The goal of TEDS is to collect information on complete treatment episodes. Thus, SAMHSA has expanded its data collection efforts to include discharge data. States are asked to submit data for all discharges from substance abuse treatment. These data can be linked to admissions data, which enhances the analytic potential of the TEDS system.
A total of 18 States submitted discharge data for Year 2000; therefore, the data presented in this chapter do not represent all discharges in all States. Most States have submitted only a single complete year of discharge data, and no data or partial data for other years.
Items on the discharge record include:
Type of service at discharge
Date of discharge or date of last contact
Reason for discharge or discontinuation of service
Definitions and classifications are detailed in the Appendix.
For this chapter, each discharge record was linked to the original admission record. Type of service at admission and type of service at discharge were the same for all linked records. In the tables presented in this chapter, Type of service and Planned use of methadone have been combined to yield discrete service types. Records where the use of methadone was planned were classified as Methadone. Detoxification represents primarily free-standing residential detoxification (95 percent), but also includes ambulatory detoxification (3 percent) and hospital inpatient detoxification (2 percent).
Tables 6.1a and 6.1b present the distribution of key variables for all Year 2000 admissions, for Year 2000 admissions in the 18 States submitting discharge data, and for linked and non-linked Year 2000 discharge records in the 18 States. These tables indicate that characteristics at the time of admission for the discharges submitted by the 18 States are similar to the characteristics of all admissions in all States. As discharge records are added to the dataset, a higher proportion of matching admission records is expected.
Almost half (47 percent) of all Year 2000 discharges reported primary alcohol abuse at admission. Fifteen percent of Year 2000 discharges were for opiate abuse at admission. Thirteen percent of Year 2000 discharges were for primary abuse of cocaine at admission. Sixteen percent of Year 2000 discharges were for abuse of marijuana at admission. Stimulant abuse at admission accounted for 5 percent of all Year 2000 discharges.
Table 6.2. A total of 347,923 records for clients discharged in Year 2000 were submitted by 18 States. Ninety-four percent of these records (n = 326,135) could be linked to a TEDS admission record from 1998, 1999, or 2000. An additional 615 methadone records were linked to an admission that occurred between 1992 and 1995. No matching admission record was found for 21,173 of the Year 2000 discharges.
Table 6.3a and 6.3b and Figure 39 present reason for discharge and length of stay by type of service. Two measures of length of stay (median and average) are included. About half of the Year 2000 discharges represented positive treatment outcomes, defined here as those who completed treatment (42 percent) and those who transferred to another treatment program (9 percent). One in four (24 percent) left against professional advice, while the treatment of an additional 18 percent was terminated by the facility.
The treatment completion rate was over 50 percent among admissions to short-term and hospital residential/rehabilitation treatment (61 percent and 55 percent, respectively), and to detoxification (51 percent). Completion rates were lower in longer-term and less structured settings. For intensive outpatient treatment, the completion rate was 42 percent. For outpatient treatment, it was 35 percent, and for long-term residential/rehabilitation treatment, it was 33 percent.
The completion rate was lowest among discharges from methadone treatment (15 percent). Of those who were discharged from methadone treatment, 67 percent either left against professional advice or had their treatment terminated by the facility.
Admissions to short-term and hospital residential/rehabilitation facilities were most likely to have been transferred to further substance abuse treatment (11 percent and 25 percent, respectively). In each of the other service types, 8 to 9 percent were transferred to further treatment.
Figure 39
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Admissions for various primary substances were likely to be admitted to different types of service [Table 3.4]. Discharges reflected this variation, and there were different treatment completion rates for each of the service types.
Tables 6.4-6.9 present, for each type of service, the reason for discharge and length of stay by primary substance of abuse at admission.
Tables 6.10a and 6.10b present reason for discharge and length of stay by type of service for discharges from methadone treatment.
Figure 40. Among alcohol discharges, 39 percent were from outpatient treatment and 23 percent were from detoxification. For primary alcohol discharges, treatment completion rates were 41 percent for outpatient and 54 percent for detoxification.
Figure 41. Almost half of opiate discharges (47 percent) were from detoxification. Sixteen percent were from methadone treatment and 15 percent were from outpatient treatment. For opiate discharges, the treatment completion rates were 49 percent for detoxification, 12 percent for methadone, and 27 percent for outpatient.
Figure 42. About one-third (32 percent) of cocaine discharges were from outpatient treatment, 20 percent were from detoxification, and 18 percent were from intensive outpatient treatment. Treatment completion rates for cocaine discharges were 21 percent for outpatient, 50 percent for detoxification, and 27 percent for intensive outpatient.
Figure 43. Among marijuana discharges, 53 percent were from outpatient treatment and 22 percent were from intensive outpatient. Treatment completion rates for marijuana discharges were 32 percent for outpatient and 38 percent for intensive outpatient.
Figure 44. Among stimulant discharges, 35 percent were from outpatient, 22 percent were from intensive outpatient treatment, and 19 percent were from short-term residential/rehabilitation treatment. Treatment completion rates for stimulant discharges were 30 percent for outpatient, 34 percent for intensive outpatient, and 53 percent for short-term residential/rehabilitation.
Figure 40
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Figure 41
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Figure 42
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Figure 43
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Figure 44
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Table 6.3b-6.10b. Both the average and median lengths of stay were calculated. Most persons remained in treatment for a relatively short period of time, as represented by the median. However, some were reported as remaining in treatment for extended periods, and thus the average length of stay is generally longer than the median.
Figures 45-50 present the median and average lengths of stay for persons completing treatment in different types of service and for different primary substances. The median length of stay for persons completing treatment ranged from 5 days for detoxification to 91 days for outpatient treatment. The average length of stay was longer, ranging from 9 days for those completing detoxification to 122 days for those completing outpatient treatment. Within the different service types, however, there was little variation in median length of stay by primary substance.
Figure 45
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Figure 46
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Figure 47
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Figure 48
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Figure 49
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.
Figure 50
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.