Reason for Discharge
Median Length of Stay (LOS)
Characteristics at Admission
Treatment Completion

Chapter 9 presents data on the reason for discharge and median length of stay (LOS) in treatment for the 59,190 linked admission/discharge records of discharges from outpatient medication-assisted opioid therapy (i.e., therapy with methadone or buprenorphine) in 2007. Thirty-eight of the 46 reporting States had discharges from this type of service [Table 9.1]. Discharges from outpatient medication-assisted opioid therapy included 95 percent from outpatient treatment outpatient treatment and 5 percent from intensive outpatient treatment (see Chapter 2).

Reason for Discharge

Table 9.1 and Figure 9.1. Of the 59,190 outpatient medication-assisted opioid therapy discharges in 2007:¹

• 12 percent (n = 7,385) completed treatment
• 19 percent (n = 11,497) were transferred to further treatment
• 42 percent (n = 24,742) dropped out of treatment
• 12 percent (n = 7,230) had treatment terminated by the facility
• 14 percent (n = 8,336) failed to complete treatment for other reasons

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

Median Length of Stay (LOS)

Table 2.4 and Figure 9.2. The median LOS for outpatient medication-assisted opioid therapy discharges was 155 days. By reason for discharge, the median LOS for outpatient medication-assisted opioid therapy discharges was:

• 184 days among those who completed treatment
• 165 days among those who transferred to further treatment
• 114 days among those who dropped out of treatment
• 213 days among those whose treatment was terminated by the facility
• 186 days among those who failed to complete treatment for other reasons
  

Characteristics at Admission

Table 2.6. Outpatient medication-assisted opioid therapy discharges displayed some major differences from all discharges combined. Of outpatient medication-assisted opioid therapy discharges:

• 62 percent were male compared to 68 percent of all discharges
• 3 percent were under age 21 compared to 14 percent of all discharges
• 51 percent were non-Hispanic White compared to 59 percent of all discharges; 23 percent were Hispanic compared to 14 percent of all discharges
• 96 percent reported opiates as the primary substance of abuse compared to 18 percent of all discharges
• 71 percent reported daily use of the primary substance in the month before treatment entry compared to 37 percent of all discharges; 14 percent reported no substance use in the month before treatment entry compared to 29 percent of all discharges
• 75 percent reported one or more prior treatment episodes compared to 56 percent of all discharges
• 74 percent were individual referrals to treatment compared to 33 percent of all discharges; 5 percent were referred to treatment through the criminal justice system compared to 37 percent of all discharges, and 21 percent were referred through health care or community sources compared to 30 percent of all discharges
  

Treatment Completion

Tables 9.2 and 9.3. Table 9.2 enumerates the characteristics at admission of discharges from outpatient medication-assisted opioid therapy by reason for discharge. Table 9.3 is based on Table 9.2. 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.

Linkage of discharge records from 2007 to admission records from 2000 to 2007 means that the maximum length of stay (LOS) in treatment included in this report is 8 years. However, medication-assisted opioid therapy can have a much longer duration. Indeed, some admissions may receive this form of treatment for an indefinite period. Because this report includes data only on discharges, it will underestimate LOS in treatment for those receiving medication-assisted opioid therapy. Similarly, the number and proportion of treatment completers will reflect only those who have been discharged because treatment is complete and not those who successfully remain in long-term medication-assisted opioid therapy. In addition, the characteristics at admission of those admitted to and discharged from medication-assisted opioid therapy within 8 years may differ from those of admissions who remain in medication-assisted opioid therapy for longer than 8 years.

Completion/Transfer Rates and Characteristics at Admissions

The overall combined treatment completion/transfer rate among outpatient medication-assisted opioid therapy discharges was 32 percent.

• Among variables whose categories represented a continuum—age, frequency of use, number of prior treatment episodes, employment status, and level of education—higher completion/transfer rates among outpatient medication-assisted opioid therapy discharges were associated with:
  • Less frequent use—completion/transfer rates fell from 42 percent among discharges who reported no substance use in the month before treatment entry to 29 percent among discharges who reported daily substance use
  • Higher educational level— 36 percent of discharges with more than 12 years of education completed treatment or transferred to further treatment; the rate fell to 29 percent among discharges with fewer than 12 years of education
• Among other characteristics (race/ethnicity, primary substance, treatment referral source), the completion/transfer rate among outpatient medication-assisted opioid therapy ranged from:
  • 28 percent among non-Hispanic Black discharges and discharges of Hispanic origin to 35 percent among non-Hispanic White discharges
  • 31 percent among the 94 percent of discharges who reported opiates as the primary substance to 55 percent among the 3 percent who reported alcohol
  • 31 percent of discharges those who were individually referred to treatment to 39 percent of discharges who were referred to treatment through the criminal justice system

Median LOS among Discharges Completing Treatment

The overall median LOS among discharges completing outpatient medication-assisted opioid therapy was 184 days. For most characteristics at admission, the median LOS was within 20 days of that number, between 164 days and 204 days.

• The median LOS was longest (239 days) among Hispanic discharges
• The median LOS was shortest (82 days or 84 days) among the small proportions of discharges who reported cocaine or alcohol as the primary substance. Apart from these few discharges, it was shortest (120 days) among discharges referred to treatment through the criminal justice system.

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