treatment terminated by the facility, and 72,317 (12 percent) failed to complete treatment for other reasons. Table 3.1 also presents reason for discharge by State.

Figure 3.1
Reason for discharge from outpatient treatment: TEDS 2005

Pie chart comparing Reason for discharge from outpatient treatment in TEDS 2005

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Figure 3.2, Table 2.5, and Appendix Table C.1. The median LOS for outpatient treatment was 76 days. The average (mean) LOS was longer, 117 days (standard deviation, 147). The average LOS was longer than the median LOS for all reasons for discharge and for all client characteristics [Tables 3.2-3.11].

Figure 3.2
Median and average lengths of stay in outpatient treatment, by reason for discharge: TEDS 2005

Bar chart comparing Median and average lengths of stay in outpatient treatment, by reason for discharge in TEDS 2005

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Outpatient clients who completed treatment remained in treatment longer (median LOS was 117 days) than clients who did not complete treatment. Among clients transferred to further treatment, the median LOS was 34 days; among clients who dropped out of treatment, it was 45 days; among those whose treatment was terminated by the facility, it was 64 days; and among those who failed to complete treatment for other reasons, it was 69 days.

In comparison with all discharges combined, clients discharged from outpatient treatment were [Table 2.7]:

Gender

Table 3.2 and Figure 3.3. Sixty-eight percent of clients discharged from outpatient treatment were male.

Males were more likely to complete outpatient treatment or to transfer to further treatment (49 percent, combined) than were females (47 percent).

Females who completed outpatient treatment had a longer median LOS (120 days) than did males who completed outpatient treatment (115 days).

Figure 3.3
Outpatient treatment completion or transfer to further treatment, by gender: TEDS 2005

Bar chart comparing Outpatient treatment completion or transfer to further treatment, by gender in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Age at Admission

Table 3.3 and Figure 3.4. The largest age group among clients discharged from outpatient treatment was ages 21 to 30 at admission (29 percent), followed by ages 31 to 40 (24 percent). Twenty percent each were ages 41 to 50 and under age 21. Seven percent were over age 50.

Clients over age 50 were most likely to complete outpatient treatment or to transfer to further treatment (54 percent). The combined completion/transfer rates for the younger age groups varied little and were 47 percent or 49 percent.

The median LOS among clients completing outpatient treatment displayed no consistent pattern with age and was between 104 days and 123 days.

Figure 3.4
Outpatient treatment completion or transfer to further treatment, by age at admission: TEDS 2005

Stacked bar chart comparing Outpatient treatment completion or transfer to further treatment, by age at admission in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Race/Ethnicity

Table 3.4 and Figure 3.5. Fifty-eight percent of clients discharged from outpatient treatment were non-Hispanic White, 22 percent were non-Hispanic Black, 15 percent were of Hispanic origin, and 5 percent were of other racial/ethnic groups.

Non-Hispanic Whites were most likely to complete outpatient treatment or to transfer to further treatment (51 percent). The combined completion/transfer rate was 44 percent among clients of Hispanic origin and 43 percent among non-Hispanic Blacks.

The median LOS among clients completing outpatient treatment was longest (138 days) among clients of Hispanic origin. It was shortest (111 days) among non-Hispanic Whites.

Figure 3.5
Outpatient treatment completion or transfer to further treatment, by race/ethnicity: TEDS 2005

Stacked bar chart comparing Outpatient treatment completion or transfer to further treatment, by race/ethnicity in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Primary Substance

Table 3.5 and Figure 3.6. Thirty-nine percent of clients discharged from outpatient treatment reported alcohol as their primary substance of abuse at admission. Marijuana was reported by 24 percent, cocaine by 13 percent, stimulants by 12 percent, opiates by 7 percent, and other substances by 6 percent.*

Clients reporting alcohol as their primary substance were most likely to complete outpatient treatment or to transfer to further treatment (56 percent). The combined completion/transfer rates for the other specific substances were between 46 percent (marijuana) and 41 percent (cocaine).

The median LOS among clients completing outpatient treatment was longest (137 days) among those reporting stimulants as their primary substance of abuse. It was shortest (for specific substances) among those reporting marijuana (111 days).


* Percentages do not sum to 100 percent because of rounding.
Figure 3.6
Outpatient treatment completion or transfer to further treatment, by primary substance: TEDS 2005

Stacked bar chart comparing Outpatient treatment completion or transfer to further treatment, by primary substance in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Frequency of Use

Table 3.6 and Figure 3.7. Forty-one percent of clients discharged from outpatient treatment reported no use of their primary substance in the month before entering treatment, while 20 percent reported daily use at admission.

Clients reporting less frequent substance use were more likely to complete outpatient treatment or to transfer to further treatment than were clients reporting more frequent substance use. The combined completion/transfer rate was highest (52 percent) among those reporting no substance use in the month before entering treatment. The rate declined as frequency of substance use increased and was 43 percent among those reporting daily substance use.

The median LOS among clients completing outpatient treatment displayed no consistent pattern with frequency of substance use and was between 112 days and 127 days.

Figure 3.7
Outpatient treatment completion or transfer to further treatment, by frequency of substance use: TEDS 2005

Stacked bar chart comparing Outpatient treatment completion or transfer to further treatment, by frequency of substance use in the past month in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Age at First Use*

Table 3.7 and Figure 3.8. The peak age at first use of the primary substance among clients discharged from outpatient treatment was 15 to 17 years (32 percent). Sixteen percent did not begin use until they were over age 21, and 14 percent began use at age 12 or younger.

Clients who began use of their primary substance at ages 18 to 21 had the highest combined rates of outpatient treatment completion or transfer to further treatment (55 percent). The combined completion/transfer rates were lowest among those whose use began at age 12 or younger and after age 21 (47 percent each).

The median LOS among clients completing outpatient treatment was longest (121 days) among those whose substance use began at over age 21. It displayed no consistent pattern among clients whose use began at younger ages and was between 108 days and 114 days.


* Age at first use of the primary substance was reported for 78 percent of clients discharged from outpatient treatment.

Figure 3.8
Outpatient treatment completion or transfer to further treatment, by age at first use: TEDS 2005

Stacked bar chart comparing Outpatient treatment completion or transfer to further treatment, by frequency of substance use in the past month in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Prior Treatment

Table 3.8 and Figure 3.9. Fifty-three percent of clients discharged from outpatient treatment had never been in treatment before, while 5 percent had been in treatment five or more times before.

Clients with no prior treatment episodes were most likely to complete outpatient treatment or to transfer to further treatment (53 percent). The combined completion/transfer rate fell to 49 percent among those with one prior treatment episode, to 47 percent among those with two prior episodes, to 44 percent or 45 percent among those with three or four prior episodes, and to 41 percent among those with five or more prior episodes.

The median LOS among clients completing outpatient treatment was shortest (114 days) among those with no prior treatment episodes but
displayed no consistent pattern with the number of prior treatment episodes and was between 127 days and 143 days.

Figure 3.9
Outpatient treatment completion or transfer to further treatment, by number of prior treatment episodes: TEDS 2005

Stacked bar chart comparing Outpatient treatment completion or transfer to further treatment, by number of prior treatment episodes in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Treatment Referral Source

Table 3.9 and Figure 3.10. Fifty-three percent of clients discharged from outpatient treatment were referred to treatment by the criminal justice system, 22 percent were self- or individual referrals, 14 percent were referred by community sources, 6 percent by alcohol/drug abuse care providers, and 5 percent by health care providers.

Clients referred to treatment by the criminal justice system were most likely to complete outpatient treatment or to transfer to further treatment (54 percent). The combined completion/transfer rate was lowest for self- or individual referrals and referrals by health care providers (40 percent each).

The median LOS among clients completing outpatient treatment was longest (133 days) for referrals by alcohol/drug abuse care providers. It was shortest (107 days) for self- or individual referrals.

Figure 3.10
Outpatient treatment completion or transfer to further treatment, by treatment referral source: TEDS 2005

Stacked bar chart comparing Outpatient treatment completion or transfer to further treatment, by treatment referral source in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Employment Status

Table 3.10 and Figure 3.11. Thirty-nine percent of clients age 16 and older discharged from outpatient treatment were employed either full time or part time, 32 percent were not in the labor force, and 29 percent were unemployed.

Clients who were employed were most likely to complete outpatient treatment or to transfer to further treatment (55 percent). The combined completion/transfer rates were 45 percent among those who were unemployed and 44 percent among those who were not in the labor force.

The median LOS among clients completing outpatient treatment was longest (121 days) among those who were not in the labor force. It was shortest (113 days) among those who were unemployed.

Figure 3.11
Outpatient treatment completion or transfer to further treatment, by employment status: TEDS 2005

Stacked bar chart comparing Outpatient treatment completion or transfer to further treatment, by employment status in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

Education

Table 3.11 and Figure 3.12. Forty-four percent of clients age 18 and older discharged from outpatient treatment had 12 years of education or a GED, 34 percent had fewer than 12 years of education, and 22 percent had more than 12 years of education.

Clients with more education were more likely to complete outpatient treatment or to transfer to further treatment than were clients with less education. The combined completion/transfer rate was highest (54 percent) among those with more than 12 years of education. It declined to 50 percent among clients with 12 years of education or a GED and to 45 percent among clients with fewer than 12 years of education.

The median LOS among clients completing outpatient treatment was longest (121 days) among those with fewer than 12 years of education. It was shortest (118 days) among those with more than 12 years of education.

Figure 3.12
Outpatient treatment completion or transfer to further treatment, by years of education: TEDS 2005

Stacked bar chart comparing Outpatient treatment completion or transfer to further treatment, by years of education in TEDS 2005

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.03.06.

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