Chapter 4
Intensive Outpatient Treatment Discharges: 2004

Chapter 4 presents data on the reasons for discharge and length of stay (LOS) in treatment for the 114,440 linked admission/discharge records of clients discharged from intensive outpatient treatment in 2004 in 27 States [Table 4.1]. Intensive outpatient treatment in this chapter includes outpatient care other than outpatient treatment (Chapter 3), outpatient detoxification (Chapter 8), and outpatient methadone treatment (Chapter 9).

Table 4.1 and Figure 4.1 present the distribution of reasons for discharge for discharges from intensive outpatient treatment. Overall, 43,119 (38 percent) of intensive outpatient discharges completed treatment, 20,441 (18 percent) were transferred to further treatment, 26,561 (23 percent) dropped out of treatment, 16,025 (14 percent) had treatment terminated by the facility, and 8,294 (7 percent) failed to complete treatment for other reasons. Table 4.1 also presents reason for discharge by State.

Figure 4.1
Reason for discharge from intensive outpatient treatment: TEDS 2004

Pie chart comparing Reason for discharge from intensive outpatient treatment in TEDS 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Figure 4.2, Table 2.5, and Appendix Table C.3. The median LOS for intensive outpatient treatment was 42 days. The average (mean) LOS was longer, 72 days (standard deviation, 102). The average LOS was longer than the median LOS for all reasons for discharge for all client characteristics.

Figure 4.2
Median and average lengths of stay in intensive outpatient treatment, by reason for discharge: TEDS 2004

Bar chart comparing Median and average lengths of stay in intensive outpatient treatment, by reason for discharge in TEDS 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Intensive outpatient clients who completed treatment remained in treatment longer than clients who did not complete treatment. Among treatment completers, median LOS was 52 days, and among clients transferred to further treatment, it was 42 days. Among clients who dropped out of treatment, the median LOS was 28 days; among those whose treatment was terminated by the facility, it was 37 days; and among those who failed to complete treatment for other reasons, the median LOS was 41 days.

In comparison with all discharges combined, clients discharged from intensive outpatient treatment were less likely:

Demographics

Tables 4.2-4.4 and Figures 4.3-4.5. Fifty-nine percent of clients discharged from intensive outpatient treatment were male. The peak ages at admission were 20 to 29 years and 30 to 39 years (27 percent each). Twenty-three percent were ages 40 to 49, and 14 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 intensive outpatient treatment were non-Hispanic White (61 percent), while 26 percent were non-Hispanic Black, 8 percent were of Hispanic origin, and 5 percent were of other racial/ethnic groups.

Table 4.2 and Figure 4.3. Males had a higher combined rate of intensive outpatient treatment completion or transfer to further treatment (58 percent) than did females (52 percent). Females had a longer median LOS among intensive outpatient treatment completers (57 days) than did males (49 days).

Figure 4.3
Intensive outpatient treatment completion or transfer to further treatment, by gender: TEDS 2004

Bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by gender in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Table 4.3 and Figure 4.4. Clients in the older age groups were more likely either to complete intensive outpatient treatment or to be transferred to further treatment than clients in the younger age groups. The combined rates were between 53 percent and 55 percent among clients in the age groups younger than age 40. The combined rate increased with age to 65 percent among those who were age 50 and older.

Clients who were younger at admission and who completed intensive outpatient treatment had a longer median LOS than did clients who were older at admission. The median LOS was longest (75 days) among clients younger than age 15 at admission. It fell to 47 days among those who were age 50 and older.

Figure 4.4
Intensive outpatient treatment completion or transfer to further treatment, by age at admission: TEDS 2004

Stacked bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by age at admission in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Table 4.4 and Figure 4.5. Non-Hispanic Whites were more likely either to complete intensive outpatient treatment or to be transferred to further treatment (59 percent) than were either discharges of Hispanic origin or non-Hispanic Blacks (54 percent and 48 percent, respectively).

The median LOS among intensive outpatient treatment completers was longest (60 days) among discharges of Hispanic origin and shortest (49 days) among non-Hispanic Whites.

Figure 4.5
Intensive outpatient treatment completion or transfer to further treatment, by race/ethnicity: TEDS 2004

Stacked bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by race/ethnicity in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Primary Substance

Table 4.5 and Figure 4.6. Thirty-six percent of clients discharged from intensive outpatient treatment reported alcohol as their primary substance of abuse at admission. Marijuana was reported by 22 percent, cocaine by 18 percent, stimulants by 11 percent, opiates by 10 percent, and other substances by 2 percent.*

Clients who reported alcohol as their primary substance had the highest combined rate of intensive outpatient treatment completion or transfer to further treatment (63 percent). The combined rate was lowest for clients who reported opiates as their primary substance (48 percent).

Clients who reported marijuana as their primary substance had the longest median LOS among intensive outpatient treatment completers (60 days), and clients who reported cocaine had the shortest (48 days).


* Percentages do not sum to 100 percent because of rounding.
Figure 4.6
Intensive outpatient treatment completion or transfer to further treatment, by primary substance: TEDS 2004

Stacked bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by primary substance in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Frequency of Use

Table 4.6 and Figure 4.7. Thirty percent of intensive outpatient discharges reported no use of their primary substance in the month before entering treatment, while 29 percent reported daily use in that period.

Clients with less frequent substance use before treatment entry were more likely either to complete intensive outpatient treatment or to be transferred to further treatment than were clients with more frequent use. The combined rate fell from 61 percent among those who reported no primary substance use in the month before treatment entry to 52 percent among those who reported daily use.

Clients with less frequent substance use before treatment entry and who completed intensive outpatient treatment had a longer median LOS than clients with more frequent use. The median LOS was longest (66 days) among those who reported no substance use in that period. It fell to 39 days among those who reported daily use.

Figure 4.7
Intensive outpatient treatment completion or transfer to further treatment, by frequency of substance use in the past month: TEDS 2004

Stacked bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by frequency of substance use in the past month in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Age at First Use

Table 4.7 and Figure 4.8. More than two-thirds (69 percent) of intensive outpatient discharges first used their primary substance by age 18. The peak age at first use was 15 to 16 years (21 percent of intensive outpatient treatment discharges). Thirteen 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 57 percent among those whose substance use began at age 12 or younger. It rose to 60 percent among those whose use began at ages 15 to 16, then fell to 51 percent among those whose use began at over age 25.

The median LOS among intensive outpatient treatment completers was longer among clients who were younger when they began their substance use. The median LOS was 54 days among those whose substance use began at age 12 or younger and fell to 48 days among those whose use began at over age 25.

Figure 4.8
Intensive outpatient treatment completion or transfer to further treatment, by age at first use: TEDS 2004

Stacked bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by age at first use in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Prior Treatment

Table 4.8 and Figure 4.9. Forty percent of intensive outpatient treatment discharges had never been in treatment before, while 9 percent had been in treatment five or more times previously.

Clients with fewer prior treatment episodes were more likely either to complete intensive outpatient treatment or to be transferred to further treatment than were clients with more prior treatment episodes. The combined rate fell from 58 percent among those with no prior treatment episodes or who had been in treatment once to 48 percent among those who had been in treatment five or more times.

Clients with fewer prior treatment episodes who completed intensive outpatient treatment had a longer median LOS than clients with more prior treatment episodes. The median LOS was longest (56 days) among those who had never been in treatment. It fell to 41 days among those who had been in treatment five or more times.

Figure 4.9
Intensive outpatient treatment completion or transfer to further treatment, by number of prior treatment episodes: TEDS 2004

Stacked bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by number of prior treatment episodes in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Treatment Referral Source

Table 4.9 and Figure 4.10. Thirty-eight percent of clients discharged from intensive outpatient treatment were referred to treatment through the criminal justice system, and 29 percent were self- or individual referrals. Community referrals made up 15 percent, substance abuse treatment providers 9 percent, health care providers 7 percent, and schools and employers, 1 percent each.

The combined rates of intensive outpatient completion or transfer to further treatment were above the intensive outpatient treatment average of 56 percent for those referred to treatment by employers (68 percent) and through the criminal justice system (60 percent). The combined rates were below average for referrals by community sources (54 percent), health care providers (53 percent), schools (51 percent), and among self- or individual referrals (51 percent).

The median LOS among intensive outpatient treatment completers was 62 days among clients referred through the criminal justice system. The median LOS for self- or individual referrals was 42 days. The median LOS for intensive outpatient treatment completers referred by other sources was between 40 days and 74 days.

Figure 4.10
Intensive outpatient treatment completion or transfer to further treatment, by treatment referral source: TEDS 2004

Stacked bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by treatment referral source in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Employment Status

Table 4.10 and Figure 4.11. Thirty-seven percent of clients age 16 and older discharged from intensive outpatient treatment were not in the labor force. Thirty-three percent were unemployed, and 30 percent were employed either full time or part time.

Clients who were employed were more likely either to complete intensive 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 (65 percent) or part time (56 percent). The combined rates fell to 54 percent among those who were not in the labor force and 53 percent among those who were unemployed.

The median LOS among intensive outpatient treatment completers displayed no consistent pattern with employment status and was between 49 days and 58 days.

Figure 4.11
Intensive outpatient treatment completion or transfer to further treatment, by employment status: TEDS 2004

Stacked bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by employment status in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Education

Table 4.11 and Figure 4.12. Forty-four percent of clients age 18 and older discharged from intensive outpatient treatment had 12 years of education or a GED. Twenty-eight percent had 9 to 11 years of education, 23 percent had more than 12 years of education, and 5 percent had 8 years of education or less.

Clients with more education were more likely either to complete intensive 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 (62 percent). It fell to 50 percent among both clients with 9 to 11 years of education and those with 8 years of education or less.

Clients with less education who completed intensive outpatient treatment had a longer median LOS than clients with more education. The median LOS was longest among clients with less than 8 years of education (61 days). It fell to 47 days among those with more than 12 years of education.

Figure 4.12
Intensive outpatient treatment completion or transfer to further treatment, by years of education: TEDS 2004

Stacked bar chart comparing Intensive outpatient treatment completion or transfer to further treatment, by years of education in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

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