Chapter 9
Outpatient Opioid Replacement Therapy Discharges: 2005

Chapter 9 presents data on the reasons for discharge and length of stay (LOS) in treatment for the 49,209 linked admission/discharge records of clients discharged from outpatient opioid replacement therapy in 2005 in 28 States [Table 9.1]. Outpatient opioid replacement therapy in this chapter includes outpatient opioid replacement therapy other than opioid replacement de­toxification (Chapter 10).

Table 9.1 and Figure 9.1 present the distribution of reasons for discharge among discharges from outpatient opioid replacement therapy. The treatment completion rate for outpatient opioid replacement therapy was the lowest completion rate among all types of service. Overall, 5,340 (11 percent) of outpatient opioid replacement discharges completed treatment, 8,526 (17 percent) were transferred to further treatment, 21,923 (45 percent) dropped out of treatment, 6,222 (13 percent) had treatment terminated by the facility, and 7,198 (15 percent) failed to complete treatment for other reasons.* Table 9.1 also presents reason for discharge by State.


* Percentages do not sum to 100 percent because of rounding.
Figure 9.1
Reason for discharge from outpatient opioid replacement therapy: TEDS 2005

Pie chart comparing Reason for discharge from methadone 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 9.2, Table 2.6, and Appendix Table C.1. The median LOS for outpatient opioid replacement therapy was 128 days. The average (mean) was longer, 245 days (standard deviation, 288). The average LOS was longer than the median LOS for all reasons for discharge and for all client characteristics [Tables 9.2-9.11].

Figure 9.2
Median and average lengths of stay in outpatient opioid replacement therapy, by reason for discharge: TEDS 2005

Bar chart comparing Median and average lengths of stay in methadone 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 opioid replacement clients who completed treatment generally remained in treatment longer than clients who did not complete treatment. Among treatment completers, median LOS was 180 days and among clients transferred to further treatment, it was 125 days. Among clients who dropped out of treatment, the median LOS was 95 days; among those whose treatment was terminated by the facility, it was 195 days; and among those who failed to complete treatment for other reasons, the median LOS was 166 days.

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

Gender

Table 9.2 and Figure 9.3. Sixty-three percent of clients discharged from outpatient opioid replacement therapy were male.

Females were more likely to complete outpatient opioid replacement therapy or to transfer to further treatment (31 percent, combined) than were males (26 percent).

Males who completed outpatient opioid replacement therapy had a slightly longer median LOS (181 days) than did females who completed outpatient opioid replacement therapy (178 days).

Figure 9.3
Outpatient opioid replacement therapy completion or transfer to further treatment, by gender: TEDS 2005

Stacked bar chart comparing methadone 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 9.3 and Figure 9.4. The largest age group among clients discharged from outpatient opioid replacement therapy was ages 41 to 50 at admission (32 percent), followed by ages 31 to 40 (30 percent) and ages 21 to 30 (21 percent). Thirteen percent were over age 50, and 3 percent were under age 21.*

The proportions of clients who completed outpatient opioid replacement therapy or transferred to further treatment varied little with age and were between 28 percent and 30 percent.

The median LOS among clients completing outpatient opioid replacement therapy was longest (188 days) among clients aged 41 to 50. It was shortest (115 days) among clients under age 21.


* Percentages do not sum to 100 percent because of rounding.

Figure 9.4
Outpatient opioid replacement therapy completion or transfer to further treatment, by age at admission: TEDS 2005

Stacked bar chart comparing methadone 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 9.4 and Figure 9.5. Forty-seven percent of clients discharged from outpatient opioid replacement therapy were non-Hispanic White, 26 percent were non-Hispanic Black, 24 percent were of Hispanic origin, and 3 percent were of other racial/ethnic groups.

Non-Hispanic Whites and non-Hispanic Blacks were most likely to complete outpatient opioid replacement therapy or to transfer to further treatment (29 percent for each). The combined completion/transfer rate was 26 percent among clients of Hispanic origin.

The median LOS among clients completing outpatient opioid replacement therapy was longest (201 days) among clients of Hispanic origin. It was shortest (161 days) among non-Hispanic Whites.

Figure 9.5
Outpatient opioid replacement therapy completion or transfer to further treatment, by race/ethnicity: TEDS 2005

Stacked bar chart comparing methadone 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 9.5 and Figure 9.6. Ninety-four percent of clients discharged from outpatient opioid replacement therapy reported opiates as their primary substance of abuse at admission. Alcohol was reported by 3 percent; cocaine, marijuana, stimulants, and other substances were each reported by 1 percent or less.

Of the 94 percent of clients reporting opiates as their primary substance, 28 percent completed outpatient opioid replacement therapy or transferred to further treatment. The combined completion/transfer rates for the other substances were between 47 percent (alcohol) and 24 percent (stimulants).

The median LOS among clients completing outpatient opioid replacement therapy was longest (210 days) among those reporting opiates as their primary substance of abuse. It was shortest (47 days) among those reporting cocaine.

Figure 9.6
Outpatient opioid replacement therapy completion or transfer to further treatment, by primary substance: TEDS 2005

Stacked bar chart comparing methadone 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 9.6 and Figure 9.7. Seventy-eight percent of clients discharged from outpatient opioid replacement therapy reported daily use of their primary substance at admission, while 11 percent reported no use in the month before entering treatment.

Clients reporting no substance use in the month before entering treatment were most likely to complete outpatient opioid replacement therapy or to transfer to further treatment (36 percent). The combined completion/transfer rates for more frequent substance use varied little and were between 25 percent and 30 percent.

The median LOS among clients completing outpatient opioid replacement therapy was longest (175 days) among clients reporting daily use of their primary substance. The median LOS among those with less than daily use displayed no consistent pattern with frequency of use and was between 98 days and 115 days.

Figure 9.7
Outpatient opioid replacement therapy or transfer to further treatment, by frequency of substance use: TEDS 2005

Stacked bar chart comparing methadone 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 9.7 and Figure 9.8. The peak age at first use of the primary substance among clients discharged from outpatient opioid replacement therapy was over age 21 (41 percent). Four percent began use at age 12 or younger.

The proportions of clients who completed outpatient opioid replacement therapy or transferred to further treatment displayed no consistent pattern with age at first use of the primary substance and were between 28 percent and 31 percent.

The median LOS among clients completing outpatient opioid replacement therapy was longest (203 days) among those whose substance use began after age 21. It was shortest (138 days) among clients whose use began at age 12 or younger.

Figure 9.8
Outpatient opioid replacement therapy completion or transfer to further treatment, by age at first use: TEDS 2005

Stacked bar chart comparing methadone outpatient treatment completion or transfer to further treatment, by age at first use 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 9.8 and Figure 9.9. Twenty-three percent of clients discharged from outpatient opioid replacement therapy had never been in treatment before, while 19 percent had been in treatment five or more times before.

Clients with no prior treatment episodes were most likely to complete outpatient opioid replacement therapy or to transfer to further treatment (31 percent). The combined completion/transfer rate declined with more prior treatment episodes, and was 27 percent among those with two prior episodes and 24 percent among those with five or more prior episodes.

The median LOS among clients completing outpatient opioid replacement therapy was shortest (116 days) among those who had never been in treatment before. Otherwise, the median LOS displayed no consistent pattern by number of prior treatment episodes and was between 134 days and 173 days.

Figure 9.9
Outpatient opioid replacement therapy completion or transfer to further treatment, by number of prior treatment episodes: TEDS 2005

Stacked bar chart comparing methadone 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 9.9 and Figure 9.10. Seventy-one percent of clients discharged from outpatient opioid replacement therapy were self- or individual referrals to treatment, 14 percent were referred by alcohol/drug abuse care providers, 7 percent by the criminal justice system, 5 percent by health care providers, and 4 percent by community sources.*

Clients referred to treatment by alcohol/drug abuse care providers, health care providers, or the criminal justice system were most likely to complete outpatient opioid replacement therapy or to transfer to further treatment (34 percent, 33 percent, and 32 percent, respectively). The combined completion/transfer rate was lowest for self- or individual referrals and referrals by community sources (26 percent each).

The median LOS among clients completing outpatient opioid replacement therapy was longest (195 days) for self- or individual referrals. It was shortest (85 days) for referrals by health care providers.


* Percentages do not sum to 100 percent because of rounding.
Figure 9.10
Outpatient opioid replacement therapy completion or transfer to further treatment, by treatment referral source: TEDS 2005

Stacked bar chart comparing methadone 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 9.10 and Figure 9.11. Forty-six percent of clients age 16 and older discharged from outpatient opioid replacement therapy were not in the labor force, 27 percent were unemployed, and 26 percent were employed either full time or part time.*

The proportions of clients who completed outpatient opioid replacement therapy or transferred to further treatment varied little with employment status, and were 27 percent or 28 percent.

The median LOS among clients completing outpatient opioid replacement therapy was longest (185 days) among those who were not in the labor force. It was shortest (170 days) among those who were unemployed.


* Percentages do not sum to 100 percent because of rounding.
Figure 9.11
Outpatient opioid replacement therapy completion or transfer to further treatment, by employment status: TEDS 2005

Stacked bar chart comparing methadone 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 9.11 and Figure 9.12. Forty-four percent of clients age 18 and older discharged from outpatient opioid replacement therapy had 12 years of education or a GED, 38 percent had fewer than 12 years of education, and 19 percent had more than 12 years of education.*

Clients with more education were more likely to complete outpatient opioid replacement therapy or to transfer to further treatment than were clients with less education. The combined completion/transfer rate was highest (32 percent) among those with more than 12 years of education. It declined to 28 percent among clients with 12 years of education or a GED and to 27 percent among clients with fewer than 12 years of education.

The median LOS among clients completing outpatient opioid replacement therapy displayed no consistent pattern with level of education and was between 176 days and 184 days.


* Percentages do not sum to 100 percent because of rounding.
Figure 9.12
Outpatient opioid replacement therapy completion or transfer to further treatment, by years of education: TEDS 2005

Stacked bar chart comparing methadone 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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