Chapter 6
Long-Term Residential Treatment Discharges: 2004

Chapter 6 presents data on the reasons for discharge and length of stay (LOS) in treatment for the 95,087 linked admission/discharge records of clients discharged from long-term residential treatment in 2004 in 28 States [Table 6.1].

Table 6.1 and Figure 6.1 present the distribution of reasons for discharge for discharges from long-term residential treatment. Overall, 40,771 (43 percent) of long-term residential treatment discharges completed treatment, 11,851 (12 percent) were transferred to further treatment, 26,727 (28 percent) dropped out of treatment, 7,326 (8 percent) had treatment terminated by the facility, and 8,412 (9 percent) failed to complete treatment for other reasons. Table 6.1 also presents reason for discharge by State.

Figure 6.1
Reason for discharge from long-term residential treatment: TEDS 2004

Pie chart comparing Reason for discharge from short-term residential 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 6.2, Table 2.5, and Appendix Table C.5. The median LOS for long-term residential treatment was 46 days. The average (mean) LOS was longer, 74 days (standard deviation, 97). The average LOS was longer than the median LOS for all reasons for discharge for all client characteristics.

Figure 6.2
Median and average lengths of stay in long-term residential treatment, by reason for discharge: TEDS 2004

Bar chart comparing Median and average lengths of stay in short-term residential 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.

Long-term residential clients who completed treatment remained in treatment longer than clients who did not complete treatment. Among treatment completers, median LOS was 79 days, and among clients transferred to further treatment, it was 35 days. Among clients who dropped out of treatment, the median LOS was 21 days; among those whose treatment was terminated by the facility, it was 36 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 long-term residential treatment were more likely:

Clients discharged from long-term residential treatment were less likely than all discharges combined:

Demographics

Tables 6.2-6.4 and Figures 6.3-6.5. Sixty-four percent of clients discharged from long-term residential treatment were male. The peak age group at admission was 30 to 39 years (30 percent of all long-term residential treatment discharges), followed by 20 to 29 years (27 percent). Twenty-four percent were ages 40 to 49, and 12 percent were ages 15 to 19. Small proportions were younger than age 15 (1 percent) or age 50 and older (7 percent).* Most clients discharged from long-term residential treatment were non-Hispanic White (53 percent), while 25 percent were non-Hispanic Black, 15 percent were of Hispanic origin, and 7 percent were of other racial/ethnic groups.

Table 6.2 and Figure 6.3. Males had a higher combined rate of long-term residential treatment completion or transfer to further treatment (56 percent) than did females (54 percent). Males had a longer median LOS among long-term residential treatment completers (80 days) than did females (76 days).


* Percentages do not sum to 100 percent because of rounding.
Figure 6.3
Long-term residential treatment completion or transfer to further treatment, by gender: TEDS 2004

Stacked bar chart comparing Short-term residential 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 6.3 and Figure 6.4. Clients in the older and younger age groups were more likely either to complete long-term residential treatment or to be transferred to further treatment than clients in the middle age groups. The combined rate was 58 percent among clients who were younger than age 15. It fell to 51 percent among those who were ages 20 to 29, then increased with age to 64 percent among those who were age 50 and older.

The median LOS among long-term residential treatment completers was shortest (73 days) for the oldest age group, age 50 and older, but showed no consistent pattern with age. The median LOS was between 75 days and 88 days for the other age groups.

Figure 6.4
Long-term residential treatment completion or transfer to further treatment, by age at admission: TEDS 2004

Stacked bar chart comparing Short-term residential 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 6.4 and Figure 6.5. Non-Hispanic Whites and non-Hispanic Blacks were more likely either to complete long-term residential treatment or to be transferred to further treatment (56 percent each) than were discharges of Hispanic origin (52 percent).

The median LOS among long-term residential treatment completers was longest (86 days) among discharges of Hispanic origin and shortest (75 days) for non-Hispanic Whites.

Figure 6.5
Long-term residential treatment completion or transfer to further treatment, by race/ethnicity: TEDS 2004

Stacked bar chart comparing Short-term residential 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 6.5 and Figure 6.6. Twenty-seven percent of clients discharged from long-term residential treatment reported alcohol as their primary substance of abuse at admission. Cocaine was reported by 23 percent, stimulants by 19 percent, opiates by 15 percent, marijuana by 13 percent, and other substances by 3 percent.

Clients who reported alcohol as their primary substance had the highest combined rate of long-term residential treatment completion or transfer to further treatment (61 percent). The combined rate was lowest for clients who reported opiates as their primary substance (48 percent).

Clients who reported stimulants as their primary substance had the longest median LOS for the major substances of abuse (alcohol, cocaine, stimulants, opiates, and marijuana) among long-term residential treatment completers (89 days), and clients who reported alcohol had the shortest (71 days).

Figure 6.6
Long-term residential treatment completion or transfer to further treatment, by primary substance: TEDS 2004

Stacked bar chart comparing Short-term residential 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 6.6 and Figure 6.7. Forty-five percent of long-term residential treatment discharges reported daily use of their primary substance in the month before entering treatment, while 25 percent reported no use in that period.

Clients with less frequent substance use before treatment entry were more likely either to complete long-term residential treatment or to be transferred to further treatment than were clients with more frequent use. The combined rate fell from 58 percent among those who reported no primary substance use or use one to three times per month in the month before treatment entry to 52 percent among those who reported daily use.

The median LOS among long-term residential treatment completers displayed no consistent pattern with frequency of primary substance use and was between 69 days and 89 days.

Figure 6.7
Long-term residential treatment completion or transfer to further treatment, by frequency of substance use in the past month: TEDS 2004

Stacked bar chart comparing Short-term residential 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 6.7 and Figure 6.8. Age at first use was reported for only 63 percent of long-term residential discharges. Among those reporting age at first use, more than two-thirds (68 percent) first used their primary substance by age 18. The peak ages at first use were 13 to 14 and 15 to 16 years (each with 19 percent of long-term residential treatment discharges). Thirteen percent did not begin use until they were over age 25.

The combined rate of long-term residential treatment completion or transfer to further treatment displayed no consistent pattern with age at first use and was between 55 percent and 60 percent.

The median LOS for long-term residential treatment completers displayed no consistent pattern with age at first use of the primary substance and was between 62 days and 73 days.

Figure 6.8
Long-term residential treatment completion or transfer to further treatment, by age at first use: TEDS 2004

Stacked bar chart comparing Short-term residential 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 6.8 and Figure 6.9. Thirty-seven percent of long-term residential treatment discharges had never been in treatment before, while 11 percent had been in treatment five or more times previously.

Clients with fewer prior treatment episodes were more likely either to complete long-term residential treatment or to be transferred to further treatment than were clients with more prior treatment episodes. The combined rate fell from 57 percent among those with no prior treatment episodes to 45 percent among those who had been in treatment five or more times.

Clients with more prior treatment episodes who completed long-term residential treatment had a longer median LOS than clients with fewer prior treatment episodes. The median LOS was longest (85 days) among those with five or more prior treatment episodes. It fell to 78 days among those with one or no prior treatment episodes.

Figure 6.9
Long-term residential treatment completion or transfer to further treatment, by number of prior treatment episodes: TEDS 2004

Stacked bar chart comparing Short-term residential 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 6.9 and Figure 6.10. Thirty-six percent of clients discharged from long-term residential treatment were referred to treatment through the criminal justice system, and 30 percent were self- or individual referrals. Substance abuse treatment providers made up 16 percent, community referrals 10 percent, health care providers 7 percent, and schools and employers less than 1 percent each.*

The combined rates of long-term residential treatment completion or transfer to further treatment were above the long-term residential treatment average of 55 percent for those referred to treatment by employers (71 percent) and through the criminal justice system (59 percent). The combined rates were below average among self- or individual referrals (53 percent) and for referrals through substance abuse treatment providers (49 percent).

The median LOS among long-term residential treatment completers was longest (88 days) for those referred though the criminal justice system and by substance abuse treatment providers. The median LOS was 59 days for self- or individual referrals. The median LOS for long-term residential treatment completers referred by other sources was between 51 days and 85 days.


* Percentages do not sum to 100 percent because of rounding.
Figure 6.10
Long-term residential treatment completion or transfer to further treatment, by treatment referral source: TEDS 2004

Stacked bar chart comparing Short-term residential 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 6.10 and Figure 6.11. Fifty-seven percent of clients age 16 and older discharged from long-term residential treatment were not in the labor force. Thirty-three percent were unemployed, and 10 percent were employed either full time or part time.

Clients who were employed were more likely either to complete long-term residential 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 (68 percent) or part time (66 percent). The combined rates fell to 56 percent among those who were unemployed and 53 percent among those who were not in the labor force.

Clients who were unemployed or not in the labor force and who completed long-term residential treatment had a longer median LOS than clients who were employed. The median LOS was longest (89 days) among those who were not in the labor force. It was 65 days among those who were unemployed. The median LOS was shortest among those who were employed full time or part time (54 days and 56 days, respectively).

Figure 6.11
Long-term residential treatment completion or transfer to further treatment, by employment status: TEDS 2004

Stacked bar chart comparing Short-term residential 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 6.11 and Figure 6.12. Forty-three percent of clients age 18 and older discharged from long-term residential treatment had 12 years of education or a GED. Thirty percent had 9 to 11 years of education, 21 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 long-term residential 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 (60 percent). It fell to 56 percent among clients with 12 years of education or a GED, and to 51 percent among clients with 9 to 11 years of education and 8 years of education or less.

The median LOS among clients completing long-term residential treatment displayed no consistent pattern with years of education and was between 63 days and 85 days.

Figure 6.12
Long-term residential treatment completion or transfer to further treatment, by years of education: TEDS 2004

Stacked bar chart comparing Short-term residential 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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