Characteristics of Repeat Admissions to Substance Abuse Treatment

In Brief

In 1999, 58 percent of substance abuse treatment admissions (about 920,000) had at least one prior treatment episode

Admissions with 5 or more prior treatment episodes were more likely not to be part of the labor force (54 percent) than were new admissions (32 percent)

About 24 percent of those with 5 or more prior treatment episodes were homeless compared with 8 percent of first-time admissions

Many alcohol and drug abusers are admitted to treatment multiple times before they are able to achieve long-term abstinence. Those admitted to substance abuse treatment more than once have different socioeconomic and substance use characteristics than first-time admissions. This report compares first-time, or new, treatment admissions in the Treatment Episode Data Set (TEDS) with admissions of persons who had entered treatment before.

TEDS collects data primarily on the approximately 1.6 million annual admissions to substance abuse treatment facilities that receive some public funds. TEDS records represent admissions rather than individuals; a person may be admitted to treatment more than once in a given time period.

In 1999, 58 percent of TEDS admissions for substance abuse treatment (about 920,000 admissions) had at least one prior treatment episode. About 200,000 had been in treatment 5 or more times before.

Substance of Abuse

An earlier DASIS Report indicated that alcohol accounted for about half of both new and repeat 1999 treatment episodes.¹ Those admitted to treatment 5 or more times previously were more likely to report opiate abuse (34 percent) than were new admissions (9 percent). They were also less likely to report marijuana as a primary substance (4 percent compared with 21 percent of new admissions).

Demographics

A strong association between older age and a higher number of prior treatment episodes was noted in the earlier report.

Men and women reported similar proportions of repeat treatment admissions (data not shown).

Some 57 percent of White admissions were repeat admissions, as were 61 percent of Black admissions (data not shown). Puerto Rican admissions had the highest percentage of readmissions among all racial/ethnic groups, with 71 percent reporting prior treatment. The lowest proportions of readmissions were among Mexicans (52 percent) and Asian and Pacific Islanders (45 percent).

Socioeconomic Characteristics

TEDS includes a Minimum Data Set collected by all States and a Supplemental Data Set collected by some States. Most socioeconomic characteristics are Supplemental Data Set items. Percentages in this section of the report are based on admissions of those aged 20 years or older in States where the 1999 item response rate was at least 75 percent. Admissions of those younger than age 20 were excluded because their economic characteristics reflected their dependent status.

Admissions with 5 or more prior treatment episodes were more likely not to be part of the labor force² (54 percent) than were new admissions (32 percent) (Figure 1). Only 20 percent of admissions with 5 or more prior treatment episodes were employed full- or part-time compared with 44 percent of new admissions.

Those admitted with 5 or more prior treatment episodes were less likely to report wages or salary as their primary source of income³ (22 percent) than were new admissions (49 percent) (Figure 2). They were also more likely to report receiving public assistance (17 percent compared with 8 percent of first-time admissions).

Figure 1. Employment Status Among First-Time Admissions and Repeat Admissions: 1999	Figure 2. Primary Source of Income Among First-Time Admissions and Repeat Admissions: 1999

Source: 1999 SAMHSA Treatment Episode Data Set (TEDS).

The proportion of homeless⁴ admissions was greater among those with 5 or more prior treatment episodes (24 percent compared with 8 percent of first-time admissions) (Figure 3).

About two-thirds of all admissions had no health insurance⁵ (Figure 4). Admissions with 5 or more prior treatment episodes were more likely to be covered by Medicaid (26 percent) than were first-time admissions (9 percent).

Those admitted with 5 or more prior treatment episodes were less likely to be married⁶ (13 percent) than were new admissions (24 percent) or admissions with 1 to 4 prior treatment episodes (19 percent) (data not shown).

Figure 3. Living Arrangements Among First-Time Admissions and Repeat Admissions: 1999	Figure 4. Health Insurance Status Among First-Time Admissions and Repeat Admissions: 1999

Psychiatric Problems

Admissions with 5 or more prior treatment episodes were more likely to have a psychiatric problem⁷ in addition to a substance abuse problem (26 percent) than were new admissions (12 percent) or admissions with 1 to 4 previous admissions (17 percent) (data not shown).

End Notes

¹ Substance Abuse and Mental Health Services Administration (2002, April 26). The DASIS Report. New and Repeat Admissions to Substance Abuse Treatment. Rockville, MD: Author.
²Employment status is a Minimum Data Set item.
³Primary source of income is a Supplemental Data Set item reported in 1999 by 24 States and jurisdictions, excluding AL, AR, AZ, CA, CO, CT, DC, IN, LA, MA, MD, MI, MT, NC, NE, NH, NJ, NM, OK, OR, TN, VA, VT, WA, WI, WV, and WY.
⁴ Living arrangements is a Supplemental Data Set item reported in 1999 by 41 States and jurisdictions, excluding AR, CA, CT, MT, NC, NM, PA, WV, WI, and WY.
⁵ Health insurance is a Supplemental Data Set item reported in 1999 by 32 States and jurisdictions, excluding AL, CA, IA, LA, ME, MN, NC, NM, NY, OH, OK, RI, SD, TN, VA, VT, WA, WI, and WY.
⁶ Marital status is a Supplemental Data Set item reported in 1999 by 42 States and jurisdictions, excluding CA, CT, GA, MT, NM, UT, VA, VT, and WI.
⁷Psychiatric problems in addition to the substance abuse problem is a Supplemental Data Set item reported in 1999 by 24 States and jurisdictions, excluding AK, AL, AR, AZ, CT, FL, HI, IL, IN, MI, MN, MT, NC, NE, NM, OH, OR, PA, SD, TX, UT, VA, VT, WA, WI, WV, and WY.

The Drug and Alcohol Services Information System (DASIS) is an integrated data system maintained by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment Episode Data Set (TEDS). TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. Information on treatment admissions is routinely collected by State administrative systems and then submitted to SAMHSA in a standard format. Approximately 1.6 million records are included in TEDS each year. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once.

The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and RTI, Research Triangle Park, North Carolina.

Information and data for this issue are based on data reported to TEDS through April 16, 2001.

Access the latest TEDS reports at:
www.oas.samhsa.gov/dasis.htm

Access the latest TEDS public use files at:
webapp.icpsr.umich.edu/cocoon/SAMHDA-SERIES/00056.xml

Other substance abuse reports are available at:
http://www.oas.samhsa.gov

The DASIS Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report may be downloaded from

Other reports from the Office of Applied Studies are also available on-line at the OAS home page: http://www.oas.samhsa.gov.

This page was last updated on December 31, 2008.