Treatment Episode Data Set (TEDS)
2012

To Table of Contents

Title Page

Acknowledgments

List of Tables

List of Figures

Highlights

Chapter 1. Discharge Data Description and Data Overview for All Types of Service: 2012

Chapter 2. Outpatient Treatment Discharges Aged 12 and Older: 2012

Chapter 3. Intensive Outpatient Treatment Discharges Aged 12 and Older: 2012

Chapter 4. Short-Term Residential Treatment Discharges Aged 12 and Older: 2012

Chapter 5. Long-Term Residential Treatment Discharges Aged 12 and Older: 2012

Chapter 6. Hospital Residential Treatment Discharges Aged 12 and Older: 2012

Chapter 7. Detoxification Discharges Aged 12 and Older: 2012

Chapter 8. Outpatient Medication-Assisted Opioid Therapy Discharges Aged 12 and Older: 2012

Chapter 9. Medication-Assisted Opioid Detoxification Discharges Aged 12 and Older: 2012

Appendix A. About the Treatment Episode Data Set (TEDS)

Appendix B. TEDS Data Elements

Appendix C. List of Contributors

List of Tables

Discharge Data Description and Data Overview for All Types of Service

1.1a. Total and linked discharges aged 12 and older, by state or jurisdiction: Number, 2012

1.1b. Total and linked discharges aged 12 and older, by state and jurisdiction: Percent distribution, 2012

1.2a. Discharges aged 12 and older, by type of service and state or jurisdiction: Number, 2012

1.2b. Discharges aged 12 and older, by type of service and state or jurisdiction: Percent distribution, 2012

1.3a. Discharges aged 12 and older, by reason for discharge and state or jurisdiction: Number, 2012

1.3b. Discharges aged 12 and older, by reason for discharge and state or jurisdiction: Percent distribution, 2012

1.4. Discharges aged 12 and older, by reason for discharge and type of service: Number, percent distribution, and median length of stay (LOS),2012

1.5. Discharges aged 12 and older, by type of service and characteristics at admission: Number, 2012

1.6a. Discharges aged 12 and older, by type of service and selected characteristics at admission: Number, 2012

1.6b. Discharges aged 12 and older, by type of service and selected characteristics at discharge: Number, 2012

1.7. Discharges aged 12 and older, by type of service and characteristics at admission: Percent distribution, 2012

1.8a. Discharges aged 12 and older, by type of service and selected characteristics at admission: Percent distribution, 2012

1.8b. Discharges aged 12 and older, by type of service and selected characteristics at discharge: Percent distribution, 2012

1.9. Discharges aged 12 and older completing treatment or transferring to further treatment, by type of service and characteristics at admission: Percent, 2012

1.10a. Discharges aged 12 and older completing treatment or transferring to further treatment, by type of service and selected characteristics at admission: Percent, 2012

1.10b. Discharges aged 12 and older completing treatment or transferring to further treatment, by type of service and selected characteristics at discharge: Percent, 2012

Outpatient Treatment

2.1. Outpatient treatment discharges aged 12 and older, by reason for discharge and state or jurisdiction: Number and percent distribution, 2012

2.2. Outpatient treatment discharges aged 12 and older, by reason for discharge, treatment completion/transfer, median length of stay (LOS), and characteristics at admission: Number, percent distribution, and rate, 2012

2.3. Outpatient treatment discharges aged 12 and older, by reason for discharge and selected characteristics at admission and discharge: Number, 2012

2.4. Outpatient treatment discharges aged 12 and older, by treatment completion/transfer, median length of stay (LOS), and selected characteristics at admission and discharge: Number, percent distribution, and rate, 2012

Intensive Outpatient Treatment

3.1. Intensive outpatient treatment discharges aged 12 and older, by reason for discharge and state or jurisdiction: Number and percent distribution, 2012

3.2. Intensive outpatient treatment discharges aged 12 and older, by reason for discharge, treatment completion/transfer, median length of stay (LOS), and characteristics at admission: Number, percent distribution, and rate, 2012

3.3. Intensive outpatient treatment discharges aged 12 and older, by reason for discharge and selected characteristics at admission and discharge: Number, 2012

3.4. Intensive outpatient treatment discharges aged 12 and older, by treatment completion/transfer, median length of stay (LOS), and selected characteristics at admission and discharge: Number, percent distribution, and rate, 2012

Short-Term Residential Treatment

4.1. Short-term residential treatment discharges aged 12 and older, by reason for discharge and state or jurisdiction: Number and percent distribution, 2012

4.2. Short-term residential treatment discharges aged 12 and older, by reason for discharge, treatment completion/transfer, median length of stay (LOS), and characteristics at admission: Number, percent distribution, and rate, 2012

4.3. Short-term residential treatment discharges aged 12 and older, by reason for discharge and selected characteristics at admission and discharge: Number, 2012

4.4. Short-term residential treatment discharges aged 12 and older, by treatment completion/transfer, median length of stay (LOS), and selected characteristics at admission and discharge: Number, percent distribution, and rate, 2012

Long-Term Residential Treatment

5.1. Long-term residential treatment discharges aged 12 and older, by reason for discharge and state or jurisdiction: Number and percent distribution, 2012

5.2. Long-term residential treatment discharges aged 12 and older, by reason for discharge, treatment completion/transfer, median length of stay (LOS), and characteristics at admission: Number, percent distribution, and rate, 2012

5.3. Long-term residential treatment discharges aged 12 and older, by reason for discharge and selected characteristics at admission and discharge: Number, 2012

5.4. Long-term residential treatment discharges aged 12 and older, by treatment completion/transfer, median length of stay (LOS), and selected characteristics at admission and discharge: Number, percent distribution, and rate, 2012

Hospital Residential Treatment

6.1. Hospital residential treatment discharges aged 12 and older, by reason for discharge and state or jurisdiction: Number and percent distribution, 2012

6.2. Hospital residential treatment discharges aged 12 and older, by reason for discharge, treatment completion/transfer, median length of stay (LOS), and characteristics at admission: Number, percent distribution, and rate, 2012

6.3. Hospital residential treatment discharges aged 12 and older, by reason for discharge and selected characteristics at admission and discharge: Number, 2012

6.4. Hospital residential treatment discharges aged 12 and older, by treatment completion/transfer, median length of stay (LOS), and selected characteristics at admission and discharge: Number, percent distribution, and rate, 2012

Detoxification

7.1. Detoxification discharges aged 12 and older, by reason for discharge and state or jurisdiction: Number and percent distribution, 2012

7.2. Detoxification discharges aged 12 and older, by reason for discharge, treatment completion/transfer, median length of stay (LOS), and characteristics at admission: Number, percent distribution, and rate, 2012

7.3. Detoxification discharges aged 12 and older, by reason for discharge and selected characteristics at admission and discharge: Number, 2012

7.4. Detoxification discharges aged 12 and older, by treatment completion/transfer, median length of stay (LOS), and selected characteristics at admission and discharge: Number, percent distribution, and rate, 2012

Outpatient Medication-Assisted Opioid Therapy

8.1. Outpatient medication-assisted opioid therapy discharges aged 12 and older, by reason for discharge and state or jurisdiction: Number and percent distribution, 2012

8.2. Outpatient medication-assisted opioid therapy discharges aged 12 and older, by reason for discharge, treatment completion/transfer, median length of stay (LOS), and characteristics at admission: Number, percent distribution, and rate, 2012

8.3. Outpatient medication-assisted opioid therapy discharges aged 12 and older, by reason for discharge and selected characteristics at admission and discharge: Number, 2012

8.4. Outpatient medication-assisted opioid therapy discharges aged 12 and older, by treatment completion/transfer, median length of stay (LOS), and selected characteristics at admission and discharge: Number, percent distribution, and rate, 2012

Medication-Assisted Opioid Detoxification

9.1. Medication-assisted opioid detoxification discharges aged 12 and older, by reason for discharge and state or jurisdiction: Number and percent distribution, 2012

9.2. Medication-assisted opioid detoxification discharges aged 12 and older, by reason for discharge, treatment completion/transfer, median length of stay (LOS), and characteristics at admission: Number, percent distribution, and rate, 2012

9.3. Medication-assisted opioid detoxification discharges aged 12 and older, by reason for discharge and selected characteristics at admission and discharge: Number, 2012

9.4. Medication-assisted opioid detoxification discharges aged 12 and older, by treatment completion/transfer, median length of stay (LOS), and selected characteristics at admission and discharge: Number, percent distribution, and rate, 2012

Appendix A: About the Treatment Episode Data Set (TEDS)

Appendix Table 1. State data system reporting characteristics: 2012

Appendix Table 2. Item percentage response rate: Linked Data Set, 2012

List of Figures

Discharge Data Description and Data Overview for All Types of Service

1.1 Type of service at discharge: 2012

1.2 Reason for discharge: 2012

1.3 Reason for discharge, by type of service: 2012

1.4 Median length of stay (LOS), by reason for discharge and type of service: 2012

Outpatient Treatment

2.1 Reason for discharge from outpatient treatment: 2012

2.2 Median length of stay (LOS) in outpatient treatment, by reason for discharge: 2012

Intensive Outpatient Treatment

3.1 Reason for discharge from intensive outpatient treatment: 2012

3.2 Median length of stay (LOS) in intensive outpatient treatment, by reason for discharge: 2012

Short-Term Residential Treatment

4.1 Reason for discharge from short-term residential treatment: 2012

4.2 Median length of stay (LOS) in short-term residential treatment, by reason for discharge: 2012

Long-Term Residential Treatment

5.1 Reason for discharge from long-term residential treatment: 2012

5.2 Median length of stay (LOS) in long-term residential treatment, by reason for discharge: 2012

Hospital Residential Treatment

6.1 Reason for discharge from hospital residential treatment: 2012

6.2 Median length of stay (LOS) in hospital residential treatment, by reason for discharge: 2012

Detoxification

7.1 Reason for discharge from detoxification: 2012

7.2 Median length of stay (LOS) in detoxification, by reason for discharge: 2012

Outpatient Medication-Assisted Opioid Therapy

8.1 Reason for discharge from outpatient medication-assisted opioid therapy: 2012

8.2 Median length of stay (LOS) in outpatient medication-assisted opioid therapy, by reason for discharge: 2012

Medication-Assisted Opioid Detoxification

9.1 Reason for discharge from medication-assisted opioid detoxification: 2012

9.2 Median length of stay (LOS) in medication-assisted opioid detoxification, by reason for discharge: 2012

This report presents results from the Treatment Episode Data Set (TEDS) for discharges aged 12 and older from substance abuse treatment in 2012. The report provides information on treatment completion, length of stay in treatment, and demographic and substance abuse characteristics of discharges from alcohol or drug treatment in facilities that are reported to individual state administrative data systems. Data are presented for specific service types rather than for treatment episodes, which can involve treatment in multiple service types.¹

• Forty-nine states and jurisdictions submitted 1,767,243 eligible records for discharges occurring in 2012. (Kansas, Mississippi, and New Mexico submitted no data or incomplete data for 2012 by January 23, 2015, and are excluded from this report.)
• Ninety-two percent of the eligible records (1,634,695) could be linked to a TEDS admission record from 2000 through 2012. The 1,634,695 linked discharge records form the basis for this report [Tables 1.1a-b].

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.

Type of Service

Of the 1,634,695 discharges in 2012 [Table 1.2b]:

• 43 percent were discharged from outpatient treatment
• 21 percent were discharged from detoxification
• 12 percent were discharged from intensive outpatient treatment
• 10 percent were discharged from short-term residential treatment
• 7 percent were discharged from long-term residential treatment
• 6 percent were discharged from medication-assisted (i.e., using methadone or buprenorphine) opioid therapy or detoxification
• Less than 1 percent were discharged from hospital residential treatment

For Tables 1.3a-b only, the “Other” category excludes the categories “Death” and “Incarcerated.”

Reason for Discharge

Of the 1,634,695 discharges in 2012 [Table 1.3b]:

• 45 percent of the discharges completed treatment
• 26 percent of the discharges dropped out of treatment
• 15 percent of the discharges were transferred to further treatment
• 7 percent of the discharges had treatment terminated by the facility
• 2 percent of the discharges were incarcerated
• Less than 1 percent of the discharges failed to complete treatment because they died
• 5 percent of the discharges failed to complete treatment for other reasons

Treatment Completion by Service Type

The treatment completion rate was 45 percent for discharges from all service types combined. For the individual service types, treatment was completed by [Table 1.4]:

• 69 percent of discharges from detoxification
• 55 percent of discharges from short-term residential treatment
• 54 percent of discharges from hospital residential treatment
• 47 percent of discharges from medication-assisted opioid detoxification
• 45 percent of discharges from long-term residential treatment
• 37 percent of discharges from outpatient treatment
• 33 percent of discharges from intensive outpatient treatment
• 12 percent of discharges from outpatient medication-assisted opioid therapy

Median Length of Stay (LOS)

The median LOS in treatment by type of service was [Table 1.4]:

• 153 days for discharges from outpatient medication-assisted opioid therapy
• 90 days for discharges from outpatient treatment
• 56 days for discharges from long-term residential treatment
• 56 days for discharges from intensive outpatient treatment
• 21 days for discharges from short-term residential treatment
• 7 days for discharges from hospital residential treatment
• 7 days for discharges from medication-assisted opioid detoxification
• 4 days for discharges from detoxification

The median LOS by type of service, limited to only those who completed treatment, was [Table 1.4]:

• 201 days for discharges completing outpatient medication-assisted opioid therapy
• 129 days for discharges completing outpatient treatment
• 90 days for discharges completing long-term residential treatment
• 84 days for discharges completing intensive outpatient treatment
• 27 days for discharges completing short-term residential treatment
• 14 days for discharges completing hospital residential treatment
• 6 days for discharges completing medication-assisted opioid detoxification
• 4 days for discharges completing detoxification

To Table of Contents

Data Definitions
Data Overview
Reason for Discharge by Type of Service
Median Length of Stay (LOS) by Type of Service and Reason for Discharge
Socio-Demographic and Substance Use Related Characteristics at Time of Admission
Comparison of Selected Characteristics at Admission and Discharge
Treatment Completion or Transfer to Further Treatment

This report presents data from the Treatment Episode Data Set (TEDS) for discharges from treatment in 2012. It is a companion to the reports Treatment Episode Data Set (TEDS): 2002-2012 National Admissions to Substance Abuse Treatment and Treatment Episode Data Set (TEDS): 2002-2012 State Admissions to Substance Abuse Treatment. These reports provide information on the demographic and substance abuse characteristics of substance abuse treatment admissions and discharges aged 12 and older in facilities that report to individual state administrative data systems.^1,2 In addition, characteristics used to analyze changes from admission to discharge among the linked admission and discharge records are included. Primary substance of abuse, frequency of use, and employment status at admission are repeated in several tables. This is done so that characteristics at admission and discharge can be appropriately compared with each other and to ensure the inclusion of important data that might otherwise be overlooked. Data in this report include records for discharges during calendar year 2012 that were received and processed through January 23, 2015.³

Categories for three data items are excluded from the narrative analysis: the “6 to 96” category for the variable “arrests in the past 30 days” is excluded because of large variance, the “other” category for the variable “detailed not in labor force” is excluded because of “unknown” categories, and the “some attendance but frequency unknown” category for the variable “self-help program attended in the past 30 days” is excluded because the actual number of times an individual attended a program is “unknown.”

TEDS does not include all admissions to substance abuse treatment. It includes admissions to facilities that are licensed or certified by a state substance abuse agency to provide substance abuse treatment (or are administratively tracked for other reasons). In general, facilities reporting TEDS data are those that receive state alcohol and/or drug agency funds (including federal block grant funds) for the provision of alcohol and/or drug treatment services. Additional information on the history and methodology of TEDS and this report as well as important issues related to state data collection systems are detailed in Appendix A.

TEDS is an admission-based system, and TEDS admissions do not represent individuals. Thus, an individual admitted to and discharged from treatment twice within a calendar year is counted as two discharges.

Data in this report are presented for specific service types rather than for treatment episodes, which can involve treatment in multiple service types. States are asked to submit a record for each initial admission to a treatment service, for each transfer from one service to another, and for a discharge corresponding to each admission or transfer. The linked pairs of admission/transfer and discharge records enable analyses of treatment completion and length of stay (LOS) in treatment in specific service types.

This chapter describes the discharge data and provides an overview of the linked admission/discharge records for discharges in 2012. Some tables in this report present data by state or jurisdiction. It is important to note that comparisons between and across states and jurisdictions should be made with caution. There are many factors (e.g., facilities included, clients included, ability to track multi-service episodes, services offered, and completeness and timeliness of reporting) that can affect comparability. See Appendix A for a full discussion.

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.
² For employment status and detailed not in labor force, only discharges aged 16 and older are included; for years of education, only discharges aged 18 and older are included.
³ For researchers interested in more detailed analysis, TEDS public use files are available for online data analysis or download at the Substance Abuse and Mental Health Data Archive, which can be accessed at http://datafiles.samhsa.gov. Summary data for individual states that have submitted the full year of data are available online through the Quick Statistics website at http://wwwdasis.samhsa.gov/webt/NewMapv1.htm.

Data Definitions

Type of Service

Data are presented for each of the eight different types of services (listed below). The following types of services exclude records where medication-assisted (with methadone or buprenorphine) opioid therapy or detoxification was planned as part of treatment:

• Outpatient treatment (less than 24-hours per day case)—Includes individual, family, and/or group services and may include pharmacological therapies other than methadone or buprenorphine
  
• Intensive outpatient treatment (less than 24-hours per day case)—A minimum of 2 or more hours per day for 3 or more days per week
• Short-term residential treatment—Typically, 30 days or fewer of non-acute care in a setting with treatment services for substance abuse and dependency
• Long-term residential treatment—Typically, more than 30 days of non-acute care in a setting with treatment services for substance abuse and dependence; may include transitional living arrangements such as halfway houses
• Hospital residential treatment—24-hour per day medical care in a hospital facility in conjunction with treatment services for substance abuse and dependence; excludes detoxification
• Detoxification—Includes free-standing residential detoxification (81 percent of detoxification discharges), hospital detoxification (16 percent), and outpatient detoxification (3 percent)
  
  • Free-standing residential detoxification—24-hour per day services in a non-hospital setting providing for safe withdrawal and transition to ongoing treatment
  • Hospital detoxification—24-hour per day acute medical care services in a hospital setting for persons with severe medical complications associated with withdrawal
  • Outpatient detoxification—Treatment services providing for safe withdrawal in an outpatient setting

The following include only medication-assisted opioid therapy or detoxification records:

• Outpatient medication-assisted opioid therapy—Outpatient or intensive outpatient treatment services (94 percent and 6 percent of outpatient medication-assisted opioid therapy discharges, respectively) where medication-assisted therapy with methadone or buprenorphine was planned
• Medication-assisted opioid detoxification—Outpatient detoxification, free-standing residential detoxification, and hospital detoxification (46 percent, 43 percent, and 11 percent of medication-assisted opioid detoxification discharges, respectively) where medication-assisted therapy with methadone or buprenorphine was planned

Medication-assisted opioid therapy discharges from short- and long-term residential treatment and hospital residential treatment represented less than 1 percent of all records. They are excluded from this report.

Reason for Discharge

The reasons for discharge from substance abuse treatment tabulated in this report include:

• Completed treatment—Client completed all parts of the treatment plan or program
• Transferred to another substance abuse program or facility—Client was transferred to another substance abuse treatment service type, program, provider, or facility; except when it is known that the client did not report to the next program
• Dropped out—Client chose not to complete the treatment program, with or without specific advice to continue treatment; includes clients who dropped out for unknown reasons and clients who had not received treatment for some time and received administrative discharges
• Terminated by facility—Treatment was terminated by the action of the facility, generally because of client non-compliance or violation of rules, laws, or procedures; excludes client drop-out, incarceration, or client-motivated reason for discontinuance
• Incarcerated—Treatment was terminated because the client was incarcerated (jail, prison, house confinement)
• Death—Treatment was terminated because the client died
• Other—Client left treatment for other specified reasons (e.g., client moved, became ill, was hospitalized, or other reason somewhat out of client’s control)

Because both treatment completion and transfer to further treatment represent positive conclusions to a treatment episode or component of a treatment episode, their rates are combined in some of the analyses.

Length of Stay (LOS) in Treatment

The length of stay (LOS) in days was calculated for each record by subtracting the date of admission from the date of last contact. For all outpatient service types, one day was added so that both the day of admission and the day of last contact were counted as days on which services were delivered. For hospital and residential service types, this was not done, and records where the date of admission and the date of last contact were the same (LOS = 0 days) were excluded from the analysis. The measure of LOS used in this report is the median—the number of days at which half of all discharges had taken place.

Linking discharge records from 2012 to admission records from 2000 to 2012 means that the maximum LOS in treatment included in this report is 13 years. However, outpatient medication-assisted opioid therapy can have a much longer duration. Indeed, some admissions may receive this form of treatment indefinitely. Because this report includes data only on discharges, it will underestimate LOS in treatment for those receiving outpatient medication-assisted opioid therapy. Similarly, the number and proportion of treatment completers will reflect only those who have been discharged because treatment is complete and not those who successfully remain in long-term outpatient medication-assisted opioid therapy. In addition, the characteristics at admission of those admitted to and discharged from outpatient medication-assisted opioid therapy within 13 years may differ from those of admissions who remain in outpatient medication-assisted opioid therapy for longer than 13 years.

Data Overview

Forty-nine states and jurisdictions submitted 1,767,243 eligible records for clients discharged in 2012. (Kansas, Mississippi, and New Mexico submitted no data or incomplete data for 2012 by January 23, 2015, and are excluded from this report.)

Tables 1.1a-b. Of the 1,767,243 eligible discharge records, 92 percent (1,634,695) could be linked to a TEDS admission or transfer record from 2000 through 2012. These 1,634,695 records form the basis of this report. Most of the 2012 discharge records linked to an admission or transfer occurring in 2012 (72 percent of the total discharge records), 18 percent linked to a 2011 admission record and 2 percent linked were from a 2000 to 2010 admission record.

Type of Service

Tables 1.2a-b. These tables present type of service at discharge by state for 2012 discharges. There was considerable state-to-state variability in the combination of service types available and in the proportions discharged from each of these service types.

Figure 1.1 illustrates the overall distribution of service type among all 2012 discharges: the majority were discharged from an outpatient service type—43 percent from outpatient treatment and 12 percent from intensive outpatient treatment—in addition, 21 percent were discharged from detoxification, 10 percent from short-term residential treatment, 7 percent from long-term residential treatment, 6 percent from medication-assisted opioid therapy or detoxification, and less than 1 percent from hospital residential treatment.

Reason for Discharge

Tables 1.3a-b. These tables present reason for discharge by state or jurisdiction. However, the “Other” category does not include data for “Death” and “Incarcerated.”

Figure 1.2 illustrates the overall distribution of reason for discharge among 2012 discharges. Almost half (45 percent) of all discharges completed treatment. Another 15 percent were transferred to further substance abuse treatment. Twenty-six percent dropped out of treatment, 7 percent had their treatment terminated at the facility’s request, 2 percent were incarcerated during treatment, less than 1 percent died before being discharged, and 5 percent failed to complete treatment for other reasons.

Reason for Discharge by Type of Service

Table 1.4 and Figure 1.3 present reason for discharge by type of service.

• The treatment completion rate was highest among discharges from detoxification (69 percent).
• The treatment completion rate for medication-assisted opioid treatment was 47 percent.
• The completion rates for residential treatment (55 percent for short-term residential treatment, 54 percent for hospital residential treatment, and 45 percent for long-term residential treatment) were higher than those in the less structured outpatient settings (37 percent for outpatient treatment, 33 percent for intensive outpatient treatment, and 12 percent for outpatient medication-assisted opioid therapy treatment).
• Transfer to further substance abuse treatment was most common among discharges from intensive outpatient treatment (23 percent), followed by medication-assisted opioid detoxification and outpatient medication-assisted opioid therapy (20 percent each), and short-term residential treatment (17 percent).
• Treatment dropout was highest among discharges from outpatient medication-assisted opioid therapy (41 percent) and outpatient treatment (31 percent).

Median Length of Stay (LOS) by Type of Service and Reason for Discharge

Table 1.4.

• The median LOS was longest for all discharges from outpatient medication-assisted opioid therapy (153 days), followed by outpatient treatment (90 days) and long-term residential treatment and intensive outpatient treatment (both 56 days).
• The median LOS for all discharges from short-term residential treatment was 21 days; from hospital residential treatment and medication-assisted opioid detoxification, 7 days each; and from detoxification, 4 days.

Figure 1.4.

• The median LOS for discharges who completed treatment was longer than or equal to those who transferred to further treatment or who did not complete treatment in all service types except medication-assisted opioid detoxification.
• Among discharges completing treatment, the median LOS was longest for outpatient medication-assisted opioid therapy (201 days), followed by outpatient treatment (129 days), long-term residential treatment (90 days), intensive outpatient treatment (84 days), short-term residential treatment (27 days), hospital residential treatment (14 days), medication-assisted opioid detoxification (6 days), and detoxification (4 days).

Socio-Demographic and Substance Use Related Characteristics at Time of Admission

Tables 1.5 and 1.7 summarize the number and percent distribution of characteristics at admission, by service type for all discharges. Summary findings of the admission characteristics of all discharges combined include:

• 66 percent of all discharges were male
• 31 percent of all discharges were 21 to 30 years of age at the time of admission and 22 and 21 percent, respectively, were 31 to 40 years of age or 41 to 50 years of age, while 13 percent each were 12 to 20 or over age 50
• 61 percent of all discharges were non-Hispanic White
• 60 percent of all discharges had been in treatment at least once prior to the current episode
• 36 percent of all discharges were self- or individual referrals and 33 percent were referred to treatment through a criminal justice/DUI source
• 71 percent of all discharges, aged 18 and older reported completing 12 or more years of education

Comparison of Selected Characteristics at Admission and Discharge

Tables 1.6a-b and 1.8a-b summarize the number and percent distribution of selected characteristics at admission and at discharge, by service type for all discharges. Summary findings for all discharges combined include:

• Of all discharges aged 16 and older, 40 percent were unemployed and 38 percent were not in the labor force at admission, while 40 percent were unemployed and 34 percent were not in the labor force at discharge
• At admission, among all those not in the labor force, 54 percent reported being in a category “other than homemaker, student, retired, disabled, or institutional inmate” and 23 percent reported being “disabled”; among all those not in the labor force at discharge, 48 percent reported being in a category “other than homemaker, student, retired, disabled, or institutional inmate” and 25 percent reported being “disabled”
• At admission, 65 percent of all discharges reported living independently, and 67 percent reported living independently at discharge
• At admission, 92 percent of all discharges had not been arrested in the past 30, and 95 percent had not been arrested in the past 30 days at discharge
• At admission, 40 percent reported daily use of the primary substance in the month before treatment entry and 29 percent reported no use in the past month; at discharge, 20 percent reported daily use and 55 percent reported no use in the past month
• At admission, 19 percent of all discharges reported attending at least one self-help program in the 30 days, and 26 percent of all discharges reported attending at least one such program in the 30 days before discharge

Characteristics at Admission by Type of Service

Table 1.7. Although the characteristics at admission of discharges varied by service type, some general observations can be made.

• Discharges from outpatient and intensive outpatient treatment, compared with discharges from other service types, were generally younger, reported one or more previous treatment episodes less frequently, and reported being employed more frequently. In regards to primary substance, these discharges reported marijuana more frequently and opiates less frequently. These discharges were more frequently referred to treatment by a criminal justice/DUI source and also reported using the primary substance less than daily in the month before treatment entry.
• Discharges from detoxification, outpatient medication-assisted opioid therapy, and medication-assisted opioid detoxification, compared with discharges from other service types, were generally older and reported being of Hispanic origin more frequently. These discharges reported being self- or individual referrals to treatment more frequently, but reported being referred by a criminal justice/DUI source less frequently. These discharges reported opiates as the primary substance more frequently (a high proportion of discharges from detoxification also reported alcohol). These discharges reported daily use of the primary substance in the month before treatment entry as well as one or more prior treatment episode more frequently than other discharges.
• Discharges from short-term and long-term residential treatment, compared with discharges from other service types, reported cocaine as the primary substance and being unemployed or not in the labor force more frequently. These discharges generally reported having one or more prior treatment episodes and being referred to treatment through a health care or community provider more frequently.
• Discharges from hospital residential treatment, compared with discharges from other service types, were generally older, non-Hispanic White with more than 12 years of education. These discharges also more frequently reported alcohol as the primary substance.

Treatment Completion or Transfer to Further Treatment

Completion/Transfer Rates

In this section, “completion/transfer rate” refers to the number of treatment completions or transfers per 100 discharges. To illustrate, the overall rate is calculated as the sum of all treatment completions and transfers divided by all discharges (which includes those who dropped out, were terminated by facility, or did not complete treatment for other reasons) and the resulting number (fraction) is multiplied by 100. Of all treatment discharges aged 12 and older in 2012, the overall percentage that completed treatment or transferred to further treatment (i.e., completion/transfer rate) was 60 percent.

Table 1.9 and Table 1.3b present the percentage of all discharges either completing treatment or transferring to further treatment by service type and characteristics at admission. For all service types combined, the treatment completion/transfer rate was 60 percent (45 percent completed treatment, 15 percent transferred).

Completion/transfer rates showed some variation both by admission characteristics and by service type. The largest variation in treatment completion/transfer rates by admission characteristic for all discharges for all service types was for primary substance, ranging from 52 percent for marijuana to 67 percent for alcohol. For service type, the rates ranged from 32 percent among discharges from outpatient medication-assisted opioid therapy to 79 percent among discharges from detoxification.

Some general observations can be made about the completion/transfer rate for all discharges aged 12 and older combined:

• The treatment completion/transfer rate increased with education
• For known primary substance of abuse, the treatment completion/transfer rates were highest for alcohol (67 percent), followed by stimulants and cocaine (62 percent and 56 percent, respectively)
• The treatment completion/transfer rate was higher among those who were employed than among those who were unemployed or not in the labor force
• The treatment completion/transfer rate was lower among non-Hispanic Blacks and those of Hispanic origin (56 percent and 58 percent, respectively) than among non-Hispanic Whites (61 percent)

To Tables

To Table of Contents

Reason for Discharge
Median Length of Stay (LOS)
Socio-Demographic and Substance Use Characteristics at Time of Admission
Comparison of Outpatient Discharges to All Discharges on Characteristics at Admission
Comparison of Selected Characteristics at Admission and at Discharge for Outpatient Discharges
Treatment Completion or Transfer to Further Treatment

Chapter 2 presents data on the reason for discharge, median length of stay (LOS) in treatment, and socio-demographic and substance use characteristics of the 703,290 outpatient treatment discharges aged 12 and older in 2012.^1,2 Each of the 49 reporting states and jurisdictions, reported discharges from outpatient treatment [Table 2.1]. Outpatient treatment in this chapter excludes intensive outpatient treatment (covered in Chapter 3), outpatient detoxification (covered in Chapter 7), and outpatient medication-assisted opioid therapy (covered in Chapter 8).

Reason for Discharge

Table 2.1 and Figure 2.1. For the 703,290 discharges from outpatient treatment, the reasons for discharge were:

• Completed treatment: 37 percent (262,270)
• Transferred to further treatment: 14 percent (96,182)
• Dropped out of treatment: 31 percent (216,925)
• Treatment terminated by the facility: 8 percent (58,636)
• Failed to complete treatment for other reasons: 10 percent (69,277)

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.
² For employment status and detailed not in labor force, only discharges aged 16 and older are included; for years of education, only discharges aged 18 and older are included.

Median Length of Stay (LOS)

Table 1.4 and Figure 2.2. The median length of stay (LOS) for outpatient treatment discharges aged 12 and older in 2012 was 90 days. By reason for discharge, the median LOS for outpatient treatment discharges was:

• Completed treatment: 129 days
• Transferred to further treatment: 42 days
• Dropped out of treatment: 61 days
• Treatment terminated by the facility: 79 days
• Failed to complete treatment for other reasons: 79 days

Socio-Demographic and Substance Use Characteristics at Time of Admission

Table 1.7. Summary findings of characteristics at time of admission of outpatient treatment discharges aged 12 and older include:

• Gender: 66 percent of outpatient discharges were male
• Age at admission: 18 percent of outpatient discharges were 12 to 20 years of age, 32 percent were 21 to 30 years of age, 22 percent were 31 to 40 years of age, 18 percent were 41 to 50 years of age, and 11 percent were over 50 years of age
• Race/ethnicity: 60 percent of outpatient discharges were non-Hispanic White, 20 percent were non-Hispanic Black, 14 percent were Hispanic, and 6 percent were a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Primary substance: Alcohol was the most commonly reported primary substance of abuse at time of admission among outpatient discharges (40 percent), followed by marijuana (27 percent), opiates (14 percent), stimulants (8 percent), cocaine (7 percent), and other or unknown substances (3 percent)
• Frequency of use: 43 percent of outpatient discharges reported no substance use in the month before treatment entry
  
• Number of prior treatment episodes: Half (50 percent) of outpatient discharges had one or more prior treatment episodes
• Treatment referral source: 49 percent of outpatient discharges were referred to treatment by criminal justice/DUI sources, 28 percent were health care or community referrals, and 23 percent were self- or individual referrals
• Employment status: Of all discharges aged 16 and older, 39 percent were unemployed and 30 percent were not in the labor force at time of admission
• Years of education: 44 percent of outpatient discharges aged 18 and older had 12 years of education or a GED

Comparison of Outpatient Discharges to All Discharges on Characteristics at Admission

Tables 1.7 and 1.8a. There were some notable differences in the characteristics at admission of discharges from outpatient treatment compared to the characteristics at admission of all discharges combined.

• Number of prior treatment episodes: 50 percent of outpatient discharges vs. 40 percent of all discharges had no prior treatment episodes
• Treatment referral source:
  
  • 49 percent of outpatient discharges were criminal justice/DUI referrals vs. 33 percent of all discharges
  • 23 percent of outpatient discharges were self- or individual referrals vs. 36 percent of all discharges
• Detailed not in labor force: Among outpatient discharges aged 16 and older not in the labor force at admission, 21 percent were students vs. 12 percent of all discharges
• Employment status: 31 percent of outpatient discharges aged 16 and older were employed vs. 22 percent of all discharges
  
• Primary substance:
  
  • 27 percent of outpatient discharges reported marijuana as their primary substance of abuse vs. 17 percent of all discharges
  • 14 percent of outpatient discharges reported opiates as their primary substance of abuse vs. 26 percent of all discharges
• Frequency of use:
  
  • 19 percent of outpatient discharges reported daily substance use in the month before treatment entry vs. 40 percent of all discharges
  • 43 percent of outpatient discharges reported no substance use in the month before treatment entry vs. 29 percent of all discharges
• Living arrangements: 5 percent of outpatient discharges were homeless vs. 14 percent of all discharges

Comparison of Selected Characteristics at Admission and at Discharge for Outpatient Discharges

Tables 1.8a-b. Certain socio-demographic and substance use characteristics were collected at both time of admission and time of discharge. Differences (changes) in status between admission and discharge for outpatient discharges include:

• Arrests in past 30 days: 92 percent of outpatient discharges reported no arrests in past 30 days at admission vs. 95 percent at discharge
• Detailed not in labor force: Among outpatient discharges aged 16 and older not in the labor force, 27 percent reported being disabled at admission and 21 percent were students at admission; at discharge, 28 percent reported being disabled and 20 percent were students
• Employment status: 31 percent of outpatient discharges aged 16 and older were employed at admission vs. 36 percent at discharge
• Frequency of use: 43 percent of outpatient discharges reported no substance use in the month before treatment vs. 62 percent at discharge
• Living arrangements: 73 percent of outpatient discharges reported living independently at admission vs. 75 percent at discharge
• Self-help programs attended in past 30 days: 23 percent of outpatient discharges reported attending at least one self-help program in the past 30 days at admission vs. 27 percent at discharge

Treatment Completion or Transfer to Further Treatment

Completion/Transfer Rates

In this section, “completion/transfer rate” refers to the number of treatment completions or transfers per 100 discharges. To illustrate, the overall rate is calculated as the sum of all treatment completions and transfers divided by all discharges (which includes those who dropped out, were terminated by facility, or did not complete treatment for other reasons) and the resulting number (fraction) is multiplied by 100. Of outpatient treatment discharges aged 12 and older in 2012, the overall percentage that completed treatment or transferred to further treatment (i.e., completion/transfer rate) was 51 percent. Up to three top rates for each characteristic are presented below.

Completion/Transfer Rates for Characteristics at Admission

Table 2.2. For outpatient discharges in 2012, the completion/transfer rates according to characteristics at admission include:

• Gender: The completion/transfer rate was 51 percent for male discharges and 50 percent for female discharges
  
• Age at admission: The completion/transfer rate was 55 percent for discharges over 50 years of age, 51 percent for discharges 31 to 50 years of age, and 50 percent for discharges 12 to 30 years of age
• Race/ethnicity: The completion/transfer rate was 53 percent each for non-Hispanic White and “other” discharges, 50 percent for Hispanic discharges, and 45 percent for non-Hispanic Black discharges
• Number of prior treatment episodes: The completion/transfer rate was 55 percent for discharges with no prior treatment episodes, and 48 percent for discharges with one or more prior treatment episodes
• Treatment referral source: The completion/transfer rate was 59 percent for discharges with criminal justice/DUI referrals, 46 percent for discharges from health care or community referrals, 41 percent for discharges with self- or individual referrals
• Years of education: The completion/transfer rate for ages 18 and older was 54 percent for discharges with more than 12 years of education; 52 percent for those with 12 years of education; and 47 percent for those with fewer than 12 years of education

Completion/Transfer Rates for Selected Characteristics at Discharge

Table 2.4. For outpatient discharges in 2012, the completion/transfer rates according to characteristics at discharge include:

• Arrests in past 30 days: The completion/transfer rate was 56 percent for discharges with no arrests in the 30 days before discharge, 42 percent for discharges with 4 arrests in the 30 days before discharge, and 41 percent for those with 3 arrests in the 30 days before discharge
• Detailed not in labor force: The completion/transfer rate for ages 16 and older was 64 percent for discharges who were retired, 54 percent for students, and 52 percent for homemakers
• Employment status: The completion/transfer rate for ages 16 and older was 64 percent for discharges who were employed and 49 percent for those who were unemployed or not in the labor force
• Frequency of use: The completion/transfer rate was 65 percent for discharges with no substance use in the 30 days before discharge and 42 percent each for those with daily or some substance use in the 30 days before discharge
• Living arrangements: The completion/transfer rate was 61 percent for discharges with dependent living status, 53 percent with independent living status, and 46 percent for the discharges who were homeless
• Self-help programs attended in past 30 days: The completion/transfer rate was 69 percent for discharges who attended self-help programs 8-15 times in the 30 days before discharge, 67 percent for those who attended self-help programs 16-30 times in the 30 days before discharge, and 62 percent for those who attended 4-7 times in the 30 days before discharge

Median Length of Stay (LOS) of Discharges Completing Treatment

Tables 2.2 and 2.4. The overall median LOS among those completing outpatient treatment (excluding those who were transferred to further treatment) was 129 days. Median LOS for characteristics at admission and at discharge for outpatient discharges that completed treatment include:

At admission:

From Table 2.2,

• The median LOS was longest for discharges of Hispanic origin (148 days)
• The median LOS was shortest for discharges aged 12 to 20 years (120 days)

From Table 2.4,

• The median LOS was longest among discharges not in the labor force that reported being disabled (148 days)
• The median LOS was shortest among discharges not in the labor force that reported being institutional inmates (84 days)

At discharge:

From Table 2.4,

• The median LOS was longest among discharges not in the labor force that reported being disabled (156 days)
• The median LOS was shortest among discharges that reported daily use of the primary substance in the past month (51 days)

To Tables

To Table of Contents

Reason for Discharge
Median Length of Stay (LOS)
Socio-Demographic and Substance Use Characteristics at Time of Admission
Comparison of Intensive Outpatient Discharges to All Discharges on Characteristics at Admission
Comparison of Selected Characteristics at Admission and at Discharge for Intensive Outpatient Discharges
Treatment Completion or Transfer to Further Treatment

Chapter 3 presents data on the reason for discharge, median length of stay (LOS) in treatment, and socio-demographic and substance use characteristics of the 203,127 intensive outpatient treatment discharges aged 12 and older in 2012.^1,2 Of the 49 reporting states and jurisdictions, 46 states and 2 jurisdictions had discharges from intensive outpatient treatment [Table 3.1].

Reason for Discharge

Table 3.1 and Figure 3.1. For the 203,127 discharges from intensive outpatient treatment, the reasons for discharge were:

• Completed treatment: 33 percent (67,411)
• Transferred to further treatment: 23 percent (45,708)
• Dropped out of treatment: 26 percent (53,407)
• Treatment terminated by the facility: 9 percent (18,372)
• Failed to complete treatment for other reasons: 9 percent (18,229)

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.
² For employment status and detailed not in labor force, only discharges aged 16 and older are included; for years of education, only discharges aged 18 and older are included.

Median Length of Stay (LOS)

Table 1.4 and Figure 3.2. The median length of stay (LOS) for intensive outpatient treatment discharges aged 12 and older in 2012 was 56 days. By reason for discharge, the median LOS for intensive outpatient treatment discharges was:

• Completed treatment: 84 days
• Transferred to further treatment: 45 days
• Dropped out of treatment: 38 days
• Treatment terminated by the facility: 49 days
• Failed to complete treatment for other reasons: 50 days

Socio-Demographic and Substance Use Characteristics at Time of Admission

Table 1.7. Summary findings of characteristics at time of admission of intensive outpatient treatment discharges aged 12 and older include:

• Gender: 62 percent of intensive outpatient discharges were male
• Age at admission: 14 percent of intensive outpatient discharges were 12 to 20 years of age, 34 percent were 21 to 30 years of age, 23 percent were 31 to 40 years of age, 19 percent were 41 to 50 years of age, and 10 percent were over 50 years of age
• Race/ethnicity: 63 percent of intensive outpatient discharges were non-Hispanic White, 21 percent were non-Hispanic Black, 8 percent were Hispanic, and 8 percent were a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Primary substance: Alcohol was the most commonly reported primary substance of abuse at time of admission among intensive outpatient discharges (37 percent), followed by marijuana (23 percent), opiates (19 percent), stimulants (10 percent), cocaine (8 percent), and other or unknown substances (3 percent)
• Frequency of use: 39 percent of intensive outpatient discharges reported no substance use in the month before treatment entry
  
• Number of prior treatment episodes: 63 percent of intensive outpatient discharges had one or more prior treatment episodes, and 37 percent had no prior treatment episodes
• Treatment referral source: 44 percent of intensive outpatient discharges were referred to treatment from criminal justice/DUI referrals, 31 percent were health care or community referrals, and 25 percent were self- or individual referrals
• Employment status: Of all discharges aged 16 and older, 44 percent were unemployed and 33 percent were not in the labor force at time of admission
• Years of education: 43 percent of intensive outpatient discharges aged 18 and older had 12 years of education or a GED

Comparison of Intensive Outpatient Discharges to All Discharges on Characteristics at Admission

Tables 1.7 and 1.8a. There were some notable differences in the characteristics at admission of discharges from intensive outpatient treatment compared to the characteristics of all discharges combined.

• Treatment referral source:
  
  • 44 percent of intensive outpatient discharges were criminal justice/DUI referrals vs. 33 percent of all discharges
  • 25 percent of intensive outpatient discharges were self- or individual referrals vs. 36 percent of all discharges
• Detailed not in labor force: Among intensive outpatient discharges aged 16 and older not in the labor force at admission, 13 percent were institutional inmates vs. 6 percent of all discharges
• Primary substance:
  
  • 23 percent of intensive outpatient discharges reported marijuana as their primary substance of abuse vs. 17 percent of all discharges
  • 19 percent of intensive outpatient discharges reported opiates as their primary substance of abuse vs. 26 percent of all discharges
• Frequency of use:
  
  • 25 percent of intensive outpatient discharges reported daily substance use in the month before treatment entry vs. 40 percent of all discharges
  • 39 percent of intensive outpatient discharges reported no substance use in the month before treatment entry vs. 29 percent of all discharges
• Living arrangements: 7 percent of intensive outpatient discharges were homeless vs. 14 percent of all discharges

Comparison of Selected Characteristics at Admission and at Discharge for Intensive Outpatient Discharges

Tables 1.8a-b. Certain socio-demographic and substance use characteristics were collected at both time of admission and time of discharge. Differences (changes) in status between admission and discharge for outpatient discharges include:

• Arrests in past 30 days: 91 percent of intensive outpatient discharges reported no arrests in past 30 days at admission vs. 94 percent at discharge
• Detailed not in labor force: Among intensive outpatient discharges aged 16 and older not in the labor force, 25 percent reported being disabled at admission and 15 percent were students at admission; at discharge, 24 percent reported being disabled and 14 percent were students
• Employment status: 22 percent of intensive outpatient discharges aged 16 and older were employed at admission vs. 27 percent at discharge
• Frequency of use: 39 percent of intensive outpatient discharges reported no substance use in the month before treatment vs. 61 percent at discharge
• Living arrangements: 67 percent of intensive outpatient discharges reported living independently at admission vs. 68 percent at discharge
• Self-help programs attended in past 30 days: 31 percent of intensive outpatient discharges reported attending at least one self-help program in the past month at admission vs. 44 percent at discharge

Treatment Completion or Transfer to Further Treatment

Completion/Transfer Rates

In this section, “completion/transfer rate” refers to the number of treatment completions or transfers per 100 discharges. To illustrate, the overall rate is calculated as the sum of all treatment completions and transfers divided by all discharges (which includes those who dropped out, were terminated by facility, or did not complete treatment for other reasons) and the resulting number (fraction) is multiplied by 100. Of intensive outpatient treatment discharges aged 12 and older in 2012, the overall percentage that completed treatment or transferred to further treatment (i.e., completion/transfer rate) was 56 percent. Up to three top rates for each characteristic are presented below.

Completion/Transfer Rates for Characteristics at Admission

Table 3.2. For intensive outpatient discharges in 2012, the completion/transfer rates according to characteristics at admission include:

• Gender: The completion/transfer rate was 56 percent for male discharges and 54 percent for female discharges
• Age at admission: The completion/transfer rate was 61 percent for discharges over 50 years of age, 57 percent for discharges 31 to 50 years of age, and 55 percent for discharges 21 to 30 years of age
• Race/ethnicity: The completion/transfer rate was 58 percent for non-Hispanic White and “other” discharges, 53 percent for Hispanic discharges, and 49 percent for non-Hispanic Black discharges
• Number of prior treatment episodes: The completion/transfer rate was 58 percent for discharges with no prior treatment episodes and 55 percent for discharges with one or more prior treatment episodes
• Treatment referral source: The completion/transfer rate was 61 percent for discharges from criminal justice/DUI referrals, 53 percent for discharges from health care/community referrals, and 50 percent for discharges from self- or individual referrals
• Years of education: The completion/transfer rate for ages 18 and older was 60 percent for discharges with more than 12 years of education, 57 percent for those with 12 years of education, and 51 percent for those with fewer than 12 years of education

Completion/Transfer Rates for Selected Characteristics at Discharge

Table 3.4. For intensive outpatient discharges in 2012, the completion/transfer rates according to characteristics at discharge include:

• Arrests in past 30 days: The completion/transfer rate was 60 percent for discharges with no arrests in the 30 days before discharge, 48 percent for discharges with 4 arrests in the 30 days before discharge, and 44 percent for those with 3 arrests in the 30 days before discharge
• Detailed not in labor force: The completion/transfer rate for ages 16 and older was 69 percent for discharges who were retired, 64 percent for institutional inmates and homemakers, and 60 percent for students
• Employment status: The completion/transfer rate for ages 16 and older was 67 percent for discharges who were employed and 55 percent for those who were unemployed
• Frequency of use: The completion/transfer rate was 72 percent for discharges with no substance use in the 30 days before discharge, 48 percent for those with daily substance use in the 30 days before discharge, and 47 percent for those with some substance use in the 30 days before discharge
• Living arrangements: The completion/transfer rate was 62 percent for discharges with dependent living status, 58 percent with independent living status, and 47 percent for the discharges who were homeless
• Self-help programs attended in past 30 days: The completion/transfer rate was 81 percent for discharges who attended self-help programs 16-30 times in the 30 days before discharge, 80 percent for those who attended self-help programs 8-15 times in the 30 days before discharge, and 74 percent for those who attended such programs 4-7 times in the 30 days before discharge

Median Length of Stay (LOS) of Discharges Completing Treatment

Tables 3.2 and 3.4. The overall median LOS among those completing intensive outpatient treatment (excluding those who were transferred to further treatment) was 84 days. Median LOS for characteristics at admission and at discharge for intensive outpatient discharges that completed treatment include:

At admission:

From Table 3.2,

• The median LOS was longest for discharges from criminal justice/DUI referrals (93 days)
• The median LOS was shortest for discharges from self- or individual referrals (68 days)

From Table 3.4,

• The median LOS was longest among discharges that were arrested 5 times in past 30 days (107 days)
• The median LOS was shortest among discharges that reported daily use of the primary substance in the past month and discharges that attended self-help programs 16-30 times in the 30 days before admission (59 days each)

At discharge:

From Table 3.4,

• The median LOS was longest among discharges not in the labor force that reported being disabled (106 days)
• The median LOS was shortest among discharges that reported daily use of the primary substance in the past month (36 days)

To Tables

To Table of Contents

Reason for Discharge
Median Length of Stay (LOS)
Socio-Demographic and Substance Use Characteristics at Time of Admission
Comparison of Short-term Residential Discharges to All Discharges on Characteristics at Admission
Comparison of Selected Characteristics at Admission and at Discharge for Short-Term Residential Discharges
Treatment Completion or Transfer to Further Treatment

Chapter 4 presents data on the reason for discharge, median length of stay (LOS) in treatment, and socio-demographic and substance use characteristics of the 165,609 short-term residential treatment discharges aged 12 and older in 2012.^1,2 Of the 49 reporting states and jurisdictions, 43 states and 1 jurisdiction had discharges from short-term residential treatment [Table 4.1].

Reason for Discharge

Table 4.1 and Figure 4.1. For the 165,609 discharges from short-term residential treatment, the reasons for discharge were:

• Completed treatment: 55 percent (90,561)
• Transferred to further treatment: 17 percent (27,502)
• Dropped out of treatment: 18 percent (30,455)
• Treatment terminated by the facility: 7 percent (11,203)
• Failed to complete treatment for other reasons: 4 percent (5,888)

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.
² For employment status and detailed not in labor force, only discharges aged 16 and older are included; for years of education, only discharges aged 18 and older are included.

Median Length of Stay (LOS)

Table 1.4 and Figure 4.2. The median length of stay (LOS) for short-term residential treatment discharges aged 12 and older in 2012 was 21 days. By reason for discharge, the median LOS for short-term residential treatment discharges was:

• Completed treatment: 27 days
• Transferred to further treatment: 21 days
• Dropped out of treatment: 7 days
• Treatment terminated by the facility: 13 days
• Failed to complete treatment for other reasons: 13 days

Socio-Demographic and Substance Use Characteristics at Time of Admission

Table 1.7. Summary findings of characteristics at time of admission of short-term residential treatment discharges aged 12 and older include:

• Gender: 65 percent of short-term residential discharges were male
• Age at admission: 11 percent of short-term residential discharges were 12 to 20 years of age, 32 percent were 21 to 30 years of age, 22 percent were 31 to 40 years of age, 22 percent were 41 to 50 years of age, and 13 percent were over 50 years of age
• Race/ethnicity: 68 percent of short-term residential discharges were non-Hispanic White, 19 percent were non-Hispanic Black, 9 percent were Hispanic, and 4 percent were a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Primary substance: Alcohol was the most commonly reported primary substance of abuse at admission among short-term residential discharges (37 percent), followed by opiates (30 percent), marijuana and cocaine (11 percent each), stimulants (8 percent), and other substances (4 percent)
• Frequency of use: 57 percent of short-term residential discharges reported daily substance use in the month before treatment entry
• Number of prior treatment episodes: 72 percent of short-term residential discharges had one or more prior treatment episodes, 28 percent had no prior treatment episodes
• Treatment referral source: 47 percent of short-term residential discharges were referred to treatment from health care/community referrals, 34 percent were self- or individual referrals, and 18 percent were criminal justice/DUI referrals
• Employment status: Of all short-term residential discharges aged 16 and older, 43 percent were unemployed and 45 percent were not in the labor force at time of admission
• Years of education: 43 percent of short-term residential discharges aged 18 and older had 12 years of education or a GED

Comparison of Short-term Residential Discharges to All Discharges on Characteristics at Admission

Tables 1.7 and 1.8a. There were some notable differences in the characteristics at admission of discharges from outpatient treatment compared to the characteristics at admission of all discharges combined.

• Number of prior treatment episodes: 28 percent of short-term residential discharges vs. 40 percent of all discharges had no prior treatment episodes
• Treatment referral source:
  
  • 47 percent of short-term residential discharges were health care/community referrals vs. 31 percent of all discharges
  • 18 percent of short-term residential discharges were criminal justice/DUI referrals vs. 33 percent of all discharges
• Detailed not in labor force: Among short-term residential discharges aged 16 and older not in the labor force at admission, 7 percent were students vs. 12 percent of all discharges
• Employment status: 12 percent of short-term residential discharges aged 16 and older were employed vs. 22 percent of all discharges
• Primary substance:
  
  • 11 percent of short-term residential discharges reported marijuana as their primary substance of abuse vs. 17 percent of all discharges
• Frequency of use:
  
  • 57 percent of short-term residential discharges reported daily substance use in the month before treatment entry vs. 40 percent of all discharges
  • 12 percent of short-term residential discharges reported no substance use in the month before treatment entry vs. 29 percent of all discharges
• Living arrangements: 60 percent of short-term residential discharges were living independently vs. 65 percent of all discharges

Comparison of Selected Characteristics at Admission and at Discharge for Short-Term Residential Discharges

Tables 1.8a-b. Certain socio-demographic and substance use characteristics were collected at both time of admission and time of discharge. Differences (changes) in status between admission and discharge for short-term residential discharges include:

• Arrests in past 30 days: 88 percent of short-term residential discharges reported no arrests in past 30 days at admission vs. 95 percent at discharge
• Detailed not in labor force: Among short-term residential discharges aged 16 and older not in the labor force, 21 percent reported being disabled at admission vs. 22 percent at discharge
• Frequency of use: 12 percent of short-term residential discharges reported no substance use in the month before treatment entry vs. 64 percent at discharge
• Living arrangements: 22 percent of short-term residential discharges reported living dependently at admission vs. 30 percent at discharge
• Self-help programs attended in past 30 days: 69 percent of short-term residential discharges reported attending no self-help programs in the past 30 days at admission vs. 33 percent at discharge

Treatment Completion or Transfer to Further Treatment

Completion/Transfer Rates

In this section, “completion/transfer rate” refers to the number of treatment completions or transfers per 100 discharges. To illustrate, the overall rate is calculated as the sum of all treatment completions and transfers divided by all discharges (which includes those who dropped out, were terminated by facility, or did not complete treatment for other reasons) and the resulting number (fraction) is multiplied by 100. Of short-term residential treatment discharges aged 12 and older in 2012, the overall percentage that completed treatment or transferred to further treatment (i.e., completion/transfer rate) was 71 percent. Up to three top rates for each characteristic are presented below.

Completion/Transfer Rates for Characteristics at Admission

Table 4.2. For short-term residential discharges in 2012, the completion/transfer rates according to characteristics at admission include:

• Gender: The completion/transfer rate was 72 percent for male discharges and 70 percent for female discharges
• Age at admission: The completion/transfer rate was 78 percent for discharges over 50 years of age, 74 percent for discharges 41 to 50 years of age, and 71 percent for discharges 31 to 40 years of age
• Race/ethnicity: The completion/transfer rate was 72 percent for non-Hispanic White discharges, 70 percent for discharges of a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic, and 69 percent each for non-Hispanic Black discharges and Hispanic discharges
• Number of prior treatment episodes: The completion/transfer rate was 72 percent for discharges with one or more prior treatment episodes and 71 percent for discharges with no prior treatment episodes
• Treatment referral source: The completion/transfer rate was 77 percent for discharges from criminal justice/DUI referrals, 72 percent for discharges from health care/community referrals, and 67 percent for discharges from self- or individual referrals
• Years of education: The completion/transfer rate for ages 18 and older was 75 percent for discharges with more than 12 years of education, 71 percent for those with 12 years of education, and 68 percent for those with fewer than 12 years of education

Completion/Transfer Rates for Selected Characteristics at Discharge

Table 4.4. For short-term residential discharges in 2012, the completion/transfer rates according to characteristics at discharge include:

• Arrests in past 30 days: The completion/transfer rate was 73 percent for discharges with no arrests in the 30 days before discharge, 64 percent for discharges with 1 arrest in the 30 days before discharge, and 62 percent for those with 3 arrests in the 30 days before discharge
• Detailed not in labor force: The completion/transfer rate for ages 16 and older was 82 percent for discharges who were retired, 72 percent for homemakers, and 71 percent for discharges who were disabled
• Employment status: The completion/transfer rate for ages 16 and older was 80 percent for discharges who were employed and 71 percent for those who were unemployed
• Frequency of use: The completion/transfer rate was 80 percent for discharges with no substance use in the 30 days before discharge, 61 percent for those with some use of a substance in the 30 days before discharge, and 55 percent for those with daily use of a substance in the 30 days before discharge
• Living arrangements: The completion/transfer rate was 77 percent for discharges with dependent living status, 72 percent with independent living status, and 61 percent for the discharges who were homeless
• Self-help programs attended in past 30 days: The completion/transfer rate was 84 percent for discharges who attended self-help programs 16-30 times in the 30 days before discharge, 76 percent for those who attended self-help programs 8-15 times in the 30 days before discharge, and 65 percent for those who attended 4-7 times in the 30 days before discharge

Median Length of Stay (LOS) of Discharges Completing Treatment

Tables 4.2 and 4.4. The overall median LOS among those completing short-term residential treatment (excluding those who were transferred to further treatment) was 27 days. Median LOS for characteristics at admission and at discharge for short-term residential discharges that completed treatment include:

At admission:

From Table 4.2,

• The median LOS was longest for discharges aged 12 to 20 years and discharges who were referred to treatment through a criminal justice/DUI source (28 days each)
• The median LOS was shortest for discharges from self- or individual referrals (24 days)

From Table 4.4,

• The median LOS was longest among discharges not in the labor force that reported being students (33 days)
• The median LOS was shortest among discharges not in the labor force that reported being retired (22 days)

At discharge:

From Table 4.4,

• The median LOS was longest among discharges not in the labor force that reported being students (32 days)
• The median LOS was shortest among discharges that reported some use of the primary substance in the past month (20 days)

To Tables

To Table of Contents

Reason for Discharge
Median Length of Stay (LOS)
Socio-Demographic and Substance Use Characteristics at Time of Admission
Comparison of Long-Term Residential Discharges to All Discharges on Characteristics at Admission
Comparison of Selected Characteristics at Admission and at Discharge for Long-Term Residential Discharges
Treatment Completion or Transfer to Further Treatment

Chapter 5 presents data on the reason for discharge, median length of stay (LOS) in treatment, and socio-demographic and substance use characteristics of the 122,467 long-term residential treatment discharges aged 12 and older in 2012.^1,2 Of the 49 reporting states and jurisdictions, 44 states and 2 jurisdictions had discharges from long-term residential treatment [Table 5.1].

Reason for Discharge

Table 5.1 and Figure 5.1. For the 122,467 discharges from long-term residential treatment, the reasons for discharge were:

• Completed treatment: 45 percent (54,632)
• Transferred to further treatment: 16 percent (19,655)
• Dropped out of treatment: 25 percent (30,947)
• Treatment terminated by the facility: 10 percent (12,598)
• Failed to complete treatment for other reasons: 4 percent (4,635)

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.
² For employment status and detailed not in labor force, only discharges aged 16 and older are included; for years of education, only discharges aged 18 and older are included.

Median Length of Stay (LOS)

Table 1.4 and Figure 5.2. The median length of stay (LOS) for long-term residential treatment discharges aged 12 and older in 2012 was 56 days. By reason for discharge, the median LOS for long-term residential treatment discharges was:

• Completed treatment: 90 days
• Transferred to further treatment: 29 days
• Dropped out of treatment: 26 days
• Treatment terminated by the facility: 49 days
• Failed to complete treatment for other reasons: 49 days

Socio-Demographic and Substance Use Characteristics at Time of Admission

Table 1.7. Summary findings of characteristics at time of admission of long-term residential treatment discharges aged 12 and older include:

• Gender: 64 percent of long-term residential discharges were male
• Age at admission: 12 percent of long-term residential discharges were 12 to 20 years of age, 33 percent were 21 to 30 years of age, 23 percent were 31 to 40 years of age, 21 percent were 41 to 50 years of age, and 11 percent were over 50 years of age
• Race/ethnicity: 56 percent of long-term residential discharges were non-Hispanic White, 20 percent were non-Hispanic Black, 14 percent were Hispanic, and 9 percent were a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Primary substance: Alcohol was the most commonly reported primary substance of abuse at the time of admission among long-term residential discharges (30 percent), followed by opiates (26 percent), stimulants (16 percent), marijuana (13 percent), cocaine (12 percent), and other substances (3 percent)
• Frequency of use: 34 percent each of long-term residential discharges who reported daily substance use in the month before treatment entry, and discharges who reported no substance use in the month before treatment entry
• Number of prior treatment episodes: 74 percent of long-term residential discharges had one or more prior treatment episodes, and 26 percent had no prior treatment episodes
• Treatment referral source: 37 percent of long-term residential discharges were referred to treatment by health care/community referrals, 35 percent were criminal justice/DUI referrals, and 28 percent were self- or individual referrals
• Employment status: Of all long-term residential discharges aged 16 and older, 35 percent were unemployed and 59 percent were not in the labor force at time of admission
• Years of education: 43 percent of long-term residential discharges aged 18 and older had 12 years of education or a GED

Comparison of Long-Term Residential Discharges to All Discharges on Characteristics at Admission

Tables 1.7 and 1.8a. There were some notable differences in the characteristics at admission of discharges from long-term residential treatment compared to the characteristics of all discharges combined.

• Number of prior treatment episodes: 26 percent of long-term residential discharges had no prior treatment episodes vs. 40 percent of all discharges
• Treatment referral source:
  
  • 37 percent of long-term residential discharges were health care/community referrals vs. 31 percent of all discharges
  • 28 percent of long-term residential discharges were self- or individual referrals vs. 36 percent of all discharges
• Detailed not in labor force: Among long-term residential discharges aged 16 and older not in the labor force at admission, 12 percent were disabled vs. 23 percent of all discharges
• Employment status: 6 percent of long-term residential discharges aged 16 and older were employed vs. 22 percent of all discharges
• Primary substance:
  
  • 30 percent of long-term residential discharges reported alcohol as their primary substance of abuse vs. 39 percent of all discharges
  • 16 percent of long-term residential discharges reported stimulants as their primary substance of abuse vs. 8 percent of all discharges
• Frequency of use:
  
  • 34 percent of long-term residential discharges reported daily substance use in the month before treatment entry vs. 40 percent of all discharges
  • 34 percent of long-term residential discharges reported no substance use in the month before treatment entry vs. 29 percent of all discharges
• Living arrangements: 37 percent of long-term residential discharges were living independently vs. 65 percent of all discharges

Comparison of Selected Characteristics at Admission and at Discharge for Long-Term Residential Discharges

Tables 1.8a-b. Certain socio-demographic and substance use characteristics were collected at both time of admission and time of discharge. Differences (changes) in status between admission and discharge for long-term residential discharges include:

• Arrests in past 30 days: 89 percent of long-term residential discharges reported no arrests in past 30 days at admission vs. 96 percent at discharge
• Detailed not in labor force: Among long-term residential discharges aged 16 and older not in the labor force, 11 percent reported being students at admission vs. 17 percent at discharge
• Employment status: 6 percent of long-term residential discharges aged 16 and older were employed at admission vs. 16 percent at discharge
• Frequency of use: 34 percent of long-term residential discharges reported no substance use in the month before treatment vs. 76 percent at discharge
• Living arrangements: 26 percent of long-term residential discharges reported being homeless at admission vs. 16 percent at discharge
• Self-help programs attended in past 30 days: 58 percent of long-term residential discharges reported attending no self-help programs in past 30 days at admission vs. 31 percent at discharge

Treatment Completion or Transfer to Further Treatment

Completion/Transfer Rates

In this section, “completion/transfer rate” refers to the number of treatment completions or transfers per 100 discharges. To illustrate, the overall rate is calculated as the sum of all treatment completions and transfers divided by all discharges (which includes those who dropped out, were terminated by facility, or did not complete treatment for other reasons) and the resulting number (fraction) is multiplied by 100. Of long-term residential treatment discharges aged 12 and older in 2012, the overall percentage that completed treatment or transferred to further treatment (i.e., completion/transfer rate) was 61 percent. Up to three top rates for each characteristic are presented below.

Completion/Transfer Rates for Characteristics at Admission

Table 5.2. For long-term residential discharges in 2012, the completion/transfer rates according to characteristics at admission include:

• Gender: The completion/transfer rate was 62 percent for female discharges and 60 percent for male discharges
• Age at admission: The completion/transfer rate was 68 percent for discharges over 50 years of age, 63 percent for discharges 41 to 50 years of age, and 61 percent for discharges 31 to 40 years of age
• Race/ethnicity: The completion/transfer rate was 63 percent for non-Hispanic White discharges, 59 percent for Hispanic discharges, and 54 percent for non-Hispanic Black discharges
• Number of prior treatment episodes: The completion/transfer rate was 67 percent for discharges with no prior treatment episodes, and 58 percent for discharges with one or more prior treatment episodes
• Treatment referral source: The completion/transfer rate was 65 percent for discharges who were referred to treatment by a criminal justice/DUI source, 61 percent for discharges who were self- or individual referrals, and 57 percent for discharges who were health care or community referrals
• Years of education: The completion/transfer rate for ages 18 and older was 65 percent for discharges with more than 12 years of education, 61 percent for those with 12 years of education, and 57 percent for those with fewer than 12 years of education

Completion/Transfer Rates for Selected Characteristics at Discharge

Table 5.4. For long-term residential discharges in 2012, the completion/transfer rates according to characteristics at discharge include:

• Arrests in past 30 days: The completion/transfer rate was 65 percent for discharges with no arrests in the 30 days before discharge, 65 percent for discharges with 5 arrests in the 30 days before discharge, and 63 percent for those with 3 arrests in the 30 days before discharge
• Detailed not in labor force: The completion/transfer rate for ages 16 and older was 76 percent for discharges who were retired, 66 percent for homemakers, and 62 percent for students
• Employment status: The completion/transfer rate for ages 16 and older was 78 percent for discharges who were employed and 63 percent for those who were unemployed
• Frequency of use: The completion/transfer rate was 71 percent for discharges with no substance use in the 30 days before discharge, 54 percent for those with daily substance use in the 30 days before discharge, and 53 percent for those with some substance use in the 30 days before discharge
• Living arrangements: The completion/transfer rate was 67 percent for discharges with dependent living status, 65 percent for those with independent living status, and 63 percent for those who were homeless
• Self-help programs attended in past 30 days: The completion/transfer rate was 68 percent for discharges who attended self-help programs 16-30 times in the 30 days before discharge, 65 percent for those who attended self-help programs 8-15 times in the 30 days before discharge, and 62 percent for those who attended such programs 4-7 times in the 30 days before discharge

Median Length of Stay (LOS) of Discharges Completing Treatment

Tables 5.2 and 5.4. The overall median LOS among those completing long-term residential treatment (excluding those who were transferred to further treatment) was 90 days. Median LOS for characteristics at admission and at discharge for long-term residential discharges that completed treatment include:

At admission:

From Table 5.2,

• The median LOS was longest for non-Hispanic Black discharges (111 days)
• The median LOS was shortest for discharges that were a race/ethnicity other than non-Hispanic White, non-Hispanic Black or Hispanic (65 days)

From Table 5.4,

• The median LOS was longest among discharges not in the labor force that reported being institutional inmates (141 days)
• The median LOS was shortest among discharges not in the labor force that reported being retired (43 days)

At discharge:

From Table 5.4,

• The median LOS was longest among discharges arrested 4 times in the 30 days prior to discharge (166 days)
• The median LOS was shortest among discharges that reported some use of the primary substance in the past month (28 days)

To Tables

To Table of Contents

Reason for Discharge
Median Length of Stay (LOS)
Socio-Demographic and Substance Use Characteristics at Time of Admission
Comparison of Hospital Residential Treatment Discharges to All Discharges on Characteristics at Admission
Comparison of Selected Characteristics at Admission and at Discharge for Hospital Residential Treatment Discharges
Treatment Completion or Transfer to Further Treatment

Chapter 6 presents data on the reason for discharge, median length of stay (LOS) in treatment, and socio-demographic and substance use characteristics of the 5,637 discharges from hospital residential treatment aged 12 and older in 2012.^1,2 Of the 49 reporting states and jurisdictions, 16 states had discharges from hospital residential treatment [Table 6.1].

Reason for Discharge

Table 6.1 and Figure 6.1. For the 5,637 discharges from hospital residential treatment, the reasons for discharge were:

• Completed treatment: 54 percent (3,037)
• Transferred to further treatment: 16 percent (929)
• Dropped out of treatment: 23 percent (1,299)
• Treatment terminated by the facility: 3 percent (178)
• Failed to complete treatment for other reasons: 3 percent (194)

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.
² For employment status and detailed not in labor force, only discharges aged 16 and older are included; for years of education, only discharges aged 18 and older are included.

Median Length of Stay (LOS)

Table 1.4 and Figure 6.2. The median LOS in 2012 for hospital residential treatment discharges aged 12 and older was 7 days. By reason for discharge, the median LOS for hospital residential treatment discharges was:

• Completed treatment: 14 days
• Transferred to further treatment: 5 days
• Dropped out of treatment: 5 days
• Treatment terminated by the facility: 12 days
• Failed to complete treatment for other reasons: 4 days

Socio-Demographic and Substance Use Characteristics at Time of Admission

Table 1.7. Summary findings of characteristics at time of admission of hospital residential treatment discharges aged 12 and older include:

• Gender: 64 percent of hospital residential treatment discharges were male
• Age at admission: 5 percent were 12 to 20 years of age, 27 percent were 21 to 30 years of age, 23 percent were 31 to 40 years of age, 28 percent were 41 to 50 years of age, and 18 percent were over 50 years of age
• Race/ethnicity: 77 percent were non-Hispanic White, 13 percent were non-Hispanic Black, 6 percent were Hispanic, and 4 percent were a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Primary substance: Alcohol was reported most frequently (55 percent), followed by opiates (23 percent), cocaine (8 percent), other or unkown substances (6 percent), marijuana/hashish (4 percent), and stimulants (4 percent)
• Frequency of use: 65 percent reported daily substance use, and 11 percent reported no subatance use in the month before treatment entry
• Number of prior treatment episodes: 63 percent of hospital residential treatment discharges had one or more prior treatment episodes, and 37 percent had no prior treatment episodes
• Treatment referral source: 54 percent of hospital residential treatment discharges were self- or individual referrals, 39 percent were health care or community referrals, and 7 percent were referred to treatment by criminal justice/DUI sources
• Employment status: Of all hospital residential treatment discharges aged 16 and older, 56 percent were unemployed and 28 percent were not in the labor force at time of admission
• Years of education: 47 percent of hospital residential treatment discharges aged 18 and older had 12 years of education or a GED

Comparison of Hospital Residential Treatment Discharges to All Discharges on Characteristics at Admission

Tables 1.7 and 1.8a. There were some notable differences in the characteristics at admission of discharges from hospital residential treatment compared to the characteristics of all discharges combined.

• Treatment referral source:
  
  • 54 percent of hospital residential treatment discharges were self- or individual referrals vs. 36 percent of all discharges
  • 7 percent of hospital residential treatment discharges were criminal justice/DUI referrals vs. 33 percent of all discharges
• Detailed not in labor force: 5 percent of hospital residential treatment discharges aged 16 and older were students vs. 12 percent of all discharges
• Employment status: 16 percent of hospital residential treatment discharges aged 16 and older were employed vs. 22 percent of all discharges
• Primary substance:
  
  • 4 percent of hospital residential treatment discharges reported marijuana as their primary substance of abuse vs. 17 percent of all discharges
• Frequency of use:
  
  • 65 percent of hospital residential treatment discharges reported daily substance use in the month before treatment entry vs. 40 percent of all discharges
  • 11 percent of hospital residential treatment discharges reported no substance use in the month before treatment entry vs. 29 percent of all discharges
• Living arrangements: 6 percent of hospital residential treatment discharges were living dependently vs. 21 percent of all discharges

Comparison of Selected Characteristics at Admission and at Discharge for Hospital Residential Treatment Discharges

Tables 1.8a-b. Certain socio-demographic and substance use characteristics were collected at both time of admission and time of discharge. Differences (changes) in status between admission and discharge for hospital residential treatment discharges include:

• Arrests in past 30 days: 94 percent of hospital residential treatment discharges reported no arrests in past 30 days at admission vs. 98 percent at discharge
• Detailed not in labor force: Among hospital residential treatment discharges aged 16 and older not in the labor force, 9 percent reported being institutional inmates at admission vs. 12 percent at discharge
• Frequency of use: 65 percent of hospital residential treatment discharges reported daily substance use in the month before treatment entry vs. 34 percent at discharge
• Living arrangements: 16 percent of hospital residential treatment discharges reported being homeless at admission vs. 13 percent at discharge
• Self-help programs attended in past 30 days: 81 percent of hospital residential treatment discharges reported not attending self-help programs in the past 30 days at admission vs. 61 percent at discharge

Treatment Completion or Transfer to Further Treatment

Completion/Transfer Rates

In this section, “completion/transfer rate” refers to the number of treatment completions or transfers per 100 discharges. To illustrate, the overall rate is calculated as the sum of all treatment completions and transfers divided by all discharges (which includes those who dropped out, were terminated by facility, or did not complete treatment for other reasons) and the resulting number (fraction) is multiplied by 100. Of hospital residential treatment discharges aged 12 and older in 2012, the overall percentage that completed treatment or transferred to further treatment (i.e., completion/transfer rate) was 70 percent. Up to three top rates for each characteristic are presented below.

Completion/Transfer Rates for Characteristics at Admission

Table 6.2. For hospital residential treatment discharges in 2012, the completion/transfer rates according to characteristics at admission include:

• Gender: The completion/transfer rate was 72 percent for male discharges and 68 percent for female discharges
• Age at admission: The completion/transfer rate was 77 percent for discharges over 50 years of age, 71 percent for discharges 41 to 50 years of age, and 69 percent for discharges 31 to 40 years of age
• Race/ethnicity: The completion/transfer rate was 74 for Hispanics, 71 percent for non-Hispanic White discharges, and 69 percent for discharges that were of a race/ethnicity other than non-Hispanic Black, non-Hispanic White, or Hispanic
• Number of prior treatment episodes: The completion/transfer rate was 68 percent for discharges with one or more prior treatment episodes and 66 percent for those with no prior treatment episodes
• Treatment referral source: The completion/transfer rate was 78 percent for discharges who were referred to treatment by a criminal justice/DUI source, 75 percent for self- or individual referrals, and 61 percent for health care or community referrals
• Years of education: The completion/transfer rate for ages 18 and older was 73 percent for discharges with more than 12 years of education, 69 percent for those with 12 years of education or a GED, and 65 percent for those with fewer than 12 years of education

Completion/Transfer Rates for Selected Characteristics at Discharge

Table 6.4. For hospital residential treatment discharges in 2012, the completion/transfer rates according to characteristics at discharge include:

• Arrests in past 30 days: The completion/transfer rate was 86 percent for those with 2 arrests in the 30 days prior to discharge, 71 percent for those with no arrests, and 59 percent for those who were arrested once
• Detailed not in labor force: The completion/transfer rate for ages 16 and older was 87 percent for students, 84 percent for those who were retired, and 81 percent for institutional inmates
• Employment status: The completion/transfer rate for ages 16 and older was 76 percent for discharges who were employed, 64 percent for the unemployed, and 78 percent for those who were not in the labor force
• Frequency of use: The completion/transfer rate was 81 percent for those with no substance use in the 30 days prior to discharge, 73 percent for those with some substance use, and 56 percent with daily substance use
• Living arrangements: The completion/transfer rate was 75 percent for those who were living dependently, 71 percent for those living independently, and 67 percent for those who were homeless
• Self-help programs attended in past 30 days: The completion/transfer rate was 91 percent for those who attended self-help programs 16-30 times in the 30 days prior to discharge, 87 percent for those who attended self-help programs 4-7 times, and 85 percent for those who attended such programs 8-15 times

Median Length of Stay (LOS) of Discharges Completing Treatment

Tables 6.2 and 6.4. The overall median LOS among those completing hospital residential treatment (excluding those who were transferred to further treatment) was 14 days. Median LOS for selected characteristics at admission and at discharge for hospital residential treatment discharges that completed treatment include:

At admission:

From Table 6.2,

• The median LOS was longest for discharges that were referred to treatment by a criminal justice/DUI source (28 days)
• The median LOS was shortest for those who had no prior treatment episodes (9 days)

From Table 6.4,

• The median LOS was longest for those who were arrested 3 times in the 30 days prior to admission (41 days)
• The median LOS shortest for those who attended self-help programs 4-7 times in the 30 days prior to admission (5 days)

At discharge:

From Table 6.4,

• The median LOS was longest for discharges who were arrested 2-3 times in the 30 days prior to discharge or those who did not use a substance in the past month (30 days)
• The median LOS was shortest for those who reported daily substance use (5 days)

To Tables

To Table of Contents

Reason for Discharge
Median Length of Stay (LOS)
Socio-Demographic and Substance Use Characteristics at Time of Admission
Comparison of Detoxification Discharges to All Discharges on Characteristics at Admission
Comparison of Selected Characteristics at Admission and at Discharge for Detoxification Discharges
Treatment Completion or Transfer to Further Treatment

Chapter 7 presents data on the reason for discharge, median length of stay (LOS) in treatment, and socio-demographic and substance use characteristics of the 337,160 discharges from detoxification aged 12 and older in 2012.^1,2 Of the 49 reporting states and jurisdictions, 44 states and 2 jurisdictions reported discharges from detoxification [Table 7.1]. Detoxification in this chapter includes free-standing residential detoxification, hospital detoxification, and outpatient detoxification (see Chapter 1). Medication-assisted opioid detoxification is excluded and reported in Chapter 9.

Reason for Discharge

Table 7.1 and Figure 7.1. For the 337,160 discharges from detoxification, the reasons for discharge were:

• Completed treatment: 69 percent (233,431)
• Transferred to further treatment: 10 percent (34,200)
• Dropped out of treatment: 16 percent (53,813)
• Treatment terminated by the facility: 2 percent (6,991)
• Failed to complete treatment for other reasons: 3 percent (8,725)

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.
² For employment status and detailed not in labor force, only discharges aged 16 and older are included; for years of education, only discharges aged 18 and older are included.

Median Length of Stay (LOS)

Table 1.4 and Figure 7.2. The median length of stay (LOS) for detoxification discharges aged 12 and older in 2012 was 4 days. By reason for discharge, the median LOS for detoxification discharges was:

• Completed treatment: 4 days
• Transferred to further treatment: 4 days
• Dropped out of treatment: 2 days
• Treatment terminated by the facility: 3 days
• Failed to complete treatment for other reasons: 2 days

Socio-Demographic and Substance Use Characteristics at Time of Admission

Table 1.7. Summary findings of characteristics at time of admission of detoxification discharges aged 12 and older include:

• Gender: 73 percent of detoxification discharges were male
• Age at admission: 4 percent were 12 to 20 years of age, 26 percent were 21 to 30 years of age, 22 percent were 31 to 40 years of age, 28 percent were 41 to 50 years of age, and 20 percent were over 50 years of age
• Race/ethnicity: 62 percent were non-Hispanic White, 18 percent were non-Hispanic Black, 14 percent were Hispanic, and 6 percent were a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Primary substance: Alcohol was reported most frequently (50 percent), followed by opiates (36 percent), cocaine (5 percent), stimulants (4 percent), other or unknown substances (3 percent), and marijuana/hashish (2 percent)
• Frequency of use: 76 percent reported daily subatance use, and 3 percent reported no substance use in the month before treatment entry
• Number of prior treatment episodes: 66 percent of detoxification discharges had one or more prior treatment episodes, and 34 percent had no prior treatment episodes
• Treatment referral source: 61 percent of detoxification discharges were self- or individual referrals, 28 percent were health care or community referrals, and 10 percent were referred to treatment by criminal justice/DUI sources
• Employment status: Of all detoxification discharges aged 16 and older, 40 percent were unemployed and 47 percent were not in the labor force at time of admission
• Years of education: 46 percent of detoxification discharges aged 18 and older had 12 years of education or a GED

Comparison of Detoxification Discharges to All Discharges on Characteristics at Admission

Tables 1.7 and 1.8a. There were some notable differences in the characteristics at admission of discharges from detoxification treatment compared to the characteristics of all discharges combined.

• Number of prior treatment episodes: 34 percent of detoxification discharges had no prior treatment episodes vs. 40 percent of all discharges had no prior treatment episodes
• Treatment referral source:
  
  • 61 percent of detoxification discharges were self- or individual referrals vs. 36 percent of all discharges
  • 10 percent of detoxification discharges were criminal justice/DUI referrals vs. 33 percent of all discharges
• Detailed not in labor force: 2 percent of detoxification discharges aged 16 and older were students vs. 12 percent of all discharges
• Employment status: 13 percent of detoxification discharges aged 16 and older were employed vs. 22 percent of all discharges
• Primary substance:
  
  • 2 percent of detoxification discharges reported marijuana as their primary substance of abuse vs. 17 percent of all discharges
  • 36 percent of detoxification discharges reported opiates as their primary substance of abuse vs. 26 percent of all discharges
• Frequency of use:
  
  • 76 percent of detoxification discharges reported daily substance use in the month before treatment entry vs. 40 percent of all discharges
  • 3 percent of detoxification discharges reported no substance use in the month before treatment entry vs. 29 percent of all discharges
• Living arrangements: 31 percent of detoxification discharges were homeless vs. 14 percent of all discharges

Comparison of Selected Characteristics at Admission and at Discharge for Detoxification Discharges

Tables 1.8a-b. Certain socio-demographic and substance use characteristics were collected at both time of admission and time of discharge. Differences (changes) in status between admission and discharge for detoxification discharges include:

• Arrests in past 30 days: 94 percent of detoxification discharges reported no arrests in past 30 days at admission vs. 96 percent at discharge
• Detailed not in labor force: Among detoxification discharges aged 16 and older not in the labor force, 21 percent reported being disabled at admission vs. 26 percent at discharge
• Employment status: 13 percent of detoxification discharges aged 16 and older were employed at admission vs. 14 percent at discharge
• Frequency of use: 76 percent of detoxification discharges reported daily substance use in the month before treatment entry vs. 45 percent at discharge
• Living arrangements: 31 percent of detoxification discharges reported being homeless at admission vs. 25 percent at discharge
• Self-help programs attended in past 30 days: 82 percent of detoxification discharges reported not attending self-help programs in the past 30 days at admission vs. 69 percent at discharge

Treatment Completion or Transfer to Further Treatment

Completion/Transfer Rates

In this section, “completion/transfer rate” refers to the number of treatment completions or transfers per 100 discharges. To illustrate, the overall rate is calculated as the sum of all treatment completions and transfers divided by all discharges (which includes those who dropped out, were terminated by facility, or did not complete treatment for other reasons) and the resulting number (fraction) is multiplied by 100. Of detoxification treatment discharges aged 12 and older in 2012, the overall percentage that completed treatment or transferred to further treatment (i.e., completion/transfer rate) was 79 percent. Up to three top rates for each characteristic are presented below.

Completion/Transfer Rates for Characteristics at Admission

Table 7.2. For detoxification discharges in 2012, the completion/transfer rates according to characteristics at admission include:

• Gender: The completion/transfer rate was 80 percent for male discharges and 79 percent for female discharges
• Age at admission: The completion/transfer rate was 85 percent for discharges over 50 years of age, 82 percent for discharges 41 to 50 years of age, and 80 percent of discharges 12 to 20 years of age
• Race/ethnicity: The completion/transfer was 82 percent for non-Hispanic Black discharges and 81 percent each for Hispanic discharges and discharges who were of a race other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Number of prior treatment episodes: The completion/transfer rate was 80 percent for discharges with one or more prior treatment episodes and 77 percent for those with no prior treatment episodes
• Treatment referral source: The completion/transfer rate was 85 percent each for discharges who were health care or community referrals and criminal justice/DUI referrals, and 76 percent for discharges with self- or individual referrals
• Years of education: The completion/transfer rate for ages 18 and older was 81 percent for those with more than 12 years of education, 79 percent for those 12 years of education or a GED, and 78 percent for those with fewer than 12 years of education

Completion/Transfer Rates for Selected Characteristics at Discharge

Table 7.4. For detoxification discharges in 2012, the completion/transfer rates according to characteristics at discharge include:

• Arrests in past 30 days: The completion/transfer rate was 84 percent for those with 2 arrests in the 30 days before discharge, 82 percent for those who were arrested once, and 80 percent for those with no arrests
• Detailed not in labor force: The completion/transfer rate for ages 16 and older was 89 percent for the retired, 87 percent for inmates of an institution, and 85 percent for students
• Employment status: The completion/transfer rate for ages 16 and older was 83 percent for discharges who were employed, 80 percent for the unemployed, and 81 percent for those who were not in the labor force
• Frequency of use: The completion/transfer rate was 87 percent for those who reported some substance use in the 30 days before discharge, 78 percent for those who reported no substance use, and 76 percent who reported daily substance use
• Living arrangements: The completion/transfer rate was 87 percent for those who were living dependently, 82 percent for the homeless, and 79 percent for those living independently
• Self-help programs attended in past 30 days: The completion/transfer rate was 86 percent for those who attended self-help programs 16-30 times in the 30 days before discharge, 81 percent for those who attended self-help programs 4-7 times, and 79 percent for those who attended such programs 8-15 times

Median Length of Stay (LOS) of Discharges Completing Treatment

Tables 7.2 and 7.4. The overall median LOS among those completing detoxification treatment (excluding those who were transferred to further treatment) was 4 days. Median LOS for selected characteristics at admission and at discharge for detoxification discharges that completed treatment include:

At admission:

From Table 7.2,

• The median LOS was longest for discharges aged 12-30 years and those who were self or individually referred to treatment (5 days each).
• The median LOS was shortest for discharges who were referred to treatment by a criminal justice/DUI source and discharges who were of a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic (3 days each).

From Table 7.4,

• The median LOS was longest for discharges who were inmates of institutions (60 days)
• The median LOS shortest for discharges arrested 5 times in past 30 days and those reported some substance use in the 30 days prior to admission (3 days each)

At discharge:

From Table 7.4,

• The median LOS was longest among discharges who attended self-help programs 16-30 times in the 30 days prior to discharge (9 days)
• The median LOS was shortest (3 days) among the following categories—those arrested 5 times in past 30 days, those not in labor force who were retired or disabled, those who were employed, those who reported some substance use in the month before discharge, those who were
  homeless, and those whose primary substance of abuse was alcohol.

To Tables

To Table of Contents

Reason for Discharge
Median Length of Stay (LOS)
Socio-Demographic and Substance Use Characteristics at Time of Admission
Comparison of Outpatient Medication-Assisted Opioid Therapy Discharges to All Discharges on Characteristics at Admission
Comparison of Selected Characteristics at Admission and at Discharge for Outpatient Medication-Assisted Opioid Therapy Discharges
Treatment Completion or Transfer to Further Treatment

Chapter 8 presents data on the reason for discharge, median length of stay (LOS) in treatment, and socio-demographic and substance use characteristics for the 72,071 discharges aged 12 and older from outpatient medication-assisted opioid therapy (i.e., therapy with methadone or buprenorphine) in 2012.^1,2 Of the 49 states and jurisdictions, 40 states and 2 jurisdictions had discharges from outpatient medication-assisted opioid therapy [Table 8.1]. Discharges from outpatient medication-assisted opioid therapy were from outpatient treatment (94 percent) and intensive outpatient treatment (6 percent) (see Chapter 1).

Reason for Discharge

Table 8.1 and Figure 8.1. For the 72,071 outpatient medication-assisted opioid therapy discharges, the reasons for discharge were:

• Completed treatment: 12 percent (8,656)
• Transferred to further treatment: 20 percent (14,417)
• Dropped out of treatment: 41 percent (29,667)
• Treatment terminated by the facility: 11 percent (8,229)
• Failed to complete treatment for other reasons: 15 percent (11,102)

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.
² For employment status and detailed not in labor force, only discharges aged 16 and older are included; for years of education, only discharges aged 18 and older are included.

Median Length of Stay (LOS)

Table 1.4 and Figure 8.2. The median length of stay (LOS) for outpatient medication-assisted opioid therapy treatment discharges aged 12 and older in 2012 was 201 days. By reason for discharge, the median LOS for outpatient medication-assisted opioid therapy treatment discharges was:

• Completed treatment: 201 days
• Transferred to further treatment: 129 days
• Dropped out of treatment: 114 days
• Treatment terminated by the facility: 239 days
• Failed to complete treatment for other reasons: 215 days

Socio-Demographic and Substance Use Characteristics at Time of Admission

Table 1.7. Summary findings of characteristics at time of admission of outpatient medication-assisted opioid therapy discharges aged 12 and older include:

• Gender: 57 percent of outpatient medication-assisted opioid therapy discharges were male
• Age at admission: 3 percent were 12 to 20 years of age, 33 percent were 21 to 30 years of age, 25 percent were 31 to 40 years of age, 22 percent were 41 to 50 years of age, and 17 percent were over 50 years of age
• Race/ethnicity: 63 percent were non-Hispanic White, 17 percent were Hispanic, 15 percent were non-Hispanic Black, and 5 percent were of a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Primary substance: Opiates (95 percent) were the most commonly reported primary substance of abuse at the time of admission, followed by alcohol (2 percent), cocaine and marijuana/ hashish (1 percent each), and stimulants (less than 1 percent)
• Frequency of use: 66 percent reported daily substance use in the month before treatment entry and 18 percent reported no substance use
  
• Number of prior treatment episodes: 78 percent of outpatient medication-assisted opioid therapy discharges had one or more prior treatment episodes, and 22 percent had no prior treatment episodes
• Treatment referral source: 74 percent of outpatient medication-assisted opioid therapy discharges were self- or individual referrals, 21 percent were health care or community referrals, and 5 percent were referred to treatment by a criminal justice/DUI source
• Employment status: Of all outpatient medication-assisted opioid therapy discharges aged 16 and older, 39 percent were unemployed and 40 percent were not in the labor force at time of admission
• Years of education: 44 percent of outpatient medication-assisted opioid therapy discharges aged 18 and older had 12 years of education or a GED

Comparison of Outpatient Medication-Assisted Opioid Therapy Discharges to All Discharges on Characteristics at Admission

Tables 1.7 and 1.8a. There were some notable differences in the characteristics at admission of discharges from outpatient medication-assisted opioid therapy treatment compared to the characteristics of all discharges combined.

• Number of prior treatment episodes: 22 percent of outpatient medication-assisted opioid therapy discharges had no prior treatment episodes vs. 40 percent of all discharges
• Treatment referral source:
  
  • 5 percent of outpatient medication-assisted opioid therapy discharges were criminal justice/DUI referrals vs. 33 percent of all discharges
  • 74 percent of outpatient medication-assisted opioid therapy discharges were self- or individual referrals vs. 36 percent of all discharges
• Detailed not in labor force: 3 percent of outpatient medication-assisted opioid therapy discharges aged 16 and older were students vs. 12 percent of all discharges
• Primary substance:
  
  • 1 percent of outpatient medication-assisted opioid therapy discharges reported marijuana as their primary substance of abuse vs. 17 percent of all discharges
  • 95 percent of outpatient medication-assisted opioid therapy discharges reported opiates as their primary substance of abuse vs. 26 percent of all discharges
• Frequency of use:
  
  • 66 percent of outpatient medication-assisted opioid therapy discharges reported daily substance use in the month before treatment entry vs. 40 percent of all discharges
  • 18 percent of outpatient medication-assisted opioid therapy discharges reported no substance use in the month before treatment entry vs. 29 percent of all discharges
• Living arrangements: 7 percent of outpatient medication-assisted opioid therapy discharges were homeless vs. 14 percent of all discharges

Comparison of Selected Characteristics at Admission and at Discharge for Outpatient Medication-Assisted Opioid Therapy Discharges

Tables 1.8a-b. Certain socio-demographic and substance use characteristics were collected at both time of admission and time of discharge. Differences (changes) in status between admission and discharge for outpatient medication-assisted opioid therapy discharges include:

• Arrests in past 30 days: 95 percent of outpatient medication-assisted opioid therapy discharges reported no arrests in past 30 days at admission vs. 93 percent at discharge
• Detailed not in labor force: Among outpatient medication-assisted opioid therapy discharges aged 16 and older not in the labor force, 36 percent reported being disabled at admission vs. 35 percent at discharge
• Employment status: 21 percent of outpatient medication-assisted opioid therapy discharges aged 16 and older were employed at admission vs. 23 percent at discharge
• Frequency of use: 66 percent of outpatient medication-assisted opioid therapy discharges reported daily substance use in the month before treatment entry vs. 33 percent at discharge
• Living arrangements: 7 percent of outpatient medication-assisted opioid therapy discharges reported being homeless at admission vs. 6 percent at discharge
• Self-help programs attended in past 30 days: 79 percent of outpatient medication-assisted opioid therapy discharges reported not attending self-help programs in the past 30 days at admission vs. 80 percent at discharge

Treatment Completion or Transfer to Further Treatment

Completion/Transfer Rates

In this section, “completion/transfer rate” refers to the number of treatment completions or transfers per 100 discharges. To illustrate, the overall rate is calculated as the sum of all treatment completions and transfers divided by all discharges (which includes those who dropped out, were terminated by facility, or did not complete treatment for other reasons) and the resulting number (fraction) is multiplied by 100. Of outpatient medication-assisted opioid therapy treatment discharges aged 12 and older in 2012, the overall percentage that completed treatment or transferred to further treatment (i.e., completion/transfer rate) was 32 percent. Up to three top rates for each characteristic are presented below.

Completion/Transfer Rates for Characteristics at Admission

Table 8.2. For outpatient medication-assisted opioid therapy discharges in 2012, the completion/transfer rates according to characteristics at admission include:

• Gender: The completion/transfer rate was 36 percent for female discharges and 29 percent for male discharges
• Age at admission: The completion/transfer rate was 34 percent for discharges 21 to 30 years of age, 33 percent for discharges 31 to 40 years of age, and 32 percent of discharges 12 to 20 years of age
• Race/ethnicity: The completion/transfer rate was 34 percent for non-Hispanic White discharges; 32 percent for discharges of a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic; and 30 percent for non-Hispanic Blacks
• Number of prior treatment episodes: The completion/transfer rate was 36 percent for those with no prior treatment episodes and 31 percent for discharges with one or more prior treatment episodes
• Treatment referral source: The completion/transfer rate was 46 percent for discharges who were referred to treatment by a criminal justice/DUI source, 40 percent for health care/ community referrals, and 29 percent for self- or individual referrals
• Years of education: The completion/transfer rate for ages 18 and older was 36 percent for those with more than 12 years of education, 32 percent for those 12 years of education or a GED, and 29 percent for those with fewer than 12 years of education

Completion/Transfer Rates for Selected Characteristics at Discharge

Table 8.4. For outpatient medication-assisted opioid therapy discharges in 2012, the completion/transfer rates according to characteristics at discharge include:

• Arrests in past 30 days: The completion/transfer rate was 43 percent for those with 5 arrests in the 30 days before discharge, 39 percent for those who had no arrests in the 30 days before discharge, and 18 percent for those with 2 arrests in the 30 days before discharge
• Detailed not in labor force: The completion/transfer rate for ages 16 and older was 41 percent for homemakers, 39 percent for students, and 33 percent for inmates of institutions
• Employment status: The completion/transfer rate for ages 16 and older was 42 percent for discharges who were employed, 36 percent for the unemployed, and 35 percent for those who were not in the labor force
• Frequency of use: The completion/transfer rate was 50 percent for those who reported no substance use in the 30 days before discharge, 35 percent for those who reported daily substance use, and 33 percent who reported some substance use in the 30 days before discharge
• Living arrangements: The completion/transfer rate was 48 percent for those who were living dependently, 36 percent for those living independently, and 33 percent for the homeless
• Primary substance: The completion/transfer rate was 48 percent for those who abused alcohol, 44 percent for those who abused stimulants, and 37 percent for those who abused marijuana/hashish
• Self-help programs attended in past 30 days: The completion/transfer rate was 65 percent for those who attended self-help programs 16-30 times in the 30 days before discharge, 59 percent for those who attended self-help programs 8-15 times in the 30 days before discharge, and 53 percent for those who attended self-help programs 4-7 times in the 30 days before discharge

Median Length of Stay (LOS) of Discharges Completing Treatment

Tables 8.2 and 8.4. The overall median LOS among those completing outpatient medication-assisted opioid therapy treatment (excluding those who were transferred to further treatment) was 201 days. Median LOS for selected characteristics at admission and at discharge for outpatient medication-assisted opioid therapy discharges that completed treatment include:

At admission:

From Table 8.2,

• The median LOS was longest for discharges aged over 50 years (310 days)
• The median LOS was shortest for who were referred to treatment by a health care or community source (121 days)

From Table 8.4,

• The median LOS was longest for those arrested 5 times in the 30 days prior to admissions (343 days)
• The median LOS shortest for those arrested 4 times in the 30 days prior to admission (40 days)

At discharge:

From Table 8.4,

• The median LOS was longest for those arrested 5 times in the 30 days prior to discharge (363 days)
• The median LOS was shortest for those arrested 3 times in the 30 days prior to discharge (36 days)

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Reason for Discharge
Median Length of Stay (LOS)
Socio-Demographic and Substance Use Characteristics at Time of Admission
Comparison of Medication-Assisted Opioid Detoxification Discharges to All Discharges on Characteristics at Admission
Comparison of Selected Characteristics at Admission and at Discharge for Medication-Assisted Opioid Detoxification Discharges
Treatment Completion or Transfer to Further Treatment

Chapter 9 presents data on the reason for discharge, median length of stay (LOS) in treatment, and socio-demographic and substance use characteristics of the 19,484 medication-assisted opioid detoxification discharges aged 12 and older in 2012.^1,2 Of the 49 reporting states and jurisdictions, 25 states and 2 jurisdictions had discharges from medication-assisted opioid detoxification [Table 9.1]. Discharges from medication-assisted opioid detoxification included discharges from medication-assisted opioid detoxification (46 percent), free-standing residential detoxification (43 percent), and from hospital detoxification (11 percent) (see Chapter 1).

Reason for Discharge

Table 9.1 and Figure 9.1. For the 19,484 medication-assisted opioid detoxification discharges, the reasons for discharge were:

• Completed treatment: 47 percent (9,180)
• Transferred to further treatment: 20 percent (3,966)
• Dropped out of treatment: 28 percent (5,379)
• Treatment terminated by the facility: 2 percent (388)
• Failed to complete treatment for other reasons: 3 percent (571)

¹ Percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.
² For employment status and detailed not in labor force, only discharges aged 16 and older are included; for years of education, only discharges aged 18 and older are included.

Median Length of Stay (LOS)

Table 1.4 and Figure 9.2. The median length of stay (LOS) for medication-assisted opioid detoxification treatment discharges aged 12 and older in 2012 was 6 days. By reason for discharge, the median LOS for medication-assisted opioid detoxification treatment discharges was:

• Completed treatment: 6 days
• Transferred to further treatment: 7 days
• Dropped out of treatment: 11 days
• Treatment terminated by the facility: 5 days
• Failed to complete treatment for other reasons: 7 days

Socio-Demographic and Substance Use Characteristics at Time of Admission

Table 1.7. Summary findings of characteristics at time of admission of medication-assisted opioid detoxification discharges aged 12 and older include:

• Gender: 67 percent of medication-assisted opioid detoxification discharges were male
• Age at admission: 5 percent were 12 to 20 years of age, 37 percent were 21 to 30 years of age, 23 percent were 31 to 40 years of age, 20 percent were 41 to 50 years of age, and 15 percent were over 50 years of age
• Race/ethnicity: 66 percent were non-Hispanic White, 17 percent were Hispanic, 13 percent were non-Hispanic Black, and 4 percent were of a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Primary substance: Opiates were the most commonly reported primary substance of abuse (89 percent), followed by alcohol (7 percent), other substances (2 percent), cocaine (1 percent), and marijuana/hashish and stimulants (less than 1 percent each)
• Frequency of use: 87 percent of discharges reported daily substance use, and 2 percent reported no substance use in the month before treatment entry
• Number of prior treatment episodes: 68 percent of medication-assisted opioid detoxification discharges had one or more prior treatment episodes, and 32 percent had no prior treatment episodes
• Treatment referral source: 81 percent of discharges were self- or individual referrals, 17 percent were health care or community referrals, and 2 percent were referred to treatment from criminal justice/DUI sources
• Employment status: Of all medication-assisted opioid detoxification discharges aged 16 and older, 46 percent were unemployed and 36 percent were not in the labor force at time of admission
• Years of education: 49 percent of medication-assisted opioid detoxification discharges aged 18 and older had 12 years of education or a GED

Comparison of Medication-Assisted Opioid Detoxification Discharges to All Discharges on Characteristics at Admission

Tables 1.7 and 1.8a. There were some notable differences in the characteristics at admission of discharges from medication-assisted opioid detoxification treatment compared to the characteristics of all discharges combined.

• Number of prior treatment episodes: 32 percent of medication-assisted opioid detoxification discharges had no prior treatment episodes vs. 40 percent of all discharges
• Treatment referral source:
  
  • 2 percent of medication-assisted opioid detoxification discharges were criminal justice/DUI referrals vs. 33 percent of all discharges
  • 81 percent of medication-assisted opioid detoxification discharges were self- or individual referrals vs. 36 percent of all discharges
• Detailed not in labor force: 3 percent of medication-assisted opioid detoxification discharges aged 16 and older were students vs. 12 percent of all discharges
• Employment status: 18 percent of medication-assisted opioid detoxification discharges aged 16 and older were employed vs. 22 percent of all discharges
• Primary substance:
  
  • Less than 1 percent of medication-assisted opioid detoxification discharges reported marijuana/hashish as their primary substance of abuse vs. 17 percent of all discharges
  • 89 percent of medication-assisted opioid detoxification discharges reported opiates as their primary substance of abuse vs. 26 percent of all discharges
• Frequency of use:
  
  • 87 percent of medication-assisted opioid detoxification discharges reported daily substance use in the month before treatment entry vs. 40 percent of all discharges
  • 2 percent of medication-assisted opioid detoxification discharges reported no substance use in the month before treatment entry vs. 29 percent of all discharges

Comparison of Selected Characteristics at Admission and at Discharge for Medication-Assisted Opioid Detoxification Discharges

Tables 1.8a-b. Certain socio-demographic and substance use characteristics were collected at both time of admission and time of discharge. Differences (changes) in status between admission and discharge for medication-assisted opioid detoxification discharges include:

• Arrests in past 30 days: 95 percent of medication-assisted opioid detoxification discharges reported no arrests in the past 30 days at admission vs. 97 percent at discharge
• Detailed not in labor force: Among medication-assisted opioid detoxification discharges aged 16 and older not in labor force, 19 percent reported being disabled at admission vs. 15 percent at discharge
• Frequency of use: 87 percent of medication-assisted opioid detoxification discharges reported daily substance use in the the past 30 days at admission vs. 26 percent at discharge
• Living arrangements: 15 percent of medication-assisted opioid detoxification discharges reported being homeless at admission vs. 10 percent at discharge
• Self-help programs attended in past 30 days: 84 percent of medication-assisted opioid detoxification discharges reported not attending self-help programs in the past 30 days at admission vs. 62 percent at discharge

Treatment Completion or Transfer to Further Treatment

Completion/Transfer Rates

In this section, “completion/transfer rate” refers to the number of treatment completions or transfers per 100 discharges. To illustrate, the overall rate is calculated as the sum of all treatment completions and transfers divided by all discharges (which includes those who dropped out, were terminated by facility, or did not complete treatment for other reasons) and the resulting number (fraction) is multiplied by 100. Of medication-assisted opioid detoxification treatment discharges aged 12 and older in 2012, the overall percentage that completed treatment or transferred to further treatment (i.e., completion/transfer rate) was 67 percent. Up to three top rates for each characteristic are presented below.

Completion/Transfer Rates for Characteristics at Admission

Table 9.2. For medication-assisted opioid detoxification discharges in 2012, the completion/transfer rates according to characteristics at admission include:

• Gender: The completion/transfer rate was 70 percent for discharges who were male and 66 percent for discharges who were female
• Age at admission: The completion/transfer rate was 74 percent for discharges 12 to 20 years of age, 68 percent for discharges 21 to 30 years of age, and 67 percent for discharges over 50 years of age
• Race/ethnicity: The completion/transfer was 79 percent for non-Hispanic Black discharges, 68 percent for non-Hispanic Whites, and 65 percent for discharges of a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic
• Number of prior treatment episodes: The completion/transfer rate was 68 percent for discharges with one or more prior treatment episodes and 66 percent for those with no prior treatment episodes
• Treatment referral source: The completion/transfer rate was 87 percent or discharges who were referred to treatment by a criminal justice/DUI source, 83 percent for health care or community referrals, and 63 percent for discharges with self- or individual referrals
• Years of education: The completion/transfer rate for ages 18 and older was 73 percent for those with more than 12 years of education, 68 percent for those 12 years of education or a GED, and 60 percent for those with fewer than 12 years of education

Completion/Transfer Rates for Selected Characteristics at Discharge

Table 9.4. For medication-assisted opioid detoxification discharges in 2012, the completion/transfer rates according to characteristics at discharge include:

• Arrests in past 30 days: The completion/transfer rate was 100 percent for those with 4 arrests in the 30 days before discharge, 86 percent for those who had 3 arrests, and 85 percent for those with no arrests
• Detailed not in labor force: The completion/transfer rate for ages 16 and older was 91 percent for inmates of institutions, 88 percent for the retired, and 78 percent for students
• Employment status: The completion/transfer rate for ages 16 and older was 84 percent for discharges who were employed, 82 percent for the unemployed, and 83 percent for those who were not in the labor force
• Frequency of use: The completion/transfer rate was 94 percent for those who reported some substance use in the 30 days prior to discharge, 82 percent for those who reported daily substance use, and 81 percent for those who reported no substance use
• Living arrangements: The completion/transfer rate was 93 percent for those who were living dependently, 81 percent for those living independently, and 80 percent for the discharges who were homeless
• Self-help programs attended in past 30 days: The completion/transfer rate was 89 percent for those who attended self-help programs 8-30 times in the 30 days prior to discharge; 71 percent for those who did not attend any such programs, and 69 percent for those who attended such programs 4-7 times

Median Length of Stay (LOS) of Discharges Completing Treatment

Tables 9.2 and 9.4. The overall median LOS among those completing medication-assisted opioid detoxification treatment (excluding those who were transferred to further treatment) was 6 days. Median LOS for selected characteristics at admission and at discharge for medication-assisted opioid detoxification discharges that completed treatment include:

At admission:

From Table 9.2,

• The median LOS was longest for discharges that were of a race/ethnicity other than non-Hispanic White, non-Hispanic Black, or Hispanic (13 days)
• The median LOS was shortest for those aged 31 to 50, non-Hispanic Blacks, those who had one or more prior treatment episodes, those who were self- or individual referrals, or those that had fewer than 12 years of education (5 days each).

From Table 9.4,

• The median LOS was longest for those who reported no substance use in the month before treatment entry (20 days)
  
• The median LOS was shortest for those arrested 4 times in past 30 days (4 days)

At discharge:

From Table 9.4,

• The median LOS was longest among discharges arrested 5 times in the 30 days before discharge (20 days)
• The median LOS was shortest among discharges arrested 4 times in the 30 days before discharge (3 days)

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Introduction
History
State Data Collection Systems
Report-Specific Considerations

Introduction

This report presents results from the Treatment Episode Data Set (TEDS) for discharges from substance abuse treatment. 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.

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 four components of SAMHSA’s Behavioral Health Services Information System (BHSIS) (formerly known as the Drug and Alcohol Services Information System [DASIS]), the primary source of national data on substance and mental health abuse treatment. The other three components are:

• The Inventory of Behavioral Health Services (I-BHS), a continuously-updated comprehensive listing of all known public and private substance abuse treatment facilities
• The National Survey of Substance Abuse Treatment Services (N-SSATS), an annual survey of the location, characteristics, services offered, and utilization of alcohol and drug abuse treatment facilities in I-BHS
• The National Mental Health Services Survey (N-MHSS), an annual survey of the location, characteristics, services offered, and utilization of mental health treatment facilities in I-BHS

The TEDS system comprises two major components, the Admissions Data Set and the Linked Data Set. The TEDS Admission Data Set includes client-level data on substance abuse treatment admissions from 1992 through the present. The TEDS Linked Data Set includes discharges that can be linked at record level to admissions; it 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 Admission Data Set 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 state’s option. The Minimum Data Set consists of 19 items that include:

• Demographic information
• Primary, secondary, and tertiary substances and their route of administration, frequency of use, and age at first use
• Source of referral to treatment
• Number of prior treatment episodes
• Service type, including planned use of medication-assisted opioid therapy

The Supplemental Data Set (not presented in this report) items include psychiatric, social, and economic measures.

The TEDS Linked Data Set was designed to enable TEDS to collect information on entire treatment episodes. Discharge data, when linked to admission data, represent treatment episodes that enable analyses of questions that cannot be answered with admission data alone. Examples are the proportion of discharges that completed treatment and the average length of stay of treatment completers.

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 it 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 covers 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 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 2012. 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.

• Facilities included. The scope of facilities included in TEDS is affected by differences in state licensure, certification, and accreditation practices, and disbursement of public funds. Most SSAs require facilities that receive state/public funding (including federal block grant funds) for the provision of alcohol and/or drug treatment services to report data to the SSA. Generally this funding is distributed by the SSA but may be distributed by another public agency.
  
  Some SSAs regulate private facilities, methadone clinics, and/or individual practitioners and require them to report TEDS data. Others do not because of the difficulty in obtaining data from these facilities, although these facilities may report voluntarily. Facilities operated by federal agencies (e.g., the Bureau of Prisons, the Department of Defense, and the Department of Veterans Affairs) generally do not report TEDS data to the SSA, although some facilities operated by the Indian Health Service are included. Hospital-based substance abuse treatment facilities are frequently not licensed through the SSA and do not report TEDS data. Correctional facilities (state prisons and local jails) are monitored by the SSA and report TEDS data in some states but not in others.
  
  The primary goal of TEDS is to monitor the characteristics of clients admitted to planned, continuing treatment regimens. Thus early intervention and crisis intervention programs that do not lead to enrollment in continued treatment are excluded from TEDS.
  
  
• Clients included. About 60 percent of states reported data on all admissions to all eligible facilities, although some reported only, or largely, admissions financed by public funds. TEDS is an admission-based system; therefore, TEDS admissions do not represent individuals. For example, an individual admitted to treatment twice within a calendar year is counted as two admissions.
  
  
• Ability to track multi-service episodes. The goal for the TEDS system is to enumerate treatment episodes by distinguishing the initial admission of a client from his/her subsequent transfer to a different service type (e.g., from residential treatment to outpatient) within a single continuous treatment episode. Thus TEDS records are ideally coded as admissions if they represent the initial treatment service in a treatment episode and as transfers if they represent a change in service type or a change in provider without an interruption in treatment.
  
  This requires, however, that clients be assigned unique IDs that can be linked across providers; not all states are legally and/or technologically able to do this. Most states can identify as transfers a change in service type within the structure of a given provider, however, fewer can also identify a transfer involving a change of provider. Several states do not track transfers, but instead report as transfers those clients who are discharged and readmitted within a specified (state-specific) time period.
  
  Because some admission records in fact may represent transfers, the number of admissions reported probably overestimates the number of treatment episodes. Some states reported a limited data set on codependents of substance abusers entering treatment. On average, from 2000 through 2012, 91 percent of all records submitted were client admissions, 9 percent were client transfers, and 1 percent were codependents of substance abusers.
  
  
• Services offered. A state’s mix of service types (e.g., outpatient, detoxification, residential, opioid therapy) can have a significant effect on its admission rate. There is higher client turnover and therefore more admissions in short-stay services such as detoxification than in long-stay services such as outpatient or long-term residential treatment. Admission rates for individual substances of abuse may be affected as well (e.g., detoxification is more closely associated with alcohol or heroin use than with use of other substances).¹
  
  
• Completeness and timeliness of reporting. SAMHSA, in reporting national-level TEDS data, must balance timeliness of reporting and completeness of the data set. There may be a time lag in the publication of SAMHSA’s annual report because preparation cannot begin until states have completed their data submission for that year. States in turn rely on individual facilities to report in a timely manner so they can submit TEDS data to SAMHSA at regular intervals.

Appendix Table 2 indicates the proportions of records for which valid discharge data were received for 2012. States are expected to report all variables in the Minimum Data Set.

Report-Specific Considerations

• The report focuses on treatment for substance abusers according to service type. Thus, admissions for treatment as a codependent of a substance abuser are excluded. Records for identifiable transfers within a single treatment episode are included.
• 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 discharges on which a percentage distribution is based is reported in each table.
• States that did not collect a specific variable are excluded from tabulations of that variable. The total number of records 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.
• Stimulant admissions include methamphetamine, amphetamines, and other stimulants. However, 98 to 99 percent of these admissions were for methamphetamine or amphetamine abuse.
• The data presented in this report focus on treatment for substance abusers within service type. They do not represent complete treatment episodes, as a single episode may involve stays in more than one service type. States are asked to submit a record for each initial admission to a treatment service, for each transfer from one service to another, and for a discharge corresponding to each admission or transfer.
• The number of states included in each of the service type chapters varies because not all states reported discharges for every service type. The first table for each chapter details the states reporting discharges of that service type.
• Linkage of discharge records from 2012 to admission records from 2000 to 2012 means that the maximum length of stay (LOS) in treatment included in this report is 13 years. However, outpatient medication-assisted opioid therapy can have a much longer duration. Indeed, some admissions may receive this form of treatment indefinitely. Because this report includes data only on discharges, it will underestimate LOS in treatment for those receiving outpatient medication-assisted opioid therapy. Similarly, the number and proportion of treatment completers will reflect only those who have been discharged because treatment is complete and not those who successfully remain in long-term outpatient medication-assisted opioid therapy. In addition, the characteristics at admission of those admitted to and discharged from outpatient medication-assisted opioid therapy within 13 years may differ from those of admissions who remain in outpatient medication-assisted opioid therapy for longer than 13 years.

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TEDS Minimum Data Set
TEDS Discharge Data Set

AGE OF FIRST USE (OF PRIMARY, SECONDARY, AND TERTIARY SUBSTANCE)

For drugs other than alcohol, these fields identify the age at which the client first used the respective substance. For alcohol, these fields record the age of first intoxication.

• 0—Indicates a newborn with a substance dependency problem
• 1-96—Indicates the age at first use

CLIENT OR CODEPENDENT/COLLATERAL

Specifies whether the admission record is for a substance abuse treatment client, or a person being treated for his/her codependency or collateral relationship with a substance abuser.

Client—Must meet all of the following criteria:

• Has an alcohol or drug related problem
• Has completed the screening and intake process
• Has been formally admitted for treatment or recovery service in an alcohol or drug treatment unit
• Has his or her own client record

A person is not a client if he or she has completed only a screening or intake process or has been placed on a waiting list.

Codependent/collateral—Must meet all of the following criteria:

• Has no alcohol or drug related problem
• Is seeking services because of problems arising from his or her relationship with an alcohol or drug user
• Has been formally admitted for service to a treatment unit
• Has his or her own client record or has a record within a primary client record

GUIDELINES: Reporting of data for Codependent/collaterals is optional. If the state opts to report codependent/collateral clients, the mandatory fields are State code, Provider identifier, Client identifier, Client transaction type, Codependent/collateral, and Date of admission. Reporting of the remaining fields in the TEDS Minimum and Supplemental Data Sets is optional. For all items not reported, the data field should be coded with the appropriate “Not collected” or “Not applicable” code.

If a substance abuse client with an existing record in TEDS becomes a codependent, a new client record should be submitted indicating that the client has been admitted as a codependent, and vice versa.

If a record does not include a value for this field, it is assumed to be a substance abuse client record.

DATE OF ADMISSION

The day when the client receives his or her first direct treatment or recovery service. For transfers, this is the date when client receives his or her first direct treatment after the transfer has occurred.

DEMOGRAPHICS

AGE

Identifies client’s age at admission. Derived from client’s date of birth and date of admission.

• 0—Indicates a newborn with a substance dependency problem
• 1-96—Indicates the age at admission

EDUCATION

Specifies the highest school grade (number of school years) completed by the client.

• 0—Less than one grade completed
• 1-25—Years of school (highest grade) completed. For General Equivalency Degree, use 12.

GUIDELINES: States that use specific categories for designating education level should map their codes to a logical number of years of school completed. For Associate’s Degree, use 14. For Bachelor’s Degree, use 16.

EMPLOYMENT STATUS

Identifies the client’s employment status at the time of admission or transfer.

• Full time—Working 35 hours or more each week, including active duty members of the uniformed services
• Part time—Working fewer than 35 hours each week
• Unemployed—Looking for work during the past 30 days, or on layoff from a job
• Not in labor force—Not looking for work during the past 30 days, or a student, homemaker, disabled, retired, or an inmate of an institution. Clients in this category are further defined in the TEDS Supplemental Data Set item Detailed not-in-labor force.

GUIDELINES: Seasonal workers are coded in this category based on their employment status at admission.

ETHNICITY

Identifies client’s specific Hispanic origin.

• Cuban—Of Cuban origin, regardless of race
• Hispanic (specific origin not specified)—Of Hispanic origin, but specific origin not known or not specified
• Mexican—Of Mexican origin, regardless of race
• Not of Hispanic origin
• Other specific Hispanic—Of known Central or South American or any other Spanish cultural origin (including Spain), other than Puerto Rican, Mexican, or Cuban, regardless of race
• Puerto Rican—Of Puerto Rican origin, regardless of race

GUIDELINES: If a state does not collect specific Hispanic detail, code Ethnicity for Hispanics as Hispanic (specific origin not specified).

RACE

Specifies the client’s race.

• Alaska Native (Aleut, Eskimo, Indian)—Origins in any of the original people of Alaska
• American Indian (other than Alaska Native)—Origins in any of the original people of North America and South America (including Central America) and who maintain cultural identification through tribal affiliation or community attachment
• Asian or Pacific Islander—Origins in any of the original people of the Far East, the Indian subcontinent, Southeast Asia, or the Pacific Islands
  • Asian—Origins in any of the original people of the Far East, the Indian subcontinent, or Southeast Asia, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Philippine Islands, Thailand, and Vietnam
  • Native Hawaiian or other Pacific Islander—Origins in any of the original people of Hawaii, Guam, Samoa, or other Pacific Islands
• Black or African American—Origins in any of the black racial groups of Africa
• White—Origins in any of the original people of Europe, North Africa, or the Middle East
• Other single race—Client is not classified in any category above or whose origin group, because of area custom, is regarded as a racial class distinct from the above categories
• Two or more races—For use when the state data system allows multiple race selection and more than one race is indicated

GUIDELINES: If a state does not distinguish between American Indian and Alaska Native, both should be coded as American Indian. If a state does not distinguish between Asian and Native Hawaiian or other Pacific Islander, both should be coded as Asian or Pacific Islander. For states that collect multiple races: a) when a single race is designated, the specific race code should be used; b) if the state collects a primary or preferred race along with additional races, the code for the primary/preferred race should be used; c) if the state uses a system such as an algorithm to select a single race when multiple races have been designated, the same system may be used to determine the race code for TEDS. When two or more races have been designated and neither (b) nor (c) above apply, the TEDS code for Two or more races should be used.

SEX

Identifies client’s gender.

• Male
• Female

FREQUENCY OF USE (OF PRIMARY, SECONDARY, AND TERTIARY SUBSTANCES)

These fields identify the frequency of use of the respective Substance problems.

• No use in the past month
• 1-3 times in the past month
• 1-2 times in the past week
• 3-6 times in the past week
• Daily

MEDICATION-ASSISTED OPIOID THERAPY

Identifies whether the use of methadone or buprenorphine is part of the client’s treatment plan.

• Yes
• No

NUMBER OF PRIOR TREATMENT EPISODES

Indicates the number of previous treatment episodes the client has received in any drug or alcohol program. Changes in service for the same episode (transfers) should not be counted as separate prior episodes.

• 0 previous episodes
• 1 previous episode
• 2 previous episodes
• 3 previous episodes
• 4 previous episodes
• 5 or more previous episodes

GUIDELINES: It is preferred that the number of prior treatments be a self-reporting field collected at the time of client intake. However, this data item may be derived from the state data system if the system has that capability and episodes can be counted for at least several years.

PRINCIPAL SOURCE OF REFERRAL

Describes the person or agency referring the client to the alcohol or drug abuse treatment program.

• Alcohol/drug abuse care provider—Any program, clinic, or other health care provider whose principal objective is treating clients with substance abuse problems, or a program whose activities are related to alcohol or other drug abuse prevention, education, or treatment
• Court/criminal justice referral/DUI/DWI—Any police official, judge, prosecutor, probation officer, or other person affiliated with a federal, state, or county judicial system. Includes referral by a court for DWI/DUI, clients referred in lieu of or for deferred prosecution, or during pretrial release, or before or after official adjudication. Includes clients on pre-parole, pre-release, work or home furlough, or TASC. Client need not be officially designated as “on parole.” Includes clients referred through civil commitment. Client referrals on this category are further defined in the TEDS Supplemental Data Set item Detailed criminal justice referral.
• Employer/EAP—A supervisor or an employee counselor
• Individual (includes self-referral)—Includes the client, a family member, friend, or any other individual who would not be included in any of the following categories; includes self-referral due to pending DWI/DUI
• Other community referral—Community or religious organization or any federal, state, or local agency that provides aid in the areas of poverty relief, unemployment, shelter, or social welfare. Self-help groups such as Alcoholics Anonymous (AA), Al-Anon, and Narcotics Anonymous (NA) are also included in this category. Defense attorneys are included in this category.
• Other health care provider—A physician, psychiatrist, or other licensed health care professional; or a general hospital, psychiatric hospital, mental health program, or nursing home
• School (educational)—A school principal, counselor, or teacher; or a student assistance program (SAP), the school system, or an educational agency

SUBSTANCE PROBLEM (PRIMARY, SECONDARY, OR TERTIARY)

These fields identify the client’s primary, secondary, and tertiary substance problems. Each Substance problem (primary, secondary, and tertiary) has associated fields for Route of administration, Frequency of use, Age at first use, and the TEDS Supplemental Data Set item Detailed drug code.

• Alcohol
• Barbiturates—Amobarbital, pentobarbital, phenobarbital, secobarbital, etc.
• Benzodiazepines—Includes alprazolam, chlordiazepoxide, clonazepam, clorazepate, diazepam, flunitrazepam, flurazepam, halazepam, lorazepam, oxazepam, prazepam, temazepam, triazolam, and other unspecified benzodiazepines
• Cocaine/crack
• Heroin
• Inhalants—Includes chloroform, ether, gasoline, glue, nitrous oxide, paint thinner, etc.
• Marijuana/hashish—Includes THC and any other cannabis sativa preparations
• Methamphetamine
• Non-prescription methadone
• Other amphetamines—Includes amphetamines, MDMA, phenmetrazine, and other unspecified amines and related drugs
• Other hallucinogens—Includes LSD, DMT, STP, hallucinogens, mescaline, peyote, psilocybin, etc.
• Other non-barbiturate sedatives or hypnotics—Includes chloral hydrate, ethchlorvynol, glutethimide, methaqualone, and other non-barbiturate sedatives or hypnotics
• Other non-benzodiazepine tranquilizers—Includes meprobamate and other non-benzodiazepine tranquilizers
• Other opiates and synthetics—Includes buprenorphine, codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects
• Other stimulants—Includes methylphenidate and any other stimulants
• Over-the-counter medications—Includes aspirin, cough syrup, diphenhydramine and other antihistamines, sleep aids, and any other legally obtained nonprescription medication
• PCP—Phencyclidine
• Other—Includes diphenylhydantoin/phenytoin, GHB/GBL, ketamine, etc.
• None

GUIDELINES: Substance problems are further defined in the TEDS Supplemental Data Set item Detailed drug code. For guidance on which specific substances to include in the substance categories, please refer to the detailed drug categories listed for Detailed drug code.

• Substance problem and Route of administration:
  • For states that do collect Detailed drug code—Records may have duplicate Substance problems and identical Route of administration IF the corresponding Detailed drug codes are different or are ‘‘multiple’’ drug codes
  • For states that do not collect Detailed drug code—A record may not have duplicate Substance problems with identical Routes of administration

TRANSACTION TYPE

Identifies whether a record is for an initial admission or a transfer/change in service. Note: Some states may use other terminology such as “initial admission” and “transfer admission” in place of “admission” and “transfer.”

• A—Admission
• T—Transfer/change in service

GUIDELINES: For TEDS, a treatment episode is defined as that period of service between the beginning of treatment for a drug or alcohol problem and the termination of services for the prescribed treatment plan. The episode includes one admission (when services begin) and at least one discharge (when services end). Within a treatment episode, a client may transfer to a different service, facility, provider, program, or location. Each admission and transfer record should have an associated discharge record.

When it is feasible for the state to identify transfers, they should be reported as transfers in admissions data submissions. When admissions and transfers cannot be differentiated in a state data system, such changes in service or facility should be reported to TEDS as admissions.

Data set considerations for transfers:

• All fields from the transfer record should be updated to reflect values at the time of transfer except the following fields, which must have the same values as in the associated (preceding) admission record: Client ID, Codependent/collateral, Date of birth, Sex, Race, and Ethnicity. If a field cannot be updated, it should be transmitted to TEDS with its value from the associated (preceding) admission record.
• Date of admission is defined as the date services begin after the transfer to another service or facility.

TYPE OF SERVICES

Describes the type of service and treatment setting in which the client is placed at the time of admission or transfer.

• Ambulatory, detoxification—Outpatient treatment services providing for safe withdrawal in an ambulatory setting (pharmacological or non-pharmacological)
• Ambulatory, intensive outpatient—As a minimum, the client must receive treatment lasting two or more hours per day for three or more days per week
• Ambulatory, non-intensive outpatient—Ambulatory treatment services including individual, family, and/or group services, and may include pharmacological therapies
• Detoxification, 24-hour service, free-standing residential—24-hour per day services in a non-hospital setting providing for safe withdrawal and transition to ongoing treatment
• Detoxification, 24-hour service, hospital inpatient—24-hour per day medical acute care services in a hospital setting for detoxification of persons with severe medical complications associated with withdrawal
• Rehabilitation/residential, hospital (other than detoxification)—24-hour per day medical care in a hospital facility in conjunction with treatment services for alcohol and other drug abuse and dependency
• Rehabilitation/residential, short-term (30 days or fewer)—Typically, 30 days or less of non-acute care in a setting with treatment services for alcohol and other drug abuse and dependency
• Rehabilitation/residential, long-term (more than 30 days)—Typically, more than 30 days of non-acute care in a setting with treatment services for alcohol and other drug abuse and dependency; this may include transitional living arrangements

USUAL ROUTE OF ADMINISTRATION (OF PRIMARY, SECONDARY, AND TERTIARY SUBSTANCES)

These fields identify the usual route of administration of the respective Substance problems.

• Inhalation
  
• Injection (IV or intramuscular)
  
• Oral
  
• Smoking
  
• Other

DATE OF DISCHARGE

The date when the client was formally discharged from the treatment facility or service. The date may be the same as the date of last contact. In the event of a change of service or provider within an episode of treatment, it is the date the service terminated or the date the treatment ended at a particular provider.

DATE OF LAST CONTACT

The date when the client was last seen for a treatment. The date may be the same as the date of discharge. In the event of a change of service or provider within an episode of treatment, it is the date the client transferred to another service or provider.

DETAILED NOT IN LABOR FORCE AT DISCHARGE

These fields record more detailed information about those clients who are coded as Not in labor force in the TEDS Minimum Dataset item Employment Status.

• Disabled
  
• Homemaker
  
• Inmate of institution (prison or institution that keeps a person, otherwise able, from entering the labor force)
• Other
  
• Retired
  
• Student

EMPLOYMENT STATUS AT DISCHARGE

See TEDS Minimum Data Set item Employment status for definitions.

FREQUENCY OF ATTENDANCE AT SELF-HELP PROGRAMS IN 30 DAYS PRIOR TO DISCHARGE

These fields record the number of times the client has attended a self-help program in the 30 days preceding the date of admission to and discharge from treatment services.

• No attendance in the past month
  
• 1-3 times in the past month
  
• 4-7 times in the past month
  
• 8-15 times in the past month
  
• 16-30 times in the past month
  
• Some attendance in the past month, but frequency unknown

FREQUENCY OF USE AT DISCHARGE (OF PRIMARY, SECONDARY, AND TERTIARY SUBSTANCES)

See TEDS Minimum Data Set item Frequency of use for definitions.

LIVING ARRANGEMENTS AT ADMISSION/DISCHARGE

These fields record whether the client is homeless, living with parents, in a supervised setting, or living on his or her own at the time of admission and discharge.

• Dependent living—Clients living in a supervised setting such as a residential institution, halfway house, or group home, and children (under age 18) living with parents, relatives, or guardians or in foster care.
  
• Homeless—Clients with no fixed address; includes shelters.
• Independent living—Clients living alone or with others without supervision.

NUMBER OF ARRESTS IN 30 DAYS PRIOR TO DISCHARGE

Records the number of arrests in the 30 days preceding the date of admission to and discharge from treatment services.

• 00-96—Number of arrests

REASON FOR DISCHARGE, TRANSFER, OR DISCONTINUANCE OF TREATMENT

Indicates the outcome of treatment or the reason for transfer or discontinuance of treatment.

• Death
• Incarcerated—Jail, prison, house confinement
• Left against professional advice (dropped out)—Client chose not to complete treatment program, with or without specific advice to continue treatment; includes clients who dropped out for unknown reasons and clients who did not receive a treatment service for some time and were discharged for administrative reasons
• Other—Client moved, became ill, was hospitalized, or other reason somewhat out of client’s control
• Terminated by facility—Treatment terminated by action of facility, generally because of client non-compliance or violation of rules, laws, or procedures (excludes client drop-out, incarceration, or client-motivated reason for discontinuance)
• Transferred to another substance abuse program or facility—Client was transferred to another substance abuse treatment service type, program, provider, or facility; client may or may not have reported to the new program or facility
• Treatment completed—All parts of the treatment plan or program were completed
• Unknown—Client status at discharge not known (e.g., record incomplete or lost); not to be used for clients who dropped out of treatment

SUBSTANCE PROBLEM AT DISCHARGE (PRIMARY, SECONDARY, OR TERTIARY)

See TEDS Minimum Data Set item Substance problem for definitions.

TYPE OF SERVICE AT DISCHARGE

See TEDS Minimum Data Set item Type of service at admission for definitions.

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This report was prepared by Synectics for Management Decisions, Inc. (SMDI), and by the Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services (HHS). Work by SMDI was performed under Contract No. HHSS283200700048I/HHSS28342001T.

The report was written by Sarbajit Sinha and Anand Borse under the direction of Doren Walker (Project Director) and Hongwei Zhang (Director of Data Analysis and Reports) at SMDI.

Production of the report at SAMHSA was managed by Cathie Alderks. SAMHSA contributors and reviewers, listed alphabetically, include: Cathie Alderks, Herman Alvarado, Jamie Teufel, and Nichele Waller.

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