Treatment Episode Data Set (TEDS)
Highlights - 2003

National Admissions to Substance Abuse Treatment Services

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration Office of Applied Studies

ACKNOWLEDGMENTS

This publication was developed for the Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies (OAS), by Christian Evans and Leigh Henderson of Synectics for Management Decisions, Inc., Arlington, Virginia, under Contract No. 283-02-9026. The report was reviewed by OAS staff Deborah Trunzo, Anita Gadzuk, and Cathie Alderks. Deborah Trunzo also served as the SAMHSA Project Officer.

PUBLIC DOMAIN NOTICE

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

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Treatment Episode Data Set (TEDS). Highlights - 2003. National Admissions to Substance Abuse Treatment Services, DASIS Series: S-27, DHHS Publication No. (SMA) 05-4043, Rockville, MD, 2005.

OBTAINING ADDITIONAL COPIES OF THE PUBLICATION

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ORIGINATING OFFICE

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June 2005


TABLE OF CONTENTS

Highlights

Tables

1a Admissions by primary substance of abuse: TEDS 1993-2003.
Number

1b Admissions by primary substance of abuse: TEDS 1993-2003.
Percent distribution

2a Admissions by primary substance of abuse, according to sex, race/ethnicity, and age at admission: TEDS 2003.
Percent distribution and average age at admission

2b Admissions by sex, race/ethnicity, and age at admission, according to primary substance of abuse: TEDS 2003.
Percent distribution

3 Admissions by primary substance of abuse, according to frequency of use, route of administration, age at first use, and number of prior treatment episodes: TEDS 2003.
Percent distribution

4 Admissions by primary substance of abuse, according to type of service, source of referral to treatment, and opioid treatment: TEDS 2003.
Percent distribution

5 Admissions by primary substance of abuse, according to employment status (aged 16 and over) and education (aged 18 and over): TEDS 2003.
Percent distribution

6a Admissions by State or jurisdiction, according to primary substance of abuse: TEDS 2003.
Number

6b Admissions by State or jurisdiction, according to primary substance of abuse: TEDS 2003.
Percent distribution

Appendix A. TEDS Minimum Data Set


HIGHLIGHTS

This report presents summary results from the Treatment Episode Data Set (TEDS) for 2003. The report provides information on the demographic and substance abuse characteristics of the 1.8 million annual admissions to treatment for abuse of alcohol and drugs in facilities that report to individual State administrative data systems.

This Summary Report is issued in advance of the full TEDS Report for 1993-2003. It includes demographic data and all items from the TEDS Minimum Data Set. The Annual Report also will include data from the Supplemental Data Set, State data, and State rates.

TEDS is an admission-based system, and TEDS admissions do not represent individuals. Thus, for example, 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 to facilities that are licensed or certified by the 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.


Major Substances of Abuse
  • Five substances accounted for 96 percent of all TEDS admissions in 2003: alcohol (42 percent), opiates (18 percent; primarily heroin), marijuana/hashish (15 percent), cocaine (14 percent), and stimulants (7 percent; primarily methamphetamine) [Table 1b].
Alcohol
  • Alcohol as a primary substance accounted for just over two-fifths (42 percent) of all TEDS admissions in 2003, down from almost three-fifths (57 percent) in 1993. However, 44 percent of primary alcohol admissions reported secondary drug abuse as well [Tables 1a and 1b].


  • About three-quarters of admissions for abuse of alcohol alone and for abuse of alcohol with secondary drug abuse were male (75 percent and 74 percent, respectively) [Table 2a].


  • Almost three-quarters (70 percent) of alcohol-only admissions were White, followed by Blacks and Hispanics (13 percent and 12 percent, respectively). Among admissions for alcohol with secondary drug abuse, 59 percent were White, followed by 26 percent who were Black and 11 percent who were Hispanic [Table 2a].


  • For alcohol-only admissions, the average age at admission was 39 years, compared with 35 years among admissions for primary alcohol with secondary drug abuse [Table 2a].

Heroin
  • TEDS admissions for primary heroin abuse increased from 12 percent of all admissions in 1993 to 15 percent in 2003, exceeding the proportion of admissions for primary cocaine abuse for the fifth consecutive year [Table 1b].


  • About two-thirds (68 percent ) of primary heroin admissions were male [Table 2a].


  • Nearly half (48 percent) of primary heroin admissions were White, followed by 25 percent who were Black and 24 percent who were Hispanic [Table 2a].


  • For primary heroin admissions, the average age at admission was 36 years [Table 2a].


  • Other Opiates TEDS admissions for primary abuse of opiates other than heroin increased from 1 percent of all admissions in 1993 to 3 percent in 2003 [Table 1b].


  • Just over half (53 percent) of primary non-heroin opiate admissions were male [Table 2a].


  • Most primary non-heroin opiate admissions (89 percent) were White [Table 2a].


  • For primary non-heroin opiate admissions, the average age at admission was 34 years [Table 2a].


  • Almost three-quarters (74 percent) of primary non-heroin opiate admissions reported oral as the route of administration; 12 percent reported injection, and 11 percent reported inhalation [Table 3].
Cocaine/Crack
  • The proportion of admissions for primary cocaine abuse declined from 17 percent in 1993 to 14 percent in 2003 [Table 1b].


  • Smoked cocaine (crack) represented 72 percent of all primary cocaine admissions in 2003 [Tables 1a and 1b].


  • Fifty-nine percent of primary smoked cocaine admissions were male, compared with 66 percent of non-smoked cocaine admissions [Table 2a].


  • Among primary smoked cocaine admissions, 55 percent were Black, 35 percent were White, and 7 percent were Hispanic. Whites predominated (49 percent) among primary non-smoked cocaine admissions, followed by Blacks (31 percent) and Hispanics (16 percent) [Table 2a].


  • For primary smoked cocaine admissions, the average age at admission was 37 years, compared with 34 years for non-smoked cocaine admissions [Table 2a].


  • Among primary non-smoked cocaine admissions, 76 percent reported inhalation as the route of administration; 13 percent reported injection, and 9 percent reported oral [Table 3].

Marijuana/Hashish
  • The proportion of admissions for primary marijuana abuse increased from 7 percent in 1993 to 15 percent in 2003 [Table 1b].


  • Three-quarters (75 percent) of primary marijuana admissions were male [Table 2a].


  • Over half (55 percent) of primary marijuana admissions were White, followed by 29 percent who were Black and 12 percent who were Hispanic [Table 2a].


  • For primary marijuana admissions, the average age at admission was 23 years [Table 2a].

Methamphetamine/Amphetamine and Other Stimulants
  • The proportion of admissions for abuse of methamphetamine/amphetamine and other stimulants increased from 2 percent to 7 percent between 1993 and 2003 [Table 1b].


  • Over half (55 percent) of primary methamphetamine/amphetamine admissions were male [Table 2a].


  • Almost three-quarters (73 percent) of primary methamphetamine/amphetamine admissions were White, followed by 16 percent who were Hispanic and 3 percent each who were Black and Asian/Pacific Islander [Table 2a].


  • For primary methamphetamine/amphetamine admissions, the average age at admission was 31 years [Table 2a].


  • Fifty-six percent of primary methamphetamine/amphetamine admissions reported smoking as the route of administration; 22 percent reported injection, and 15 percent reported inhalation [Table 3].

Race/Ethnicity

Among all racial/ethnic groups except Puerto Ricans, primary alcohol use (alone or in combination with other drugs) was the most frequently reported substance at treatment admission. However, the proportion reporting use of the other four most common substances varied considerably by racial/ethnic group.

  • Among Whites, alcohol (46 percent) was followed by opiates (16 percent), marijuana (14 percent), and stimulants and cocaine (9 percent each) [Table 2b].


  • Among Blacks, alcohol (33 percent) was followed by cocaine (28 percent), marijuana (19 percent), and opiates (16 percent). Less than 1 percent reported stimulants as a primary substance [Table 2b].


  • Among persons of Mexican origin, alcohol (39 percent) was followed by stimulants (18 percent), opiates and marijuana (17 percent each), and cocaine (8 percent) [Table 2b].


  • Among persons of Puerto Rican origin, opiates (48 percent) were the most frequently reported substance at admission. They were followed by alcohol (28 percent), marijuana (11 percent), and cocaine (10 percent). Stimulants were reported as a primary substance by less than 1 percent [Table 2b].


  • Among persons of Cuban origin, alcohol (34 percent) was followed by cocaine (23 percent), opiates (20 percent), marijuana (16 percent), and stimulants (3 percent) [Table 2b].


  • Among Alaska Natives, alcohol (62 percent) was followed by opiates (17 percent), marijuana (9 percent), cocaine (6 percent), and stimulants (5 percent) [Table 2b].


  • Among American Indians, alcohol (62 percent) was followed by marijuana (14 percent), stimulants (9 percent), opiates (7 percent), and cocaine (5 percent) [Table 2b].


  • Among Asian/Pacific Islanders, alcohol (33 percent) was followed by stimulants (26 percent), marijuana (19 percent), cocaine (11 percent), and opiates (9 percent) [Table 2b].

Type of Service
  • Sixty-one percent of TEDS 2003 admissions were to ambulatory treatment, 22 percent were to detoxification, and 17 percent were to residential treatment [Table 4].


  • Admissions for primary marijuana had the largest proportion of admissions to ambulatory treatment (84 percent) [Table 4].


  • Primary heroin admissions had the largest proportion of admissions to detoxification (35 percent), followed by tranquilizers (34 percent), alcohol only (31 percent), and opiates other than heroin (29 percent) [Table 4].


  • Admissions for primary smoked cocaine had the largest proportion of admissions to residential treatment (28 percent), followed by admissions for methamphetamine/amphetamine and PCP (26 percent each), non-smoked cocaine (25 percent), hallucinogens (24 percent), and sedatives and inhalants (23 percent each) [Table 4].

Opioid Treatment
  • Overall, opioid treatment (treatment with the medications methadone, LAAM, or buprenorphine) was planned for 6 percent of 2003 TEDS admissions. Opioid treatment was planned for 32 percent of primary heroin admissions and for 17 percent of admissions for opiates other than heroin [Table 4].
Source of Referral to Treatment
  • More than one-third (36 percent) of 2003 TEDS admissions were referred to treatment through the criminal justice system. Primary marijuana admissions had the largest proportion of admissions referred through the criminal justice system (57 percent), followed by PCP (52 percent) and methamphetamine/ amphetamine (51 percent) [Table 4].


  • More than one-third (34 percent) of 2003 TEDS admissions represented self- or individual referrals. Primary heroin admissions had the largest proportion of self- or individual referrals (59 percent), followed by admissions for opiates other than heroin (50 percent) and smoked cocaine (40 percent) [Table 4].
Employment Status
  • Among 2003 TEDS admissions, admissions for alcohol only were the most likely to be employed (42 percent). Admissions for smoked cocaine and heroin were the most likely to be unemployed (39 percent and 38 percent, respectively). Admissions for inhalants, tranquilizers, and sedatives were the most likely to report that they were not in the labor force (53 percent, 49 percent, and 46 percent, respectively) [Table 5].
Educational Level
  • Among 2003 TEDS admissions, educational level was highest (more than 12 years of education) among admissions for opiates other than heroin and sedatives (31 percent each), and alcohol only and tranquilizers (28 percent each) [Table 5].

Go to Tables


APPENDIX A

TEDS MINIMUM DATA SET

CLIENT OR CODEPENDENT/COLLATERAL
  • Client:
    • 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:
    • 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 Codependent/collateral is optional. If a record does not include a value for this field, it is assumed to be a substance abuse client record. 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.

TRANSACTION TYPE
Identifies whether a record is for an admission or a transfer/change in service.

  • 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 one discharge (when services end). Within a treatment episode, a client may transfer to a different service, facility, program, or location. In some data systems, such transfers may generate admissions records. When it is feasible for the State to identify transfers, they should be reported as transfers, not as admissions. When admissions and transfers cannot be differentiated in a State data system, such changes in service should be reported to TEDS as admissions.

DATE OF ADMISSION
The day when the client receives his or her first direct treatment or recovery service.

TYPE OF SERVICE AT ADMISSION
Describes the type of service the client receives.

  • Detoxification, 24-hour service, hospital inpatient. 24-hour per day medical acute care services in a hospital setting for detoxification for persons with severe medical complications associated with withdrawal
     
  • 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
     
  • 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 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 such as halfway houses


  • 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; these may include pharmacological therapies
     
  • Ambulatory, detoxification. Outpatient treatment services providing for safe withdrawal in an ambulatory setting (pharmacological or non-pharmacological)

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

SEX
Identifies client's sex.

  • Male
     
  • Female

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.

ETHNICITY
Identifies client's specific Hispanic origin

  • Puerto Rican. Of Puerto Rican origin, regardless of race
     
  • Mexican. Of Mexican origin, regardless of race
     
  • Cuban. Of Cuban origin, regardless of race
     
  • 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
     
  • Hispanic (specific origin not specified). Of Hispanic origin, but specific origin not known or not specified
     
  • Not of Hispanic origin.

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

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.

EDUCATION
Specifies the highest school grade the client has completed.

  • 0. Less than one grade completed
     
  • 1-25. Years of school (highest grade) completed

GUIDELINES: States that use specific categories for some code numbers should map their codes to a logical number of years of school completed. For General Equivalency Degree, use 12. 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; includes 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.

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

PRINCIPAL SOURCE OF REFERRAL
Describes the person or agency referring the client to the alcohol or drug abuse treatment program.

  • 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
     
  • 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
     
  • Other health care provider. A physician, psychiatrist, or other licensed health care professional; or 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
     
  • Employer/EAP. A supervisor or an employee counselor
     
  • 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.
     
  • 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.

SUBSTANCE PROBLEM (PRIMARY, SECONDARY, OR TERTIARY)
These fields identify the client’s primary, secondary, and tertiary substance problems.

  • None.
     
  • Alcohol.
     
  • Cocaine/crack.
     
  • Marijuana/hashish. This includes THC and any other cannabis sativa preparations
     
  • Heroin. Nonprescription methadone.
     
  • Other opiates and synthetics. Includes codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects
     
  • PCP. Phencyclidine
     
  • Other hallucinogens. Includes LSD, DMT, STP, hallucinogens, mescaline, peyote, psilocybin, etc.
     
  • Methamphetamine.
     
  • Other amphetamines. Includes amphetamines, MDMA, phenmetrazine, and other unspecified amines and related drugs
     
  • Other stimulants. Includes methylphenidate and any other stimulants
     
  • Benzodiazepines. Includes alprazolam, chlordiazepoxide, clonazepam, clorazepate, diazepam, flunitrazepam, flurazepam, halazepam, lorazepam, oxazepam, prazepam, temazepam, triazolam, and other unspecified benzodiazepines
     
  • Other non-benzodiazepine tranquilizers. Includes meprobamate and other non-benzodiazepine tranquilizers


  • Barbiturates. Amobarbital, pentobarbital, phenobarbital, secobarbital, etc.


  • Other non-barbiturate sedatives or hypnotics. Includes chloral hydrate, ethchlorvynol, glutethimide, methaqualone, and other non-barbiturate sedatives or hypnotics
     
  • Inhalants. Includes chloroform, ether, gasoline, glue, nitrous oxide, paint thinner, etc.
     
  • Over-the-counter medications. Includes aspirin, cough syrup, diphenhydramine and other antihistamines, sleep aids, any other legally obtained nonprescription medication
     
  • Other. Includes diphenylhydantoin/phenytoin, GHB/GBL, ketamine, etc.

USUAL ROUTE OF ADMINISTRATION (OF PRIMARY, SECONDARY, AND TERTIARY SUBSTANCES)
These fields identify the usual route of administration of the respective substances.

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

FREQUENCY OF USE (OF PRIMARY, SECONDARY, AND TERTIARY SUBSTANCES)
These fields identify the frequency of use of the respective substances.

  • 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

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

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

  • Yes
     
  • No