Marital Status and Substance Abuse Treatment Admissions: 2005

In Brief
In 2005, over half (52 percent) of substance abuse treatment admissions aged 25 to 44 had never married, 28 percent were formerly married, and 20 percent were currently married. By contrast, in the Nation as a whole, data from the 2000 Census for this age range show 25 percent had never married, 14 percent were formerly married, and 61 percent were currently married Admissions who had never married were more likely than those who were formerly or currently married to report daily use of the primary substance (44 percent vs. 39 and 36 percent) Substance abuse treatment admissions who had never married were more likely to have extensive treatment histories and less likely to be entering treatment for the first time than other admissions aged 25 to 44 in 2005

Marital status can be a predictor for substance abuse and the course of its treatment. In particular, married persons may have fewer substance abuse problems than unmarried persons, show better courses of treatment when they do require it, and relapse less often to substance abuse after treatment.^1,2,3 For example, data from the National Survey on Drug Use and Health (NSDUH) show that persons who were married at the time of the survey had a lower rate of substance dependence or abuse than persons who were not married.⁴ Other studies have shown that for those who abuse substances, being married can be a predictor of starting substance abuse treatment, spending more hours in treatment, and staying in treatment.⁵ In contrast, being unmarried can be a predictor of higher relapse into substance abuse after treatment.⁶

Relationships between marital status and substance abuse treatment admissions can be monitored with the Treatment Episode Data Set (TEDS), an annual compilation of data on the demographic characteristics and substance abuse problems of those admitted to substance abuse treatment, primarily at facilities that receive some public funding.⁷ TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once during a single year.

TEDS includes a Minimum Data Set collected by all States and Supplemental Data Set items collected by some States. “Marital Status,” a Supplemental Data Set item, was reported for at least 75 percent of all substance abuse treatment admissions in 41 States and jurisdictions in 2005.⁸ These 41 States and jurisdictions accounted for 67 percent of all substance abuse treatment admissions in 2005. However, since marital status is associated with age, the analysis in this report is restricted to admissions between 25 and 44 years of age. In these 41 States and jurisdictions, there were approximately 631,700 admissions aged 25 to 44 whose marital status was known (34 percent of all admissions to TEDS).

For purposes of this report, marital status was divided into three categories: never married, formerly married (i.e., divorced, separated, and widowed), and currently married.

Marriage was much less common among 2005 substance abuse treatment admissions between 25 and 44 years of age than in the general U.S. population. In the Nation as a whole, data from the 2000 Census⁹ for this age range show that 25 percent had never married, 14 percent were formerly married, and 61 percent were currently married. By contrast, over half (52 percent) of 2005 substance abuse treatment admissions aged 25 to 44 had never married, 28 percent were formerly married, and only 20 percent were currently married.

In 2005, substance abuse treatment admissions aged 25 to 44 who had never married were more likely to have reported opiates as the primary substance of abuse¹⁰ than were formerly or currently married admissions (23 percent vs. 14 and 16 percent) (Figure 1). While alcohol was the most commonly reported substance of abuse among all marital status groups, currently and formerly married admissions were more likely to report this substance than never married ones (44 and 43 percent vs. 37 percent).

Marital status groups also displayed different patterns in their frequencies of substance use: admissions who had never married were more likely than those who were formerly or currently married to report daily use of the primary substance (44 percent vs. 39 and 36 percent) (Figure 2).

Figure 1. Primary Substance of Abuse, by Marital Status: 2005

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 1 Table. Primary Substance of Abuse, by Marital Status: 2005
Substance	Never Married	Formerly Married	Currently Married
Alcohol	37%	43%	44%
Opiates	23%	14%	16%
Cocaine	19%	19%	16%
Marijuana	11%	8%	10%
Stimulants	7%	13%	10%
Other	3%	3%	4%

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 2. Frequency of Substance Use, by Marital Status: 2005

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 2 Table. Frequency of Substance Use, by Marital Status: 2005
Frequency	Never Married	Formerly Married	Currently Married
Daily	44%	39%	36%
3 to 6 Times in Past Week	12%	12%	12%
1 to 2 Times in Past Week	9%	9%	10%
1 to 3 Times in Past Month	10%	11%	13%
No Use in Past Month	25%	29%	29%

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Substance abuse treatment admissions who had never married were more likely to have extensive treatment histories and less likely to be entering treatment for the first time than other admissions aged 25 to 44 in 2005. Substance abuse treatment admissions aged 25 to 44 who had never married were more likely than those who were formerly or currently married to have reported five or more prior substance abuse treatment episodes (14 percent vs. 11 and 7 percent) (Figure 3). Correspondingly, never married admissions (and formerly married ones) were less likely than currently married admissions to report no prior substance abuse treatment episodes (40 and 43 percent vs. 50 percent).

Figure 3. Prior Treatment Episodes, by Marital Status: 2005

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 3 Table. Prior Treatment Episodes, by Marital Status: 2005
Prior Treatment Episodes	Never Married	Formerly Married	Currently Married
No Prior Treatment	40%	43%	50%
1 Prior Treatment Episode	22%	22%	23%
2 to 4 Prior Treatment Episodes	24%	24%	20%
5 or More Treatment Episodes	14%	11%	7%

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

In 2005, substance abuse treatment admissions aged 25 to 44 who had never married were more likely to receive detoxification services than those who were formerly or currently married (24 percent vs. 20 and 17 percent).¹¹ In addition, never and formerly married substance abuse treatment admissions aged 25 to 44 were less likely to have received treatment in an ambulatory service setting than currently married admissions (59 and 61 percent vs. 68 percent). However, there was little difference between the proportions of never, formerly, and currently married admissions receiving residential/rehabilitative treatment services (17, 19, and 15 percent, respectively).

Unmarried substance abuse treatment admissions aged 25 to 44 had different employment patterns than their married counterparts in 2005. Only 22 percent of admissions who had never married (and 23 percent of formerly married ones) reported full-time employment compared to 37 percent of admissions who were currently married (Figure 4). Unmarried substance abuse treatment admissions aged 25 to 44 were also more likely to be unemployed or not in the labor force than currently married admissions.

Figure 4. Employment Status, by Marital Status: 2005

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 4 Table. Employment Status, by Marital Status: 2005
Employment Status	Never Married	Formerly Married	Currently Married
Full Time	22%	23%	37%
Part Time	7%	7%	7%
Unemployed	40%	40%	31%
Not in Labor Force	31%	30%	25%

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

¹ Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (October 29, 2004). The NSDUH report: Gender differences in substance dependence and abuse. Rockville, MD. The finding was for persons 18 to 49 years of age.
² Green, C. A., Polen, M. R., Dickinson, D. M., Lynch, F. L., & Bennett, M. D. (2002). Gender differences in predictors of initiation, retention, and completion in an HMO-based substance abuse treatment program. Journal of Substance Abuse Treatment, 23, 285-295.
³ Grella, C. E., Hser, Y. I., & Hsieh, S. C. (2003). Predictors of drug treatment re-entry following relapse to cocaine use in DATOS. Journal of Substance Abuse Treatment, 25(3), 145-154. The finding was for “previously married” abusers who relapsed within 5 years of their index treatment.
⁴ Substance Abuse and Mental Health Services Administration, op cit.
⁵Green et al., op cit.
⁶ Grella, Hser, & Hsieh, op cit.
⁷In 2005, TEDS collected data on 1.8 million admissions to substance abuse treatment facilities. Four States and jurisdictions (AK, DC, NM, and WY) did not submit data for 2005.
⁸The 41 States or jurisdictions are AL, AR, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, NC, ND, NE, NH, NJ, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, WA, and WV.
⁹U.S. Census Bureau. (2001). Marital status of people 15 years and over, by age, sex, personal earnings, race, and Hispanic origin, March 2000. Retrieved May 18, 2007, from http://www.census.gov/population/www/socdemo/hh-fam/p20-537_00.html
¹⁰ The primary substance of abuse is the main substance reported at the time of admission.
¹¹ Service settings are of three types: ambulatory, residential/rehabilitative, and detoxification. Ambulatory settings include intensive outpatient, non-intensive outpatient, and ambulatory detoxification. Residential/rehabilitative settings include hospital (other than detoxification), short-term (30 days or fewer), and long-term (more than 30 days). Detoxification includes 24-hour hospital inpatient and 24-hour free-standing residential.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (October 25, 2007). The DASIS Report: Marital Status and Substance Abuse Treatment Admissions: 2005. Rockville, MD.