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Treatment Episode Data Set (TEDS) 

MAIN FINDINGS

Overall, TEDS admissions data confirm that those admitted to substance abuse treatment have problems beyond their dependence on drugs and alcohol, being disadvantaged in education and employment when compared to the general population after adjusting for age, gender, and race/ethnicity distribution differences between the general population and the TEDS. It is not possible to conclude cause and effect from TEDS data - whether substance abuse precedes or follows the appearance of other life problems - but the association between problems seems clear.

Between 1981 (CODAP data) and 1992 (TEDS data), the most frequent primary drug problem at admission changed from heroin to smoked cocaine. This change coincides with the introduction of crack cocaine during the intervening decade. The percentage difference between smoked cocaine and heroin admissions has gradually declined from 1992 to 1995. [Figure 1] [Table 1]

Admissions for combined drug and alcohol abuse are more likely than those for either drug or alcohol alone. In 1995, TEDS admissions for combined alcohol and drug problems accounted for 44% of initial admissions, compared to 30% for alcohol only and 26% for drug only. [Figure 2][Table 2]

Admissions for alcohol-only have progressively declined as a percentage of total admissions from 1992-1995. [Figure 3][Table 2]

TEDS admissions differ from the general population in gender, race/ethnicity, and age distributions. TEDS is consistently more male, black, and young or early middle-aged than the U.S. population. [Figures 4, 5, and 6][Table 3]

After adjusting for age, gender, and race/ethnicity differences, persons admitted to drug treatment are less likely to be employed full time than in the U.S. population. In 1995, only 21% of TEDS admissions were employed full time compared to 53% in the general population. A higher percentage of TEDS admissions, 51%, were not in the labor force in 1995 compared to 32% in the general population. [Figure 7][Table 4]

After adjusting for age, gender, and race/ethnicity differences, TEDS admissions show an educational disadvantage compared to the U.S. population. A higher percentage do not complete high school (34% compared to 19%) and a lower percentage go beyond high school (25% compared to 48%). Whether substance abuse contributes to low educational attainment or vice versa cannot be determined from purely descriptive data, such as TEDS. [Figure 8][Table 4]

Based on all reported admissions for 1995, distinct patterns of substance abuse are observed for racial/ethnic groups. White non Hispanics and American Indians show high rates of admissionsfor abuse of alcohol only (70% and 77%, respectively, for males 45 years or older). Blacks show an unusually high rate of admissions for smoked cocaine/crack (50% for Black females aged 30 to 34). Hispanics of both Puerto Rican and Mexican origin, show unusual rates of heroin admissions (63% of admissions for Mexican-origin females aged 40-44). Females from Other racial/ethnic groups, which includes those of Asian origin, show an unusual rate of admissions for methamphetamine abuse (16% for females aged 20-24). Marijuana/hashish shows a uniformly high rate of admissions among youth, with higher rates for males than females. [Figure 9][Table 8]

All substances are used by some clients daily, but admissions for heroinstand out as being 84% for clients using daily, 74% for use by injection, and 29% for those with 5 or more prior treatment episodes. [Figure 10][Table 9]

Age at first use is reported for every admission, and the 1995 figures show that inhalants (30%), alcohol with drug (28%), marijuana (24%),and hallucinogens (14%) are the substances most often tried before the age of 13. [Figure 10][Table 9]

TEDS 1995 admissions show a high rate of self-referrals (69% for heroin) and a high rate of referral by the criminal justice system for marijuana (49%), PCP (47%), and alcohol-only (46%). [Figure 11][Table 10]

The large majority of substance abuse treatment admissions are to ambulatory settings. In 1995, the percentage of ambulatory admissions ranged from a high of 79% for marijuana abuse to a low of 52% for smoked cocaine. [Figure 12][Table 11]

Persons admitted to drug treatment in 1995 were unlikely to be currently married and most likely to have never married. The marital status of admissions varied according to the substance of abuse and may correlate with differences in average age at admission. [Figure 13][Table 14]

The percentage of homeless status for TEDS admissions varies by the primary substance abused. In 1995, heroin abusers had the highest homelessrate (24%), followed by non-smoked cocaine (22%) and smoked cocaine (21%). [Figure 14][Table 14]

Public assistance as the primary source of income in 1995 was highest for heroin abusers (33%) followed by smoked cocaine (26%) and non-smoked cocaine (20%) abusers.[Figure 15][Table 15]

An overwhelming majority of TEDS admissions had no health insurance in 1995, but reporting of insurance coverage is not required under TEDS and these findings are based on relatively small numbers of admissions. [Figure 16][Table 15]

Reporting of admissions minimum data varies widely among the States and jurisdictions. Where admissions are reported at a declining rate, this cannot be interpreted simply as a decline insubstance abuse problems. Among the other possible reasons for low admission rates are: providers or States gradually dropping out of the TEDS process, long delays in reporting while data systems are upgraded, and chronic under reporting of admission levels. [Figure 17][Table 18]

The pattern of primary substances seen at admission varies among geographical divisions and among States. These differences may reflect substance abuse patterns, admitting practices or both. The greatest variation is in the percentage of admissions for heroin and alcohol abuse. [Figure 18][Table 18]

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This page was last updated on June 16, 2008