Chapter 7 presents data on the reason for discharge and median length of stay (LOS) in treatment for the 326,365 discharges aged 12 and older from detoxification in 2009. Forty-four of the 45 reporting States and jurisdictions had discharges from this type of service [Table 7.1]. Detoxification in this chapter includes free-standing residential detoxification, hospital detoxification, and outpatient detoxification (see Chapter 1). Medication-assisted opioid detoxification is excluded and is reported in Chapter 9.

Reason for Discharge

Table 7.1 and Figure 7.1. Of the 326,365 discharges aged 12 and older from detoxification in 2009¹:

• 66 percent (n = 216,428) completed treatment
• 11 percent (n = 35,034) were transferred to further treatment
• 17 percent (n = 56,586) dropped out of treatment
• 2 percent (n = 7,590) had treatment terminated by the facility
• 3 percent (n = 10,727) failed to complete treatment for other reasons
  
  

¹ Percentages do not sum to 100 percent because of rounding.

Median Length of Stay (LOS)

Table 1.4 and Figure 7.2. The median LOS in 2009 for detoxification discharges aged 12 and older was 4 days. By reason for discharge, the median LOS for detoxification discharges was:

• 4 days among those who completed treatment
• 4 days among those who transferred to further treatment
• 2 days among those who dropped out of treatment
• 3 days among those whose treatment was terminated by the facility
• 4 days among those who failed to complete treatment for other reasons
  

Characteristics at Admission

Table 1.6. Detoxification discharges aged 12 and older displayed some major differences from all discharges aged 12 and older combined. Of detoxification discharges aged 12 and older:

• 74 percent were male compared to 68 percent of all discharges
• 32 percent were aged 41 to 50 years compared to 23 percent of all discharges; 4 percent were aged 12 to 20 compared to 14 percent of all discharges
• 55 percent reported alcohol as the primary substance of abuse compared to 42 percent of all discharges; 31 percent reported opiates compared to 21 percent of all discharges; 2 percent reported marijuana compared to 17 percent of all discharges
• 75 percent reported daily use of the primary substance in the month before treatment entry compared to 38 percent of all discharges; 2 percent reported no substance use in the month before treatment entry compared to 29 percent of all discharges
• 65 percent reported one or more prior treatment episodes compared to 58 percent of all discharges
• 61 percent were self- or individual referrals to treatment compared to 33 percent of all discharges; 11 percent were referred to treatment through the criminal justice system compared to 38 percent of all discharges
• 86 percent were unemployed or not in the labor force compared to 76 percent of all discharges
  

Treatment Completion

Tables 7.2 and 7.3. Table 7.2 enumerates the characteristics at admission of discharges aged 12 and over from detoxification by reason for discharge. Table 7.3 is based on Table 7.2. It presents two related proportions: a) the percent distribution of characteristics at admission among discharges completing treatment or transferring to further treatment compared to those who did not complete treatment, and b) the combined rate of completion or transfer to further treatment by characteristic at admission. Table 7.3 also provides the median LOS among detoxification discharges aged 12 and over that completed treatment.

Completion/Transfer Rates and Characteristics at Admission

The overall combined treatment completion/transfer rate among detoxification discharges aged 12 and over was 77 percent.

• Among variables whose categories represented a continuum—age, frequency of use, number of prior treatment episodes, and level of education—higher completion/transfer rates among detoxification discharges were associated with these three:
  
  • Older age—the completion/transfer rate fell from 83 percent among discharges older than 50 years to 72 percent among discharges aged 21 to 30 years
  • No prior treatment episodess—the completion/transfer rate rose from 71 percent of discharges with no prior treatment to 80 percent of discharges with one or more treatment episodes
  • Higher educational level—79 percent of discharges with more than 12 years of education completed treatment or transferred to further treatment; the rate fell modestly to 76 percent among discharges with fewer than 12 years of education
    
• Among other characteristics (race/ethnicity, primary substance, treatment referral source, employment status), the completion/transfer rate among detoxification discharges aged 12 and over ranged from:
  
  • 76 percent among non-Hispanic White discharges to 80 percent among discharges whose race/ethnicity was other than White, Black, or Hispanic and non-Hispanic Black
  • 70 percent among discharges whose primary substance was opiates to 81 percent among those who reported alcohol as the primary substance
  • 74 percent of discharges who were self- or individually referred to treatment to 83 percent of discharges who were referred to treatment through health care or community providers
  • 77 percent among discharges who were unemployed or not in the labor force to 81 percent among those who were employed
    

Median LOS among Discharges Completing Treatment

The overall median LOS in 2009 among discharges aged 12 and older completing detoxification was 4 days. The median LOS was between 3 days and 6 days for all characteristics.

• The median LOS was 3 days for those who indicated some substance use in the month before treatment entry, those referred by the criminal justice system, and those whose race/ethnicity was other than Hispanic, Black, or White.
• The median LOS was 6 days where the primary substance was "other/unknown," for those who reported marijuana as their primary substance of abuse, and where no use in the past month was reported
  

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