Reason for discharge from outpatient treatment: TEDS 2004
Chapter 3 presents data on the reasons for discharge and length of stay (LOS) in treatment for the 399,037 linked admission/discharge records of clients discharged from outpatient treatment in 2004 in 27 States [Table 3.1]. Outpatient treatment in this chapter includes outpatient care other than intensive outpatient treatment (Chapter 4), outpatient detoxification (Chapter 8), and outpatient methadone treatment (Chapter 9).
Table 3.1 and Figure 3.1 present the distribution of reasons for discharge for discharges from outpatient treatment. Overall, 145,426 (36 percent) of outpatient discharges completed treatment, 46,611 (12 percent) were transferred to further treatment, 108,605 (27 percent) dropped out of treatment, 41,913 (11 percent) had treatment terminated by the facility, and 56,482 (14 percent) failed to complete treatment for other reasons. Table 3.1 also presents reason for discharge by State.
Figure 3.2, Table 2.5, and Appendix Table C.2. The median LOS for outpatient treatment was 69 days. The average (mean) LOS was longer, 107 days (standard deviation, 133). The average LOS was longer than the median LOS for all reasons for discharge for all client characteristics.
Outpatient clients who completed treatment remained in treatment longer than clients who did not complete treatment. Among treatment completers, median LOS was 104 days, and among clients transferred to further treatment, it was 29 days. Among clients who dropped out of treatment, the median LOS was 45 days; among those whose treatment was terminated by the facility, it was 53 days; and among those who failed to complete treatment for other reasons, the median LOS was 70 days.
In comparison with all discharges combined, clients discharged from outpatient treatment were more likely:
Clients discharged from outpatient treatment were less likely than all discharges combined:
Demographics
Tables 3.2-3.4 and Figures 3.3-3.5. About two-thirds (68 percent) of clients discharged from outpatient treatment were male. The peak age group at admission was 20 to 29 years (29 percent of all outpatient treatment discharges), followed by ages 30 to 39 (25 percent). Twenty percent were ages 40 to 49, and 16 percent were ages 15 to 19. Small proportions were younger than age 15 (2 percent) or age 50 and older (7 percent).* Most clients discharged from outpatient treatment were non-Hispanic White (59 percent), while 22 percent were non-Hispanic Black, 14 percent were of Hispanic origin, and 6 percent were of other racial/ethnic groups.*
Table 3.2 and Figure 3.3. Males had a higher combined rate of outpatient treatment completion or transfer to further treatment (49 percent) than did females (47 percent). Females had a longer median LOS among outpatient treatment completers (105 days) than did males (103 days).
Table 3.3 and Figure 3.4. Clients in the older and younger age groups were more likely either to complete outpatient treatment or to be transferred to further treatment than clients in the middle age groups. The combined rate was 51 percent among clients who were younger than age 15. It fell to 46 percent among those who were ages 20 to 29, then increased with age to 54 percent among those who were age 50 and older.
The median LOS for outpatient treatment completers was longest (108 days) among those who were ages 30 to 39 and 40 to 49, but displayed no consistent pattern with age. The median LOS was between 94 days and 105 days for the other age groups.
Table 3.4 and Figure 3.5. Non-Hispanic Whites were more likely either to complete outpatient treatment or to be transferred to further treatment (50 percent) than either non-Hispanic Blacks or discharges of Hispanic origin (45 percent and 44 percent, respectively).
The median LOS among outpatient treatment completers was longest (126 days) among discharges of Hispanic origin and shortest (98 days) among non-Hispanic Whites.
Primary Substance
Table 3.5 and Figure 3.6. Thirty-seven percent of clients discharged from outpatient treatment reported alcohol as their primary substance of abuse at admission. Marijuana was reported by 24 percent, stimulants by 14 percent, cocaine by 13 percent, opiates by 7 percent, and other substances by 6 percent.*
Clients who reported alcohol as their primary substance had the highest combined rate of outpatient treatment completion or transfer to further treatment (56 percent). The combined rate for the major substances of abuse (alcohol, marijuana, stimulants, cocaine, and opiates) was lowest, at 41 percent, for clients who reported stimulants as their primary substance.
Clients who reported stimulants as their primary substance had the longest median LOS (for the major substances) among outpatient treatment completers (137 days), and clients who reported alcohol had the shortest (98 days).
Frequency of Use
Table 3.6 and Figure 3.7. Forty-three percent of outpatient treatment discharges reported no use of their primary substance in the month before entering treatment, while 19 percent reported daily use in that period.
Clients with less frequent substance use before treatment entry were more likely either to complete outpatient treatment or to be transferred to further treatment than were clients with more frequent use. The combined rate fell from 53 percent among those who reported no primary substance use in the month before treatment entry to 42 percent among those who reported daily use.
The median LOS among outpatient treatment completers showed no consistent pattern with frequency of primary substance use in the month before entering treatment and was between 100 days and 112 days.
Age at First Use
Table 3.7 and Figure 3.8. Three-quarters (75 percent) of outpatient discharges first used their primary substance by age 18. The peak age at first use was 15 to 16 years (24 percent of outpatient treatment discharges). Nine percent did not begin use until they were over age 25.
Clients who began use of their primary substance in their late teens had higher combined rates of outpatient treatment completion or transfer to further treatment than clients whose use began at older or younger ages. The combined rate was 49 percent among those who began substance use at age 12 or younger. It rose to 57 percent among those whose use began at ages 17 to 18, then fell to 49 percent among those whose use began at over age 25.
The median LOS for outpatient treatment completers was longest among those whose substance use began at the younger or older ages. The median LOS was 97 days among those whose use began at age 12 or younger, fell to 91 days among those whose substance use began at ages 15 to 16 and ages 17 to 18, then increased to 97 days among those whose use began at over age 25.
Prior Treatment
Table 3.8 and Figure 3.9. About half (51 percent) of outpatient treatment discharges had never been in treatment before, while 5 percent had been in treatment five or more times previously.
Clients with fewer prior treatment episodes were more likely either to complete outpatient treatment or to be transferred to further treatment than were clients with more prior treatment episodes. The combined rate fell from 51 percent among those with no prior treatment episodes to 41 percent among those who had been in treatment five or more times.
The median LOS among outpatient treatment completers displayed no consistent pattern with the number of prior treatment episodes and was between 103 days and 112 days.
Treatment Referral Source
Table 3.9 and Figure 3.10. More than half (55 percent) of clients discharged from outpatient treatment were referred to treatment through the criminal justice system, and 22 percent were self- or individual referrals. Community referrals made up 10 percent, health care providers and substance abuse treatment providers 5 percent each, schools 3 percent, and employers 1 percent.*
The combined rates of outpatient treatment completion or transfer to further treatment were above the outpatient treatment average of 48 percent for those referred to treatment through employers (59 percent), the criminal justice system (54 percent), and schools (50 percent). The combined rates were below average for referrals through substance abuse treatment providers (47 percent), community sources (45 percent), health care providers (40 percent), and for self- or individual referrals (38 percent).
The median LOS among outpatient treatment completers was longest (107 days) for clients referred through the criminal justice system. The median LOS for self- or individual referrals was 94 days. The median LOS for outpatient treatment completers referred by other sources was between 84 days and 102 days.
Employment Status
Table 3.10 and Figure 3.11. Thirty-eight percent of clients age 16 and older discharged from outpatient treatment were employed either full time or part time. Thirty-two percent were unemployed, and 30 percent were not in the labor force.
Clients who were employed were more likely either to complete outpatient treatment or to be transferred to further treatment than were clients who were unemployed or not in the labor force. The combined rates were highest among those employed full time (57 percent) or part time (51 percent). The combined rate fell to 47 percent among those who were not in the labor force and 45 percent among those who were unemployed.
The median LOS among outpatient treatment completers displayed no consistent pattern with employment status and was between 100 days and 106 days.
Education
Table 3.11 and Figure 3.12. Forty-five percent of clients age 18 and older discharged from outpatient treatment had 12 years of education or a GED. Twenty-nine percent had 9 to 11 years of education, 20 percent had more than 12 years of education, and 6 percent had 8 years of education or less.
Clients with more education were more likely either to complete outpatient treatment or to be transferred to further treatment than were clients with less education. The combined rate was highest among those with more than 12 years of education (54 percent) and among clients with 12 years of education or a GED (50 percent). It fell to 44 percent among clients with 9 to 11 years of education and 48 percent among client with 8 years of education or less.
Clients with less education who completed outpatient treatment had a longer median LOS than clients with more education. The median LOS was longest among those with less than 8 years of education (119 days). It fell to 100 days among those with more than 12 years of education.
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