Treatment Episode Data Set (TEDS) 2005-2015

National Admissions to Substance Abuse Treatment Services

 

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration

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Acknowledgments

This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). Work was performed under Task Order HHSS283200700048I/HHSS28342001T, Reference No. 283-07-4803 (Cathie Alderks, Task Order Officer).

SAMHSA complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. SAMHSA cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad,
discapacidad o sexo.

Public Domain Notice

All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, U.S. Department of Health and Human Services.

Recommended Citation

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2005-2015. National Admissions to Substance Abuse Treatment Services. BHSIS Series S-91, HHS Publication No. (SMA) 17-5037. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2017.

Electronic Access and Copies of Publication

This publication may be downloaded at datafiles.samhsa.gov.

Or call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727)
(English and Español).

Originating Office

Center for Behavioral Health Statistics and Quality
Substance Abuse and Mental Health Services Administration
5600 Fishers Lane, Room 15SEH03
Rockville, Maryland 20857

February 2017

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Table of Contents

Title Page

Acknowledgments

List of Tables

List of Figures

Highlights

Chapter 1. Trends in Substance Abuse Treatment Admissions Aged 12 and Older: 2005-2015

Chapter 2. Characteristics of Admissions by Primary Substance: 2015

Chapter 3. Topics of Special Interest

Chapter 4. Type of Treatment Services: 2015

Tables

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

Appendix B. TEDS Data Elements

Appendix C. List of Contributors

Tables

Trends in Substance Abuse Treatment Admissions Aged 12 and Older: 2005-2015

1.1a Admissions aged 12 and older, by primary substance of abuse: Number, 2005-2015

1.1b Admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2005-2015

1.2 Admissions aged 12 and older, by alcohol/drug co-abuse: Number and percent distribution, 2005-2015

1.3a Admissions aged 12 and older, by gender and age at admission: Number and average age at admission, 2005-2015

1.3b Admissions aged 12 and older, by gender and age at admission: Percent distribution, 2005-2015, and 2015 U.S. population aged 12 and older

1.4 Admissions aged 12 and older, by race/ethnicity: Number and percent distribution, 2005-2015, and 2015 U.S. population aged 12 and older

1.5a Admissions aged 16 and older, by employment status: Number, 2005-2015, and 2015 U.S. population aged 16 and older

1.5b Admissions aged 16 and older, by employment status: Percent distribution, 2005-2015, and 2015 U.S. population aged 16 and older

Characteristics of Admissions by Primary Substance: 2015

2.1a Gender and age at admission among admissions aged 12 and older, by primary substance of abuse: Number and average age at admission, 2015

2.1b Gender and age at admission among admissions aged 12 and older, by primary substance of abuse: Column percent distribution and average age at admission, 2015

2.1c Gender and age at admission among admissions aged 12 and older, by primary substance of abuse: Row percent distribution, 2015

2.2a Race/ethnicity among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.2b Race/ethnicity among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.3a Selected race/ethnicity/gender/age group among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.3b Selected race/ethnicity/gender/age group among admissions aged 12 and older, by primary substance of abuse: Column percent distribution, 2015

2.3c Selected race/ethnicity/gender/age group among admissions aged 12 and older, by primary substance of abuse: Row percent distribution, 2015

2.4a Frequency of use and usual route of administration among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.4b Frequency of use and usual route of administration among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.5a Age of first use and number of prior treatment episodes among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.5b Age of first use and number of prior treatment episodes among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.6a Treatment referral source and detailed criminal justice referral among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.6b Treatment referral source and detailed criminal justice referral among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.7a Type of treatment service at admission and planned medication-assisted opioid therapy among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.7b Type of treatment service at admission and planned medication-assisted opioid therapy among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.8a Employment status and detailed not in labor force among admissions aged 16 and older, by primary substance of abuse: Number, 2015

2.8b Employment status and detailed not in labor force among admissions aged 16 and older, by primary substance of abuse: Percent distribution, 2015

2.9a Education among admissions aged 18 and older, by primary substance of abuse: Number, 2015

2.9b Education among admissions aged 18 and older, by primary substance of abuse: Percent distribution, 2015

2.10a Marital status, living arrangements, pregnancy status, and veteran status among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.10b Marital status, living arrangements, pregnancy status, and veteran status among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.11a Psychiatric problem in addition to substance abuse problem and DSM criteria diagnosis among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.11b Psychiatric problem in addition to substance abuse problem and DSM criteria diagnosis among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.12a Source of income support among admissions aged 16 and older, by primary substance of abuse: Number, 2015

2.12b Source of income support among admissions aged 16 and older, by primary substance of abuse: Percent distribution, 2015

2.13a Type of health insurance and expected/actual primary source of payment among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.13b Type of health insurance and expected/actual primary source of payment among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.14a Arrests in 30 days prior to admission and days waiting to enter treatment among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.14b Arrests in 30 days prior to admission and days waiting to enter treatment among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.15a Frequency of attendance at self-help programs among admissions aged 12 and older, by primary substance of abuse: Number, 2015

2.15b Frequency of attendance at self-help programs among admissions aged 12 and older, by primary substance of abuse: Percent distribution, 2015

2.16 Admissions aged 12 and older, by primary, secondary, and tertiary detailed drug: Number and percent distribution, 2015

Topics of Special Interest

3.1a Admissions aged 12 to 17, by primary substance of abuse: Number, 2005-2015

3.1b Admissions aged 12 to 17, by primary substance of abuse: Percent distribution, 2005-2015

3.2a Gender and race/ethnicity among admissions aged 12 to 17, by primary substance of abuse: Number, 2015

3.2b Gender and race/ethnicity among admissions aged 12 to 17, by primary substance of abuse: Percent distribution, 2015

3.3a Age at admission and treatment referral source among admissions aged 12 to 17, by primary substance of abuse: Number, 2015

3.3b Age at admission and treatment referral source among admissions aged 12 to 17, by primary substance of abuse: Percent distribution, 2015

3.4a Admissions aged 12 to 17, by marijuana involvement and treatment referral source: Number, 2005-2015

3.4b Admissions aged 12 to 17, by marijuana involvement and treatment referral source: Percent distribution, 2005-2015

3.5a Heroin admissions aged 12 and older, by age group and race/ethnicity: Number, 2005-2015

3.5b Heroin admissions aged 12 and older, by age group and race/ethnicity: Percent distribution, 2005-2015

3.6a Heroin admissions aged 12 and older, by usual route of administration, age group, and characteristics of treatment episode: Number, 2005-2015

3.6b Heroin admissions aged 12 and older, by usual route of administration, age group, and characteristics of treatment episode: Percent distribution, 2005-2015

3.7a Heroin admissions aged 12 and older with planned medication-assisted opioid therapy, by usual route of administration and age group: Number, 2005-2015

3.7b Heroin admissions aged 12 and older with planned medication-assisted opioid therapy, by usual route of administration and age group: Percent, 2005-2015

3.8 Primary substance of abuse among admissions aged 12 and older, by additional substance of abuse: Number and percent distribution, 2015

3.9 Substance abuse combinations, by selected primary substance of abuse: Number and percent distribution, 2015

Type of Treatment Service: 2015

4.1a Primary substance of abuse and age at admission among admissions aged 12 and older, by type of treatment service: Number and average age at admission, 2015

4.1b Primary substance of abuse and age at admission among admissions aged 12 and older, by type of treatment service: Column percent distribution and average age at admission, 2015

4.1c Primary substance of abuse and age at admission among admissions aged 12 and older, by type of treatment service: Row percent distribution, 2015

4.2a Gender and race/ethnicity among admissions aged 12 and older, by type of treatment service: Number, 2015

4.2b Gender and race/ethnicity among admissions aged 12 and older, by type of treatment service: Column percent distribution, 2015

4.2c Gender and race/ethnicity among admissions aged 12 and older, by type of treatment service: Row percent distribution, 2015

4.3a Treatment referral source, frequency of use, and number of prior treatment episodes among admissions aged 12 and older, by type of treatment service: Number, 2015

4.3b Treatment referral source, frequency of use, and number of prior treatment episodes among admissions aged 12 and older, by type of treatment service: Column percent distribution, 2015

4.3c Treatment referral source, frequency of use, and number of prior treatment episodes among admissions aged 12 and older, by type of treatment service: Row percent distribution, 2015

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

Appendix A Table 1. State data system reporting characteristics: 2015

Appendix A Table 2. Item percentage response rate, by state or jurisdiction: TEDS Minimum Data Set 2015

Appendix A Table 3. Item percentage response rate, by state or jurisdiction: TEDS Supplemental Data Set 2015

Figures

Figure 1. Primary substance of abuse at admission: 2005-2015

Figure 2. Age at admission: TEDS 2005-2015 and U.S. population 2015

Figure 3. Race/ethnicity of admissions: TEDS 2005-2015 and U.S. population 2015

Figure 4. Employment status among admissions aged 16 and older: 2005-2015

Figure 5. All admissions aged 12 and older, by gender, age, and race/ethnicity: 2015

Figure 6. Alcohol-only admissions, by gender, age, and race/ethnicity: 2015

Figure 7. Alcohol admissions with secondary drug abuse, by gender, age, and race/ethnicity: 2015

Figure 8. Heroin admissions, by gender, age, and race/ethnicity: 2015

Figure 9. Non-heroin opiate admissions by gender, age, and race/ethnicity: 2015

Figure 10. Smoked cocaine (crack) admissions, by gender, age, and race/ethnicity: 2015

Figure 11. Non-smoked cocaine admissions, by gender, age, and race/ethnicity: 2015

Figure 12. Marijuana/hashish admissions, by gender, age, and race/ethnicity: 2015

Figure 13. Methamphetamine/amphetamine admissions, by gender, age, and race/ethnicity: 2015

Figure 14. Tranquilizer admissions, by gender, age, and race/ethnicity: 2015

Figure 15. Sedative admissions, by gender, age, and race/ethnicity: 2015

Figure 16. Hallucinogens admissions, by gender, age, and race/ethnicity: 2015

Figure 17. Phencyclidine (PCP) admissions, by gender, age, and race/ethnicity: 2015

Figure 18. Inhalant admissions, by gender, age, and race/ethnicity: 2015

Figure 19. Adolescent admissions aged 12 to 17, by primary substance: 2005-2015

Figure 20. Adolescent admissions aged 12 to 17, by marijuana involvement and court/criminal justice referral: 2005-2015

Figure 21. Heroin admissions aged 12 and older, by age group and race/ethnicity: 2005-2015

Figure 22. Heroin admissions 12 and older, by route of administration and age group: 2005-2015

Figure 23. Heroin admissions aged 12 and older with planned medication-assisted opioid therapy, by route of heroin administration: 2005-2015

Figure 24. Heroin admissions aged 12 and older with planned medication-assisted opioid therapy, by age group: 2005-2015

Figure 25. White (non-Hispanic) admissions, by gender, primary substance, and age: 2015

Figure 26. Black (non-Hispanic) admissions, by gender, primary substance, and age: 2015

Figure 27. Mexican origin admissions, by gender, primary substance, and age: 2015

Figure 28. Puerto Rican origin admissions, by gender, primary substance, and age: 2015

Figure 29. American Indian/Alaska Native admissions, by gender, primary substance, and age: 2015

Figure 30. Asian/Pacific Islander admissions, by gender, primary substance, and age: 2015

Figure 31. Primary and secondary/tertiary substance of abuse: 2015

Highlights

This report presents national-level data from the Treatment Episode Data Set (TEDS) for admissions in 2015 and trend data from 2005 to 2015. It provides information on the demographic and substance abuse characteristics of admissions aged 12 and older to treatment for abuse of alcohol and/or drugs in facilities that report to individual state administrative data systems.

TEDS is an admission-based system and TEDS admissions do not represent individuals. Thus, an individual admitted to treatment twice within a calendar year would be counted as two admissions. TEDS, while comprising a significant proportion of all admissions to substance abuse treatment, does not include all such admissions. TEDS is a compilation of data collected through the individual data collection systems of the State Substance Abuse Agencies (SSAs) for substance abuse treatment. Therefore 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 have cooperated with the federal government in the data collection process, and substantial progress has been made toward developing a standardized data set over the years. 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. State-to-state comparisons must be made with extreme caution.

It is important to note that percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.


For 2015, there were 1,537,025 substance abuse treatment admissions aged 12 and older reported to TEDS by 45 states, the District of Columbia, and Puerto Rico.

Major Substances of Abuse

Alcohol

Heroin

Opiates Other than Heroin1


1 These drugs include methadone, buprenorphine, codeine, hydrocodone, hydromorphone, meperidine, mor­phine, opium, oxycodone, pentazocine, pro­poxyphene, tramadol, and any other drug with morphine-like effects.

Marijuana/Hashish

Cocaine/Crack

Methamphetamine/Amphetamines

Adolescent Admissions to Substance Abuse Treatment


2 Court/criminal justice system referrals include all admissions that are coded as “Court/criminal justice referral/DUI/DWI” in the TEDS Data Set. These include referrals by any police official, judge, prosecutor, probation officer, or other person affiliated with a federal, state, or county judicial system or other recognized legal entity (e.g., corrections agency, youth services, review board/agency); referrals by a court for DUI/DWI; referrals in lieu of or for deferred prosecution, or during pretrial release, or before or after official adjudication; and referrals for clients on pre-parole, pre-release, work or home furlough, or in a diversionary program such as Treatment Assessment Screening Center (TASC). (Note that clients need not be officially designated as on parole.) Court/criminal justice system referrals also include clients referred through civil commitment.

Trends in Heroin Admissions and Medication-Assisted Opioid Therapy

Polydrug Abuse

Polydrug abuse was reported by 54 percent of all TEDS admissions aged 12 and older in 2015 [Table 3.8].

Race/Ethnicity

Alcohol was the most frequently reported primary substance at treatment admission among all racial/ethnic groups except admissions of non-Hispanic Whites and admissions of Puerto Rican origin. However, the proportions reporting primary use of the other four major substance groups (Opiates, Cocaine, Marijuana/hashish, and Methamphetamine/amphetamines) varied considerably by racial/ethnic group [Table 2.2b].

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Chapter 1

Trends in Substance Abuse Treatment Admissions
Aged 12 and Older: 2005-2015

Trends in Primary Substance of Abuse: 2005-2015
Trends in the Co-Abuse of Alcohol and Drugs
Trends in Demographic Characteristics
Trends in Employment Status


This report presents national-level data from the Treatment Episode Data Set (TEDS) for admissions in 2015 and trend data from 2005 to 2015. It is a companion to the report Treatment Episode Data Set (TEDS): 2005-2015 State Admissions to Substance Abuse Treatment. These reports provide information on the demographic and substance abuse characteristics of admissions aged 12 and older to treatment for abuse of alcohol and/or drugs in facilities that report to individual state administrative data systems. Data include records for admissions during calendar years 2005 through 2015 that were received and processed through November 1, 2016.3 It is important to note that percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.

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

TEDS does not include all admissions to substance abuse treatment. It includes admissions at 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 available in Appendix A.

This chapter details trends in the annual numbers and rates of admissions aged 12 and older from 2005 to 2015. Trend data are invaluable in monitoring changing patterns in substance abuse treatment admissions. These patterns reflect underlying changes in substance abuse in the population as well as changing priorities in the treatment and reporting system. Census population estimate data on age, gender, and race/ethnicity are currently not available for Puerto Rico.


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.

Trends in Primary Substance of Abuse: 2005-2015

Admissions can report up to three substances of abuse and are referred to as primary, secondary, and tertiary in the order that they are reported. These represent the substances that led to the treatment episode and are not necessarily a complete enumeration of all substances used at the time of admission. Most of the information in this report is based on an admission’s primary or first mentioned substance of abuse unless otherwise specified. (See Appendix A for more details.)

Table 1.1b and Figure 1. The number of all admissions aged 12 and older decreased by 19 percent from 2005 to 2015. The U.S. population aged 12 and older increased by 9 percent during this time period (U.S. Bureau of the Census, Population estimates 2005-2015).

Figure 1. Primary substance of abuse at admission: 2005-2015

Figure 1, Line chart comparing Primary substance of abuse at admission: TEDS 2005-2015


4 These drugs include methadone, buprenorphine, codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects.

Trends in the Co-Abuse of Alcohol and Drugs

Table 1.2. The concurrent abuse of alcohol and drugs continues to be a significant problem. Because TEDS collects a maximum of three substances of abuse and not all substances abused, alcohol use among polydrug abusers may be underreported.

Trends in Demographic Characteristics

Table 1.3b.Males represented 68 percent of TEDS admissions aged 12 and older in 2005; the proportion of males was 66 percent in 2015. The distribution of TEDS admissions aged 12 and older differed markedly by gender from that of the U.S. population, where 49 percent of the population aged 12 and older was male in 2015.

Table 1.3b and Figure 2. The age distribution of TEDS admissions aged 12 and older changed between 2005 and 2015.

Figure 2. Age at admission: TEDS 2005-2015 and U.S. population 2015

Figure 2. Stacked bar chart comparing Age at admission: TEDS 2005-2014 and U.S. population 2009

Table 1.4 and Figure 3. The racial/ethnic composition of TEDS admissions aged 12 and older changed very little between 2005 and 2015.

Figure 3. Race/ethnicity of admissions: TEDS 2005-2015 and U.S. population 2015

Figure 3. Stacked bar chart comparing Race/ethnicity of admissions: TEDS 2005-2014 and U.S. population 2009

Trends in Employment Status

Tables 1.5a-b and Figure 4. TEDS admissions aged 16 and older were less likely to be employed than the U.S. population aged 16 and older. This is evident in the unadjusted distributions of admissions by employment status (employed, unemployed, and not in labor force) shown in Tables 1.5a-b. Because TEDS admissions differ demographically from the U.S. population, Tables 1.5a-b also show distributions that have been statistically adjusted to provide a more valid comparison to the U.S. population.5 The adjusted distributions indicate an even greater disparity in socioeconomic status than do the unadjusted. The analysis below, however, uses the unadjusted distributions.

Figure 4. Employment status among admissions aged 16 and older: 2005-2015

Figre 4. Line chart comparing Employment status among admissions aged 16 and older: 2005-2015


5 The distributions were adjusted for age, gender, and race/ethnicity to the U.S. population using data from the U.S. Bureau of the Census, Population estimates by state, age, gender, race, and ethnicity, 2005-2015. In essence, this technique compares the distributions under the assumption that the TEDS population and the U.S. population had the same age, gender, and racial/ethnic characteristics. Population estimates by age, gender, race, and ethnicity are not currently available for Puerto Rico.

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Chapter 2

Characteristics of Admissions by Primary Substance: 2015

All Admissions Aged 12 and Older
Alcohol Only
Alcohol with Secondary Drug Abuse
Heroin
Opiates Other than Heroin
Smoked Cocaine (Crack)
Non-Smoked Cocaine
Marijuana/Hashish
Methamphetamine/Amphetamines
Tranquilizers
Sedatives
Hallucinogens
Phencyclidine (PCP)
Inhalants


This chapter highlights important findings in the 2015 TEDS data. The tables include items in the TEDS Minimum and Supplemental Data Sets for 2015 (see Appendix B for a complete data dictionary). Data are tabulated as percentage distributions of treatment admissions according to primary substance of abuse. It is important to note that percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding. The Minimum Data Set consists of items that include:

The Supplemental Data Set consists of 17 items that include psychiatric, social, and economic measures.

Not all states report all data items in the Minimum and Supplemental Data Sets. Most states report the Minimum Data Set for all or nearly all TEDS admissions. However, the items reported from the Supplemental Data Set vary greatly across states.

The figures in this chapter represent counts of admissions for each primary substance of abuse by gender, age, and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic of Mexican origin, Hispanic of Puerto Rican origin,6 American Indian/Alaska Native, and Asian/Pacific Islander).


6 Hispanics of Mexican and Puerto Rican origin made up 60 percent of all admissions of Hispanic origin in 2015.

All Admissions Aged 12 and Older


Figure 5. All admissions aged 12 and older, by gender, age, and race/ethnicity: 2015

Figure 5.Line chart comparing All admissions aged 12 and older, by gender, age, and race/ethnicity: 2015

Alcohol Only

Figure 6. Alcohol-only admissions, by gender, age, and race/ethnicity: 2015

Figure 6. Line chart comparing Alcohol-only admissions, by gender, age, and race/ethnicity: 2015

Alcohol with Secondary Drug Abuse

Figure 7. Alcohol admissions with secondary drug abuse, by gender, age, and race/ethnicity: 2015

Figure 7. Line chart comparing Alcohol admissions with secondary drug abuse, by gender, age, and race/ethnicity: 2015

Heroin

Figure 8. Heroin admissions, by gender, age, and race/ethnicity: 2015

Figure 8. Line chart comparing Heroin admissions, by gender, age, and race/ethnicity: 2015

Opiates Other than Heroin

Figure 9. Non-heroin opiate admissions, by gender, age, and race/ethnicity: 2015

Figure 9. Line chart comparing Non-heroin opiate admissions, by gender, age, and race/ethnicity: 2015

Smoked Cocaine (Crack)

Figure 10. Smoked cocaine (crack) admissions, by gender, age, and race/ethnicity: 2015

Figure 10. Line chart comparing Smoked cocaine (crack) admissions, by gender, age, and race/ethnicity: 2015

Non-Smoked Cocaine

Figure 11. Non-smoked cocaine admissions, by gender, age, and race/ethnicity: 2015

Figure 11. Line chart comaparing Non-smoked cocaine admissions, by gender, age, and race/ethnicity: 2015

Marijuana/Hashish

Figure 12. Marijuana/hashish admissions, by gender, age, and race/ethnicity: 2015

Figure 12. Line chart comparing Marijuana/hashish admissions, by gender, age, and race/ethnicity: 2015

Methamphetamine/Amphetamines

Figure 13. Methamphetamine/amphetamine admissions, by gender, age, and race/ethnicity: 2015

Figure 13. Line chart comparing Methamphetamine/amphetamine admissions, by gender, age, and race/ethnicity: 2015

Tranquilizers

Figure 14. Tranquilizer admissions, by gender, age, and race/ethnicity: 2015

Figure 14. Line chart comparing Tranquilizer admissions, by gender, age, and race/ethnicity: 2015

Sedatives

Figure 15. Sedative admissions, by gender, age, and race/ethnicity: 2015

Figure 15. Line chart comparing Sedative admissions, by gender, age, and race/ethnicity: 2015

Hallucinogens

Figure 16. Hallucinogen admissions, by gender, age, and race/ethnicity: 2015

Figure 16. Line chart comparing Hallucinogen admissions, by gender, age, and race/ethnicity: 2015

Phencyclidine (PCP)

Figure 17. Phencyclidine (PCP) admissions, by gender, age, and race/ethnicity: 2015

Figure 17. Line chart comparing Phencyclidine (PCP) admissions, by gender, age, and race/ethnicity: 2015

Inhalants

Figure 18. Inhalant admissions, by gender, age, and race/ethnicity: 2015

Figure 18. Line chart comparing Inhalant admissions, by gender, age, and race/ethnicity: 2015

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Chapter 3

Topics of Special Interest

Adolescent Admissions to Substance Abuse Treatment
Trends in Heroin Admissions and Medication-Assisted Opioid Therapy
Racial/Ethnic Subgroups
Polydrug Abuse

This chapter highlights topics that are of current or special interest. It is important to note that percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.

TEDS data indicate that admissions to substance abuse treatment aged 12 to 17 declined by 56 percent (from 148,805 to 65,370 admissions) between 2005 and 2015 [Table 3.1a].

In 2015, 89 percent of adolescent treatment admissions involved marijuana, that is, 89 percent of adolescent treatment admissions reported marijuana as a primary, secondary, or tertiary substance. Thirty-nine percent of the adolescent admissions that involved marijuana were referred to treatment by the court/criminal justice system [Table 3.4b].

The proportion of TEDS admissions for primary heroin abuse increased by 54 percent (from 260,902 to 401,743 admissions) between 2005 and 2015 [Table 3.5b].

The proportion of heroin admissions whose treatment plans included medication-assisted opioid therapy (opioid therapy using methadone or buprenorphine) increased from 30 percent in 2005 to 37 percent in 2015 [Table 3.7b].7

TEDS data indicate that substance abuse patterns differed widely among racial/ethnic subgroups; however, alcohol (alcohol only and alcohol with other drugs combined) was the predominant substance for all racial/ethnic groups except non-Hispanic Whites, where opiates were the predominant substances, and persons of Puerto Rican origin, where the predominant substance was heroin [Table 2.2b].

Polydrug abuse (the use of more than one substance) was more common among TEDS admissions than was abuse of a single substance [Table 3.8].


7 Comparisons between the TEDS heroin admissions whose treatment plans included medication-assisted opioid therapy and the clients in the National Survey of Substance Abuse Treatment Services (N-SSATS) that used methadone or buprenorphine in the treatment of opioids should be avoided for the following reasons: (i) many private for-profit treatment facilities do not report to TEDS but do report to N-SSATS; (ii) TEDS data are calculated based on a full year’s data, while N-SSATS data are calculated based on a reference date (last working day in March); and (iii) both the data collection method and the manner in which the question is asked are different for N-SSATS and TEDS data—in TEDS information is collected on planned treatment and in N-SSATS facilities report clients who received methadone or buprenorphine for detoxification or maintenance purposes.

Adolescent Admissions to Substance Abuse Treatment

Tables 3.1a and 3.1b and Figure 19. The proportion of adolescent admissions aged 12 to 17 declined by 56 percent from 2005 to 2015.


8 These drugs include methadone, buprenorphine, codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects.

Figure 19. Adolescent admissions aged 12 to 17, by primary substance: 2005-2015

Figure 19. Line chart comparing Adolescent admissions, by primary substance: 2005-2015

Table 3.2b.In 2015, overall, 69 percent of adolescent admissions were male, a proportion heavily influenced by the 74 percent of marijuana/hashish admissions that were male. The proportion of female admissions was greater than 30 percent for most substances other than marijuana/hashish. Among adolescent admissions, the two primary substances that had a higher proportion of females to males were heroin (59 percent female) and methamphetamine/amphetamines (56 percent female).

Forty-three percent of adolescent admissions were non-Hispanic White, 27 percent were of Hispanic origin, 17 percent were non-Hispanic Black, and 13 percent were of other racial/ethnic groups.

Table 3.3b. The proportion of adolescent admissions increased with age, from 1 percent of these admissions who were 12 years old at admission to 33 percent who were 17 years old. Among admissions for inhalants and alcohol only, 15 and 12 percent, respectively, were aged 12 or 13. Among admissions for heroin and for opiates other than heroin, 67 percent and 49 percent, respectively, were age 17.

In 2015, 43 percent of adolescent admissions were referred to treatment by the court/criminal justice system, 20 percent were self or individual referrals, and 13 percent were referred through schools.

Table 3.4b and Figure 20.An admission was considered marijuana-involved if marijuana/hashish was reported as a primary, secondary, or tertiary substance. In 2005, 45 percent of all adolescent admissions were marijuana involved and referred to treatment by the court/criminal justice system, and 39 percent were marijuana involved but referred by other sources. By 2015, the proportion of all adolescent admissions that were marijuana involved and referred by the court/criminal justice system had decreased to 39 percent, while the proportion that were marijuana involved and referred by other sources had increased to 49 percent.

The proportion of adolescent admissions not involving marijuana that were referred by the court/criminal justice system fell from 7 percent in 2005 to 4 percent in 2015. Admissions not involving marijuana that were referred from other sources fluctuated between 7 and 10 percent of adolescent admissions between 2005 and 2015.

Figure 20. Adolescent admissions aged 12 to 17, by marijuana involvement and court/criminal justice system referral: 2005-2015

Figure 20. Line chart comparing Adolescent admissions, by marijuana involvement and criminal justice referral: 2005-2015

Trends in Heroin Admissions and Medication-Assisted Opioid Therapy

The proportion of primary heroin admissions aged 12 and older was relatively consistent from 2005 through 2011, accounting for 14 to 15 percent of TEDS admissions in those years, but the proportion rose to 17 percent in 2012, 22 percent in 2014, and 26 percent in 2015 [Table 1.1b]. In 2015, injection was reported as the usual route of administration by 68 percent of primary heroin admissions; 25 percent of primary heroin admissions reported inhalation as the usual route of administration, and 5 percent reported smoking [Table 2.4b]. From 2005 to 2015, the largest proportion of primary heroin admissions were 20 to 34 years of age (42 to 59 percent from 2005 through 2015) [Table 3.5b].

However, these measures conceal substantial changes in the age, race/ethnicity, and route of administration of some subpopulations among primary heroin admissions.

Table 3.5b and Figure 21. TEDS data show a general increase in heroin admissions among young non-Hispanic White adults. Among non-Hispanic Blacks, however, admissions generally declined from 2005 to 2015.

Figure 21. Heroin admissions aged 12 and older, by age group and race/ethnicity: 2005-2015

Figure 21. Line chart comparing Heroin admissions aged 12 and older, by age group and race/ethnicity: 2005-2015

Table 3.6b and Figure 22.

Figure 22. Heroin admissions aged 12 and older, by route of administration and age group: 2005-2015

Figure 22. Line chart comparing  Heroin admissions aged 12 and older, by route of administration and age group: 2005-2015

Table 3.7b and Figures 23 and 24. Planned use of medication-assisted opioid therapy (MAT, i.e., opioid therapy using methadone or buprenorphine) declined among primary heroin admissions between 2005 and 2014 from 30 percent to 28 percent but increased sharply to 37 percent in 2015.

Figure 23. Heroin admissions aged 12 and older with planned medication-assisted opioid therapy, by route of heroin administration: 2005-2015

Figure 23. Line chart comparing Heroin admissions aged 12 and older with planned medication-assisted opioid therapy, by route of heroin administration: 2005-2015

Figure 24. Heroin admissions aged 12 and older with planned medication-assisted opioid therapy, by age group: 2005-2015

Figure 24. Line chart comparing Heroin admissions aged 12 and older with planned medication-assisted opioid therapy, by age group: 2005-2015

Racial/Ethnic Subgroups

Table 2.3c and Figures 25-30. TEDS data indicate that patterns of primary substance use differed widely in 2015 among not only racial/ethnic subgroups, but country of origin among Hispanic admissions, and gender within subgroups.

Figure 25.

Figure 25. White (non-Hispanic) admissions, by gender, primary substance, and age: 2015

Figure 25. Line chart comparing White (non-Hispanic) admissions, by gender, primary substance, and age: 2015

Figure 26.

Figure 26. Black (non-Hispanic) admissions, by gender, primary substance, and age: 2015

Figure 26. Line chart comparing Black (non-Hispanic) admissions, by gender, primary substance, and age: 2015

Figure 27.

Figure 27. Mexican origin admissions, by gender, primary substance, and age: 2015

Figure 27. Line chart comparing Mexican origin admissions, by gender, primary substance, and age: 2015

Figure 28.

Figure 28. Puerto Rican origin admissions, by gender, primary substance, and age: 2015

Figure 28. Line chart comparing Puerto Rican origin admissions, by gender, primary substance, and age: 2015

Figure 29. Note: Only 2 percent of all TEDS admissions were American Indians/Alaska Natives [Table 2.2b].

Figure 29. American Indian/Alaska Native admissions, by gender, primary substance, and age: 2015

Figure 29. Line chart comparing American Indian/Alaska Native admissions, by gender, primary substance, and age: 2015

Figure 30. Note: Only 1 percent of all TEDS admissions were Asian/Pacific Islanders [Table 2.2b].

Figure 30. Asian/Pacific Islander admissions, by gender, primary substance, and age: 2015

Figure 30. Line chart comparing Asian/Pacific Islander admissions, by gender, primary substance, and age: 2015

Polydrug Abuse

Polydrug abuse (the use of more than one substance) was more common among TEDS admissions than was abuse of a single substance.

Tables 1.1 and 3.8 and Figure 31. Polydrug abuse was reported by 54 percent of TEDS admissions aged 12 or older in 2015. Marijuana/hashish, alcohol, and non-smoked cocaine were the most commonly reported secondary and tertiary substances.

Table 3.9. This table details the most common substance combinations for selected primary substances. For example, of primary alcohol admissions, 56 percent reported abuse of alcohol alone, 14 percent reported abuse of alcohol and marijuana/hashish but no other drugs, and 4 percent reported primary abuse of alcohol with abuse of cocaine and marijuana/hashish as secondary and tertiary substances.

Figure 31. Primary and secondary/tertiary substance of abuse: 2015

Figure 31. Stacked bar chart comparing Primary and secondary/tertiary substance of abuse: 2015

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Chapter 4

Type of Treatment Services: 2015

TEDS records the type of service to which clients are admitted for treatment. The major categories are broadly defined as ambulatory, rehabilitation/residential, and detoxification. For this report, admissions for which medication-assisted opioid therapy (i.e., therapy using methadone or buprenorphine) was planned have been categorized as a separate treatment service type. It is important to note that percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.

The complete list of types of treatment services detailed in this report includes:

Table 4.1c. The type of treatment service received was associated with primary substance of abuse.

Table 4.3b.The type of treatment service received was associated with the referral source.

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Appendix A

About the Treatment Episode Data Set (TEDS)

Introduction
History
State Data Collection Systems
Report-Specific Considerations

Introduction

This report presents data from the Treatment Episode Data Set (TEDS) on the demographic and substance abuse characteristics of admissions to 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.

The Treatment Episode Data Set (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).

The TEDS system comprises two major components, the Admissions Data Set and the Linked Discharge Data Set. The TEDS Admissions Data Set includes client-level data on substance abuse treatment admissions from 1992 through the present. The TEDS Linked Discharge Data Set is linked at record level to admissions, and 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 Admissions Data System 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 states’ option.

The Minimum Data Set consists of items that include:

The Supplemental Data Set consists of 17 items that include psychiatric, social, and economic measures.

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 A Table 1 presents key characteristics of state data collection systems for 2015. 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.

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 2005 through 2015, 89 percent of all records submitted were client admissions, 10 percent were client transfers, and less than 1 percent were codependents of substance abusers.

Admissions from facilities that report late to the states will appear in a later data submission to SAMHSA, so the number of annual admissions in a report may be higher in subsequent reports. The number of additional admissions is small because of the time lag in issuing the report. Thus the percentage distributions will change very little in subsequent reports, although Census division- and state-level data may change somewhat more for states with reporting delays (state report only).

States continually review and improve their data collection and processing. When systematic errors are identified, states may revise or replace historical TEDS data files. While this process represents an improvement in the data system, the historical statistics in this report will differ slightly from those in earlier reports.

Appendix A Tables 2 and 3 indicate the proportions of records by state or jurisdiction for which valid data were received for 2015. States are expected to report all variables in the Minimum Data Set (Appendix A Table 2). Variables in the Supplemental Data Set are collected at each state’s option (Appendix A Table 3).

Report-Specific Considerations

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Appendix B

TEDS Data Elements

TEDS Minimum Data Set
TEDS Supplemental Data Set


TEDS Minimum 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.

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:

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:

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.

EDUCATION

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

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.

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

ETHNICITY

Identifies client’s specific Hispanic origin.

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.

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.


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

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

MEDICATION-ASSISTED OPIOID THERAPY

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

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.

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.

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.

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.

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.”

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:

TYPE OF TREAMENT SERVICES

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

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

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

TEDS Supplemental Data Set

DAYS WAITING TO ENTER TREATMENT

Indicates the number of days from the first contact or request for service until the client was admitted and the first clinical service was provided.

GUIDELINES: This item is intended to capture the number of days the client must wait to begin treatment because of program capacity, treatment availability, admissions requirements, or other program requirements. It should not include time delays caused by client unavailability or client failure to meet any requirement or obligation.

DETAILED CRIMINAL JUSTICE REFERRAL

This item gives more detailed information about those clients who are coded as “Court/criminal justice referral/DUI/DWI” in the TEDS Minimum Data Set item Principal source of referral.

DETAILED DRUG CODE (PRIMARY, SECONDARY, AND TERTIARY)

These fields identify, in greater detail, the drug problems recorded in the TEDS Minimum Data Set item Substance problem.

DETAILED NOT IN LABOR FORCE

This item gives more detailed information about those clients who are coded as “Not in labor force” in the TEDS Minimum Data Set item Employment Status.

DSM CRITERIA DIAGNOSIS

The diagnosis of the substance abuse problem from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. DSM-IV is preferred, but use of the Third Edition or ICD codes is permissible.

EXPECTED/ACTUAL PRIMARY SOURCE OF PAYMENT

Identifies the primary source of payment for this treatment episode.

FREQUENCY OF ATTENDANCE AT SELF-HELP PROGRAMS

This field records the number of times the client has attended a self-help program in the 30 days preceding the date of admission to treatment services.

HEALTH INSURANCE

Specifies the client’s health insurance (if any). The insurance may or may not cover alcohol or drug treatment.

LIVING ARRANGEMENTS

Specifies whether the client is homeless, living with parents, in a supervised setting, or living on his or her own.

MARITAL STATUS

Describes the client’s marital status. The following categories are compatible with the U.S. Census.

NUMBER OF ARRESTS IN 30 DAYS PRIOR TO ADMISSION

This field records the number of arrests in the 30 days preceding the date of admission to treatment services.

PREGNANT AT TIME OF ADMISSION

Specifies whether the client was pregnant at the time of admission.

PSYCHIATRIC PROBLEM IN ADDITION TO ALCOHOL OR DRUG PROBLEM

Identifies whether the client has a psychiatric problem in addition to his or her alcohol or drug use problem.

SOURCE OF INCOME SUPPORT

Identifies the client’s principal source of financial support. For children under 18, this field indicates the parents’ primary source of income/support.

VETERAN STATUS

Identifies whether the client has served in the uniformed services (Army, Navy, Air Force, Marines, Coast Guard, Public Health Service Commissioned Corps, Coast and Geodetic Survey, etc.).

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Appendix C

List of Contributors

This report was prepared by Synectics for Management Decisions, Inc., 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 was performed under Contract No. HHSS283200700048I/HHSS28342001T.

Production of the report at SAMHSA was managed by Cathie Alderks. SAMHSA contributors and reviewers, listed alphabetically, include: Cathie Alderks, Herman Alvarado, Elizabeth Hoeffel, Heydy Juarez, and Sharon Liu.

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