Appendix A

About the Treatment Episode Data Set (TEDS)

Introduction

History

State Data Collection System

Report-Specific Considerations

Introduction
This report presents data from the Treatment Episode Data Set (TEDS) on the demographic and substance abuse characteristics of admissions to treatment for abuse of alcohol and/or drugs. The Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration (SAMHSA), coordinates and manages collection of TEDS data from the States.

The Treatment Episode Data Set (TEDS) is a compilation of client-level data routinely collected by the individual State administrative data systems to monitor their substance abuse treatment systems. Generally, facilities that are required to report to the State substance abuse agency (SSA) are those that receive public funds and/or are licensed or certified by the SSA to provide substance abuse treatment (or are administratively tracked for other reasons).

TEDS is one of the three components of SAMHSA's Drug and Alcohol Services Infor­mation System (DASIS), the primary source of national data on substance abuse treatment. The other two DASIS components are:

The TEDS system comprises two major components, the Admissions Data Set and the Discharge Data Set. The TEDS Admissions Data Set includes client-level data on substance abuse treatment admissions from 1992 through the present. The TEDS Discharge Data Set can be linked at record level to admissions, and includes information from clients discharged in 2000 and later. For both data sets, 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 of items collected by all States, and a Supplemental Data Set where individual data items are reported at the States' option.

The Minimum Data Set consists of 19 items that include:

The Supplemental Data Set consists of 16 items that include psychiatric, social, and economic measures.

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. Examples are the proportion of discharges that completed treatment and the average length of stay of treatment completers. Results from the TEDS Discharge Data System are published in a separate report.

Definitions and classifications used in the Admissions Minimum and Supplemental Data Sets are detailed in Appendix B.

History

National-level data collection on admissions to substance abuse treatment was first mandated in 1972 under the Drug Abuse Office and Treatment Act, P.L. 92-255. This act initiated Federal funding for drug treatment and rehabilitation, and required reporting on clients entering drug (but not alcohol) abuse treatment. The Client-Oriented Data Acquisition Process (CODAP) was developed to collect admission and discharge data directly from Federally-funded drug treatment programs. (Programs for treatment of alcohol abuse were not included.) Reporting was mandatory for all such programs, and data were collected using a standard form. CODAP included all clients in Federally-funded programs regardless of individual funding source. Reports were issued from 1973 to 1981 based on data from 1,800 to 2,000 programs, including some 200,000 annual admissions.

In 1981, collection of national-level data on admissions to substance abuse treatment was discontinued because of the introduction of the Alcohol, Drug Abuse, and Mental Health Services (ADMS) Block Grant. The Block Grant transferred Federal funding from individual programs to the States for distribution, and included no data reporting requirement. Participation in CODAP became voluntary; although several States submitted data through 1984, the data were in no way nationally representative.

In 1988, the Comprehensive Alcohol Abuse, Drug Abuse, and Mental Health Amendments (P.L. 100-690) established a revised Substance Abuse Prevention and Treatment (SAPT) Block Grant and mandated Federal data collection on clients receiving treatment for either alcohol or drug abuse. The Treatment Episode Data Set (TEDS) data collection effort represents the Federal response to this mandate. TEDS began in 1989 with the issue of 3-year development grants to States.

State Data Collection Systems

TEDS is an exceptionally large and powerful data set that comprises a significant proportion of all admissions to substance abuse treatment. TEDS is a compilation of data collected through the individual data collection systems of the State Substance Abuse Agencies (SSAs) for substance abuse treatment. States have cooperated with the Federal Government in the data collection process, and substantial progress has been made toward developing a standardized data set. However, because each State system is unique and each State has u­nique powers and mandates, significant differences exist among State data collection systems. These differences are compounded by evolving health care payment systems, and State-to-State comparisons must be made with extreme caution.

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.

States differ widely in the amount of public funding available for substance abuse treatment and in the constraints placed on the use of funds. States may be directed to target special populations such as pregnant women or adolescents. Where funds are limited, States may be compelled to exercise triage in admitting persons to treatment, admitting only those with the most "severe" problems. In States with higher funding levels, a larger proportion of the population in need of treatment may be admitted, including the less severely impaired.

States may include or exclude reporting by certain sectors of the treatment population, and these sectors may change over time. For example, treat­ment programs based in the criminal justice system may or may not be administered through the State SSA. Detoxification facilities, which can generate large numbers of admissions, are not uniformly considered treatment facilities and are not uniformly reported by all States.

Appendix Table 1 presents key characteristics of State data collection systems for 2009. However, these characteristics can change as State substance abuse treatment systems change, and thus may be responsible for some year-to-year variation within States.

Report-Specific Considerations

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 excluded.

Records with partially complete data have been retained. Where records include missing or invalid data for a specific variable other than primary, secondary, or tertiary substance, those records are excluded from tabulations of that variable. For substance variables, missing or unknown responses were included in the category "Other." The total number of admissions on which a percentage distribution is based is reported in each table.

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. Secondary and tertiary substances (see Appendix B) may be grouped and referred to as secondary substances.

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 cocaine is injected, inhaled, or taken orally; it also includes admissions where the route of administration is unknown or 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. Methamphetamine constitutes about 95 percent of combined methamphetamine/amphetamine admissions. Oregon and Texas, States with large numbers of meth­amphetamine admissions, reported them as other amphetamines until 2005.

[To Appendix A Tables]


1 See: Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). 1999 - 2009. National Admissions to Substance Abuse Treatment Services, DASIS Series: S-56, HHS Publication No. (SMA) 11-4646, Rockville, MD; Substance Abuse and Mental Health Services Administration, 2011, Table 2.7.

To table of Contents

To Table of Contents