Reason for Discharge

Median Length of Stay (LOS)

Characteristics at Admission

Treatment Completion

Chapter 10 presents data on the reason for discharge and median length of stay (LOS) in treatment for the 16,652 linked admission/discharge records of discharges from medication-assisted (i.e., with methadone or buprenorphine) opioid detoxification in 2006. Twenty-two of the 42 reporting States had discharges for this type of service [Table 10.1]. Medication-assisted opioid detoxification includes free-standing residential detoxification, hospital detoxification, and outpatient detoxification (see Chapter 2).

Reason for Discharge

Table 10.1 and Figure 10.1. Of the 16,652 medication-assisted opioid detoxification discharges in 2006:¹

• 33 percent (n = 5,565) completed treatment
• 22 percent (n = 3,653) were transferred to further treatment
• 41 percent (n = 6,827) dropped out of treatment
• 1 percent (n = 245) had treatment terminated by the facility
• 2 percent (n = 362) failed to complete treatment for other reasons
  
  

Median Length of Stay (LOS)

Table 2.4 and Figure 10.2. The median LOS for medication-assisted opioid detoxification discharges was 14 days. By reason for discharge, the median LOS for medication-assisted opioid detoxification discharges was:

• 10 days among those who completed treatment
• 9 days among those who transferred to further treatment
• 16 days among those who dropped out of treatment
• 26 days among those whose treatment was terminated by the facility
• 63 days among those who failed to complete treatment for other reasons

Characteristics at Admission

Table 2.6. Medication-assisted opioid detoxification discharges displayed some major differences from all discharges combined. Of medication-assisted opioid detoxification discharges:

• 33 percent were aged 41 to 50 years compared to 25 percent of all discharges; 3 percent were under age 21 compared to 14 percent of all discharges
• 23 percent were Hispanic compared to 15 of all discharges
• 79 percent reported opiates as the primary substance of abuse compared to 19 percent of all discharges; 12 percent reported alcohol compared to 39 percent of all discharges
• 83 percent reported daily use of the primary substance in the month before treatment entry compared to 41 percent of all discharges; 2 percent reported no substance use in the month before treatment entry compared to 26 percent of all discharges
• 68 percent reported one or more prior treatment episodes compared to 54 percent of all discharges
• 67 percent were individual referrals to treatment compared to 34 percent of all discharges
  

Treatment Completion

Tables 10.2 and 10.3. Table 10.2 enumerates the characteristics at admission of discharges from outpatient medication-assisted opioid therapy by reason for discharge. Table 10.3 is based on Table 10.2. It presents two related proportions: a) the percent distribution of characteristics at admission among discharges completing treatment or transferring to further treatment compared to those who did not complete treatment, and b) the combined rate of completion or transfer to further treatment by characteristic at admission.

Completion/Transfer Rates and Characteristics at Admission

The overall combined treatment completion/transfer rate among medication-assisted opioid detoxification discharges was 55 percent.

• The completion/transfer rates among medication-assisted opioid detoxification discharges were related to frequency of use, employment status, and level of education:
• 68 percent of discharges who reported no substance use in the month before treatment entry completed treatment or transferred to further treatment; the rate fell to 53 percent among discharges who reported daily use
• 54 percent of discharges who were unemployed or not in the labor force completed treatment or transferred to further treatment; the rate was 51 percent among discharges who were employed
• 57 percent of discharges with more than 12 years of education completed treatment or transferred to further treatment; the rate fell to 54 percent among discharges with fewer than 12 years of education
• The completion/transfer rate was highest, among other characteristics, for medication-assisted opioid detoxification discharges who:
• were referred to treatment by health care/community sources (75 percent), or through the criminal justice system (66 percent); the small proportion of discharges who reported primary substances other than opiates also had high completion/transfer rates, ranging from 86 percent to 91 percent
• were non-Hispanic Black, at 63 percent
• The completion/transfer rate was lowest, among other characteristics, for medication-assisted opioid detoxification discharges who:
• were Hispanic, at 41 percent
• were individual referrals to treatment, at 45 percent

Median LOS among Discharges Completing Treatment

The overall median LOS among discharges completing medication-assisted opioid detoxification was 10 days. For most characteristics at admission, the median LOS fell within 4 days of that number, between 6 days and 14 days.

• The median LOS was longest (21 days) among Hispanic discharges and among discharges who reported opiates as the primary substance.
• The median LOS was shortest (4 days to 6 days) among the small proportions of discharges who reported marijuana, cocaine, alcohol, or stimulants as the primary substance. Apart from these few discharges, it was shortest (6 days) among non-Hispanic Black discharges.
  

¹Percentages do not sum to 100 percent because of rounding.

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