Alcohol and Drug Services Study (ADSS)

Phase II: Client Record Abstract Report

Margaret T. Lee

Sharon Reif

Grant A. Ritter

Helen J. Levine

Constance M. Horgan

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

Office of Applied Studies
ii

Acknowledgments

This publication was developed for the Substance Abuse and Mental Health Services Administration

(SAMHSA), Office of Applied Studies (OAS), by the Schneider Institute for Health Policy, Brandeis

University, under Contract No. 283-92-8331. The authors of this report were Margaret T. Lee, Sharon

Reif, Grant A. Ritter, Helen J. Levine, and Constance M. Horgan. Constance M. Horgan was the

Principal Investigator of the Alcohol and Drug Services Study (ADSS). Helen J. Levine was Co-Principal

Investigator and project director for the ADSS Phase I Facility Survey and the ADSS Phase II Client

Record Abstract Study. Mary Ellen Marsden was project director for the ADSS Phase III Client

Follow-up Study. Westat, Inc., subcontractor on the project, conducted the data collection. Anita Gadzuk

was the SAMHSA Project Officer. At RTI International (a trade name of Research Triangle Institute)

under Contract No. 283-99-9018, the document was reviewed by Carol Council, edited and proofread by

Richard S. Straw and K. Scott Chestnut, and prepared for print and Web publication by Pamela Couch

Prevatt, Teresa F. Gurley, Kim Cone, and David Belton. Final report production was provided by

Beatrice Rouse, Coleen Sanderson, and Jane Feldmann at SAMHSA.

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. However, this

publication may not be reproduced or distributed for a fee without specific, written authorization of the

Office of Communications, SAMHSA, U.S. Department of Health and Human Services. Citation of the

source is appreciated. Suggested citation:

Lee, M. T., Reif, S., Ritter, G. A., Levine, H. J., & Horgan, C. M. (2004). Alcohol and Drug

Services Study (ADSS) Phase II: Client record abstract report (DHHS Publication No. SMA 04-

3974, Analytic Series No. A-27). Rockville, MD: Substance Abuse and Mental Health Services

Administration.

Obtaining Additional Copies of Publications

Copies may be obtained, free of charge, from the National Clearinghouse for Alcohol and Drug

Information (NCADI), a service of SAMHSA. For copies of publications, please write or call:

National Clearinghouse for Alcohol and Drug Information (NCADI)

P.O. Box 2345, Rockville, MD 20847-2345

(301) 468-2600, 1-800-729-6686, TDD 1-800-487-4889

Electronic Access to Publication

http://www.samhsa.gov

http://www.oas.samhsa.gov

http://www.oas.samhsa.gov/adss.htm

Originating Office

SAMHSA, Office of Applied Studies

1 Choke Cherry Road, Room 7-1044, Rockville, MD 20857

September 2004
iii

Table of Contents

Chapter Page

List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

1. Phase II Client Record Abstracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

1.1 Introduction ......................................................1

1.2 Background and Objectives ..........................................1

1.3 Methodology .....................................................3

1.3.1 Phase II Samples ............................................3

 1.3.2 Phase II Sampling ...........................................3

1.3.3 Phase II Strata ..............................................4

1.4 Response Rates ...................................................4

1.5 Sampling Client Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

1.6 Instrument Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

1.7 Organization of the Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

2. Findings on ADSS Discharged Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

2.1 Client Type of Care, by Facility Characteristics ..........................7

2.1.1 Facility Type of Care .........................................7

2.1.2 Facility Ownership ...........................................8

2.1.3 Facility Public Revenue .......................................8

2.2 Substance Type, by Client Type of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

2.3 Client Demographics and Background Information .......................9

2.3.1 Age .......................................................9

2.3.2 Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

2.3.3 Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

2.3.4 Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

2.3.5 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

2.3.6 Employment Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

2.3.7 SSI Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

2.3.8 Marital Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

2.3.9 Parental Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

2.3.10 Living Arrangement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

2.3.11 Marital Status, Parental Status, and Living Arrangement, by

Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

2.4 Primary Source of Referral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

2.5 Criminal Justice Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

2.6 Substance Use and Substance Abuse History . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

2.6.1 Substances Ever Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

2.6.2 Substances Used in 30 Days Prior to Admission . . . . . . . . . . . . . . . . . . . 14

2.6.3 Mean Age at First Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

2.6.4 Substance of Choice at Admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

2.6.5 Injection Drug Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

2.6.6 Treatment History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
iv

Table of Contents (continued)

Chapter Page

2.7 Medical Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

2.8 Mental Health Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

2.9 Services Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

2.9.1 Treatment Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

2.9.2 Treatment Completion and Number of Counseling Sessions, by

Client Type of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

2.9.3 Support Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

2.10 Methadone Treatment Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

2.11 Average Length of Stay, Duration of Treatment, and Reason for Discharge . . . 19

2.12 Aftercare Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

2.13 Expected Primary Source of Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

3. Findings on ADSS In-Treatment Methadone Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

3.1 In-Treatment Methadone Clients, by Facility Characteristics . . . . . . . . . . . . . . . 43

3.2 Client Demographics and Background Information . . . . . . . . . . . . . . . . . . . . . . 43

3.2.1 Age, Race, Ethnicity, and Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

3.2.2 Education, Employment, and SSI Status . . . . . . . . . . . . . . . . . . . . . . . . . 43

3.2.3 Family Status and Living Arrangement . . . . . . . . . . . . . . . . . . . . . . . . . . 44

3.3 Primary Source of Referral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

3.4 Criminal Justice Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

3.5 Substance Use and Substance Abuse History . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

3.5.1 Substances Ever Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

3.5.2 Substances Used in 30 Days Prior to Admission . . . . . . . . . . . . . . . . . . . 45

3.5.3 Mean Age at First Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

3.5.4 Substance of Choice at Admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

3.5.5 Injection Drug Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

3.5.6 Treatment History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

3.6 Medical Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

3.7 Mental Health Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

3.8 Services Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

3.8.1 Treatment Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

3.8.2 Support Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

3.9 Expected Primary Source of Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

3.10 Methadone Treatment Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Appendix

A Standard Error Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
v

List of Tables

Table Page

2.A Percentage Distribution of Substance Type, by Client Type of Care for Discharged

Clients, 1997 - 1998 ......................................................9

2.B Percentage Distribution of Discharged Residential and Outpatient NonMethadone Clients by Marital Status, Parental Status, and Living Arrangement, by

Gender, 1997 - 1998 .................................................... 13

2.C Percentage Distribution of Lifetime Injection Drug Use (IDU), by Discharged

Client Type of Care, 1997 - 1998 .......................................... 15

2.D Percentage of Discharged Clients Receiving Counseling and Self-Help Services,

by Client Type of Care, 1997 - 1998 ........................................ 17

2.1 Abstract Sample Size, National Estimate of Substance Abuse Treatment Clients,

and Percentage Distribution by Client Type of Care, ADSS Phase II Client Record

Abstract Study, 1997 - 1999 .............................................. 21

2.2 Percentage Distribution of Clients by Selected Facility Characteristics, by Client

Type of Care, 1997 - 1999 ................................................ 22

2.3 Mean and Median Age and Percentage Distribution of Clients by Selected Client

Characteristics, by Client Type of Care, 1997 - 1999 ........................... 24

2.4 Percentage Distribution of Clients by Marital Status, Parental Status, and Living

Arrangement, by Client Type of Care, 1997 - 1999 ............................. 26

2.5 Percentage Distribution of Clients by Primary Source of Referral, by Client Type

of Care, 1997 - 1999 .................................................... 27

2.6 Percentage Distribution of Clients by Criminal Justice System Status, by Client

Type of Care, 1997 - 1999 ................................................ 28

2.7 Percentage of Clients Ever Using Each Substance Prior to Admission, by Client

Type of Care, 1997 - 1999 ................................................ 29

2.8 Percentage of Clients Using Each Substance During the 30 Days Prior to

Admission, by Client Type of Care, 1997 - 1999 .............................. 30

2.9 Mean Age at First Use of Substance, by Client Type of Care, 1997 - 1999 .......... 31
List of Tables (continued)

Table Page

vi

2.10 Percentage Distribution of Clients by Substance of Choice at Admission, by

Client Type of Care, 1997 - 1999 .......................................... 32

2.11 Percentage of Clients with Prior Substance Abuse Treatment History and

Characteristics of Treatment History, by Client Type of Care, 1997 - 1999 .......... 33

2.12 Percentage of Clients with Selected Medical Characteristics, by Client Type of

Care, 1997 - 1999 ....................................................... 34

2.13 Percentage of Clients with Selected Mental Health Characteristics, by Client Type

of Care, 1997 - 1999 .................................................... 35

2.14 Percentage of Clients Receiving Selected Treatment Services, by Client Type of

Care, 1997 - 1999 ....................................................... 36

2.15 Percentage of Clients Completing Treatment and Median Number of Counseling

Sessions by Completion Status, by Client Type of Care, 1997 - 1998 .............. 37

2.16 Percentage of Clients Receiving Selected Support Services, by Client Type of

Care, 1997 - 1999 ....................................................... 38

2.17 Methadone Treatment Practices (Mean Daily Methadone Dose and Percentage of

Clients Who Received Take-Home Methadone) for Discharged Methadone

Clients, 1997 - 1998 ..................................................... 39

2.18 Average Length of Stay, Average Duration of Treatment, and Reason for

Discharge, by Client Type of Care, 1997 - 1998 ............................... 40

2.19 Percentage of Discharged Clients with Aftercare Plan and Selected Aftercare

Services, by Client Type of Care, 1997 - 1998 ................................ 41

2.20 Percentage Distribution of Clients by Expected Primary Source of Payment, by

Client Type of Care, 1997 - 1999 .......................................... 42

3.A Percentage Distribution of In-Treatment Methadone Clients, by Injection Drug

Use (IDU), 1997 - 1999 .................................................. 46

3.1 Methadone Treatment Practices (Average Daily Methadone Dose) for

In-Treatment Methadone Clients, 1997 - 1999 ................................ 48
List of Tables (continued)

Table Page

vii

2.1C Standard Errors - National Estimate of Substance Abuse Treatment Clients and

Percentage Distribution by Client Type of Care, ADSS Phase II Client Record

Abstract Study, 1997 - 1999 .............................................. 51

2.2C Standard Errors - Percentage Distribution of Clients by Selected Facility

Characteristics, by Client Type of Care, 1997 - 1999 ........................... 52

2.3C Standard Errors - Mean and Median Age and Percentage Distribution of Clients

by Selected Client Characteristics, by Client Type of Care, 1997 - 1999 ............ 54

2.4C Standard Errors - Percentage Distribution of Clients by Marital Status, Parental

Status, and Living Arrangement, by Client Type of Care, 1997 - 1999 ............. 56

2.5C Standard Errors - Percentage Distribution of Clients by Primary Source of

Referral, by Client Type of Care, 1997 - 1999 ................................. 57

2.6C Standard Errors - Percentage Distribution of Clients by Criminal Justice System

Status, by Client Type of Care, 1997 - 1999 .................................. 58

2.7C Standard Errors - Percentage of Clients Ever Using Each Substance Prior to

Admission, by Client Type of Care, 1997 - 1999 .............................. 59

2.8C Standard Errors - Percentage of Clients Using Each Substance During the 30 Days

Prior to Admission, by Client Type of Care, 1997 - 1999 ........................ 60

2.9C Standard Errors - Mean Age at First Use of Substance, by Client Type of Care,

1997 - 1999 ........................................................... 61

2.10C Standard Errors - Percentage Distribution of Clients by Substance of Choice at

Admission, by Client Type of Care, 1997 - 1999 .............................. 62

2.11C Standard Errors - Percentage of Clients with Prior Substance Abuse Treatment

History and Characteristics of Treatment History, by Client Type of Care, 1997 -

1999 ................................................................. 63

2.12C Standard Errors - Percentage of Clients with Selected Medical Characteristics, by

Client Type of Care, 1997 - 1999 .......................................... 64

2.13C Standard Errors - Percentage of Clients with Selected Mental Health

Characteristics, by Client Type of Care, 1997 - 1999 ........................... 65
List of Tables (continued)

Table Page

viii

2.14C Standard Errors - Percentage of Clients Receiving Selected Treatment Services,

by Client Type of Care, 1997 - 1999 ........................................ 66

2.15C Standard Errors - Percentage of Clients Completing Treatment and Median

Number of Counseling Sessions by Completion Status, by Client Type of Care,

1997 - 1998 ........................................................... 67

2.16C Standard Errors - Percentage of Clients Receiving Selected Support Services, by

Client Type of Care, 1997 - 1999 .......................................... 68

2.17C Standard Errors - Methadone Treatment Practices (Mean Daily Methadone Dose

and Percentage of Clients Who Received Take-Home Methadone) for Discharged

Methadone Clients, 1997 - 1998 ........................................... 69

2.18C Standard Errors - Average Length of Stay, Average Duration of Treatment, and

Reason for Discharge, by Client Type of Care, 1997 - 1998 ...................... 70

2.19C Standard Errors - Percentage of Discharged Clients with Aftercare Plan and

Selected Aftercare Services, by Client Type of Care, 1997 - 1998 ................. 71

2.20C Standard Errors - Percentage Distribution of Clients by Expected Primary Source

of Payment, by Client Type of Care, 1997 - 1999 .............................. 72

3.1C Standard Errors - Methadone Treatment Practices (Average Daily Methadone

Dose) for In-Treatment Methadone Clients, 1997 - 1999 ........................ 73
1

Chapter 1. Phase II Client Record Abstracts

1.1 Introduction

This report presents data on substance abuse treatment clients from a nationally

representative sample of alcohol and drug treatment facilities included in Phase II of the Alcohol

and Drug Services Study (ADSS) sponsored by the Substance Abuse and Mental Health Services

Administration (SAMHSA). A stratified random sample of more than 5,000 client records was

selected to be nationally representative of clients in the major modalities of substance abuse

treatment. Data reported upon here were abstracted from client treatment records in a stratified

sample of 280 alcohol and drug treatment facilities. Phase II was in the field from August 1997

through April 1999. The sample of client records was selected from lists of clients discharged

from Phase II facilities within the 6 months preceding the Phase II client sample date, as well as

from lists of clients still active in outpatient methadone treatment on the client sample date.

Client records contain a rich source of information regarding substance abuse clients and

their treatment experience. This report is based on a nationally representative sample of client

treatment episodes from 1997 to 1999 and describes many demographic and background

characteristics of clients who were in the treatment system during this period. Variations by

client type of care indicate that the treatment experience could be different depending on where

the individual is treated. Understanding who is in treatment and having such information as the

types of facilities at which clients were treated, the referral sources that led them into treatment,

their treatment histories (including their substance use, medical, and mental health histories), the

services they received during treatment, their reasons for discharge, and their expected primary

payment source will shed light on the characteristics of substance abuse treatment.

This report presents findings for the Phase II main study client abstracts and the intreatment methadone study. For a complete description of the methods employed in ADSS, see

the ADSS methodology report:

Office of Applied Studies. (2003). Alcohol and Drug Services Study (ADSS):

Methodology report: Phases I, II, and III (available as a PDF at

http://www.oas.samhsa.gov/adss.htm). Rockville, MD: Substance Abuse and

Mental Health Services Administration.

1.2 Background and Objectives

The objective of ADSS, a three-phase study, was to provide detailed national data on

current substance abuse treatment practices, clients in treatment, and outcomes for use by

providers, policymakers, and researchers. ADSS gathered information linking clients, treatment

services, treatment cost, and post-treatment status. ADSS data represent an important step toward

understanding the content, utilization, and cost of treatment.

ADSS surveyed a nationally representative stratified random sample of 2,395 substance

abuse treatment facilities in Phase I, with detailed data collected on a sample of clients in a
1 The following reports, available as PDFs at the OAS website (http://www.oas.samhsa.gov/dsrs.htm),

contain the DSRS findings:

Batten, H. L., Horgan, C. M., Prottas, J. M., Simon, L. J., Larson, M. J., Elliott, E. A., Bowden, M. L., & Lee, M. T.

(1993). Drug Services Research Survey, Phase I final report: Non-correctional facilities (revised; submitted to the

National Institute on Drug Abuse). Waltham, MA: Brandeis University, Institute for Health Policy.

Batten, H. L., Prottas, J. M., Horgan, C. H., Simon, L. J., Larson, M. J., Elliott, E. A., & Marsden, M. E. (1992).

Drug Services Research Survey, Phase II final report: Non-correctional facilities (submitted to the National Institute

on Drug Abuse). Waltham, MA: Brandeis University, Institute for Health Policy.

2

subset of these facilities in Phase II. Types of treatment facilities excluded from the ADSS

sample frame included halfway houses without paid counselors, solo practitioners, correctional

facilities, Department of Defense (DoD) facilities, Indian Health Service facilities, and facilities

that provide only intake and referral services. The phases of ADSS are as follows:

! Phase I was a facility-based telephone interview with the directors of a

nationally representative random sample of 2,395 substance abuse

treatment facilities.

! Phase II included site visits to a subsample of 280 facilities for a personal

interview with the facility director, review of treatment cost records, and

client record abstraction for a nationally representative sample of clients

who had been discharged from treatment (5,005 clients) and a

representative sample of clients currently in methadone treatment (925

clients). Records for an early-drop-out (EDO) comparison group (790

clients) also were abstracted to use as a comparison group in Phase III.

! Phase III consisted of a follow-up interview and collection of a urine

specimen from clients whose records were abstracted in Phase II in order

to obtain their post-treatment status in terms of alcohol and drug use,

criminal justice status, and further treatment episodes.

ADSS builds on SAMHSA's 1990 Drug Services Research Survey (DSRS).1

 DSRS Phase

II collected client-level data from a stratified sample of 118 drug and combined drug and alcohol

treatment facilities, sampled from 1,111 treatment facilities that completed the DSRS Phase I

survey.

To continue the work started with DSRS, the research objective of ADSS Phase II was to

collect more recent client-level data to describe characteristics of clients in substance abuse

treatment from 1997 to 1999. Information was abstracted from the sampled clients' treatment

records regarding type of care for the discharge episode, length of stay in treatment, client

demographics, criminal justice information, medical and psychological information, substance

abuse history, substance abuse testing, services received, methadone treatment, discharge

information, and financial information.
3

1.3 Methodology

Phase II of ADSS consisted of an administrator interview and client record abstracting.

This report presents data obtained from client record abstracts for discharged clients, as well as

from a cross section of clients who were in outpatient methadone treatment at the time of the site

visits. During Phase II, a subset of 280 of the Phase I facilities was visited, and information was

abstracted from client records to provide client-level data from the substance abuse treatment

system. The Phase II sampling frame consisted of clients from the 2,395 eligible facilities

responding to Phase I, excluding 203 hospital inpatient facilities and 208 facilities in which 100

percent of the clients were treated for alcohol abuse only. Phase II sampled clients in residential,

outpatient methadone, and outpatient non-methadone treatment.

1.3.1 Phase II Samples

Phase II consisted of two treatment client samples:

1. Discharged clients: The discharged client sample of 5,005 client records

was designed to be nationally representative of clients discharged from

treatment during a 6-month period.

2. In-treatment methadone clients (ITMC): The in-treatment methadone study

was designed to give a picture of a cross section of methadone clients who

were in treatment at the time of the ADSS Phase II site visits.

1.3.2 Phase II Sampling

The sample design for ADSS was a multi-stage stratified clustered design. In the first

stage of the study (Phase I), a nationally representative set of 2,395 treatment facilities was

selected with probability proportional to size (PPS) from the National Master Facility Inventory

(NMFI), a national index of specialty substance abuse treatment facilities known to SAMHSA.

The second stage of the study (Phase II), which involved site visits to a subsample of facilities,

consisted of three stages of sampling:

! First, the country was partitioned in approximately 400 geographical

primary sampling units (PSUs), with a representative sample of 62 PSUs

selected for Phase II on the basis of demographic and economic

characteristics.

! Within these 62 PSUs, a stratified subsample of 306 Phase I responding

facilities was selected using a PPS design.

! Finally for Phase II, random samples of discharges and methadone

in-treatment clients were selected within the Phase II facilities.

The ADSS 62-PSU sample consists of all 24 metro certainty PSUs, 26 metro

non-certainty PSUs, and 12 non-metro, non-certainty PSUs. The ADSS PSUs were selected with
2 Office of Applied Studies. (2003). Alcohol and Drug Services Study (ADSS): Methodology report:

Phases I, II, and III (available as a PDF at http://www.oas.samhsa.gov/adss.htm). Rockville, MD: Substance Abuse

and Mental Health Services Administration.

4

probability proportionate to the population. Phase I respondents whose ZIP Code numbers placed

them outside of the 62 PSUs were excluded from Phase II. This produced a clustered sample for

more efficient on-site data collection at facilities. After excluding facilities based on modality

and geographic criteria, there were 1,052 facilities eligible for Phase II.

1.3.3 Phase II Strata

For Phase II sampling, the eligible Phase I responding facilities were placed in Phase II

sampling strata based on information collected from the Phase I questionnaire. There were six

Phase I strata:

1. Hospital inpatient;

2. Non-hospital residential;

3. Outpatient, predominantly methadone;

4. Outpatient, almost exclusively alcohol;

5. Outpatient, all other; and

6. Combination.

Phase II strata were the same as for Phase I except that the hospital inpatient stratum was

excluded.

1.4 Response Rates

The unweighted Phase II facility response rate was 79.6 percent. The unweighted

response rate for client record abstracts was 96.1 percent. Because the Phase II sampling design

incorporates a stratified random probability sample, weights were developed to produce national

estimates. See the ADSS methodology report for additional information on response rates for

each phase of ADSS.2

1.5 Sampling Client Records

During Phase II of ADSS, facility staff at sampled facilities were asked to provide the

ADSS field staff with a list of discharged substance abuse clients for the 6 months immediately

preceding the month that the administrator interview was conducted at the facility. Client records

were randomly chosen from the names on the list to achieve the targeted number of abstracts for

the facility. In addition, at 31 methadone facilities, a sample of approximately 30 clients who

were still in methadone treatment on the sample date of each facility was randomly selected for

the ITMC study. The treatment records for these sampled clients were then reviewed, and

information from the records was entered into the ADSS client record abstract form. A total of

5,930 records were abstracted—5,005 for discharged clients and 925 for the ITMC study.
5

1.6 Instrument Development

The client record abstract instrument was adapted from that used in the 1990 DSRS

study. Information was abstracted from client records for the following areas:

! demographics and background,

! criminal justice history,

! medical history,

! substance abuse history,

! substance abuse treatment history,

! treatment services,

! methadone treatment,

! discharge data, and

! financial data. 

Skip patterns were used for the in-treatment methadone clients so that questions pertaining to

discharge, treatment completion, and aftercare (which were not applicable for the in-treatment

group) were not abstracted. For the discharged methadone clients, only a partial client record

abstraction was done consisting of information for length of stay; selected demographics; prison

or jail record prior to admission; selected medical and mental health characteristics; history of

cocaine, heroin, marijuana, and alcohol use; and methadone treatment practices.

 More details on ADSS methodology can be obtained from the ADSS methodology report

(see footnote 2). The 30-page ADSS client record abstract form and its 221-page codebook are

available as PDFs on the OAS website: http://www.oas.samhsa.gov/adss.htm#Qn.

1.7 Organization of the Report

The analytic portion of this report consists of two main sections—the findings for the

ADSS discharged clients (Chapter 2) and the findings for the in-treatment methadone clients

(Chapter 3). Both Chapter 2 and Chapter 3 begin by presenting the number of client records

abstracted in that specific sample and the weighted national estimate that it represents. Next,

findings for clients by facility characteristics are presented. To obtain the facility characteristics,

client records were linked to Phase I facility-level data for the facilities where they received

treatment. Client demographics and background information from the client abstracts then are

presented, followed by subsections on primary source of referral, criminal justice information,

substance use history, medical and psychological information, services information, methadone

treatment practices, length of stay and duration of treatment, treatment completion and other

discharge information, aftercare information, and expected primary source of payment

information. Chapter 3 on the in-treatment methadone clients does not cover treatment

completion, discharge, or aftercare information because these clients were still in treatment at the

time of record abstraction. Client abstract sample size is provided where feasible. All findings

presented are weighted national estimates.

Each chapter is followed by detailed tables, and Appendix A has a corresponding

standard error (SE) table for each of the tables. Most Chapter 2 tables present data for both
6

abstract groups—the 6-month discharged clients group and the 1-day cross section of intreatment methadone clients. Therefore, many of the Chapter 2 tables also are discussed in

Chapter 3, which presents the analysis for the in-treatment methadone group.
7

Chapter 2. Findings on ADSS Discharged Clients

This chapter presents national estimates on the characteristics of substance abuse

treatment clients discharged from treatment during a 6-month period, based on data from ADSS

Phase II client record abstracts. The analysis is presented by client type of care—residential,

outpatient methadone, and outpatient non-methadone.

The sample of 5,005 abstracts from discharged clients consists of 880 non-hospital

residential clients, 467 outpatient methadone discharged clients, and 3,658 outpatient

non-methadone clients. These sampled records weight up for the 6-month period to national

estimates of 349,853 non-hospital residential discharges, 60,336 outpatient methadone

discharges, and 704,341 outpatient non-methadone discharges. The total number of discharges

for the 6-month period was estimated to be 1,114,530, or about 2,229,000 discharges in a 1-year

period. [Table 2.1].

The percentage distribution of discharged clients indicates that 63 percent were outpatient

non-methadone clients, 31 percent were non-hospital residential clients, and 5 percent were

outpatient methadone clients.

A general note about the estimates derived from client record abstraction is that the

estimates are based on information available in client treatment records. The percentage of

"unknown" values presented in the report tables reflects the proportion of records that did not

include information about the selected variable. In cases where there is a large percentage of

unknowns, the estimate of the event is conservative.

2.1 Client Type of Care, by Facility Characteristics

As part of the analysis, the client record abstracts were linked to the Phase I facility

survey file in order to determine the type of facility from which they received treatment. The type

of care that clients received varied with selected facility characteristics.

2.1.1 Facility Type of Care

Across all facility types of care, half of the discharged clients were in treatment at

outpatient non-methadone-only facilities. Almost a third (30 percent) were in treatment at

combination facilities (i.e., facilities that offered more than one type of care). Some 17 percent of

clients were treated in non-hospital residential-only facilities, and only 4 percent were in

outpatient methadone-only facilities; however, the estimate for methadone facilities had a high

coefficient of variation (CV $ 0.3), indicating that it is unstable and should be interpreted with

caution. [Table 2.2].

Of the clients receiving non-hospital residential care, about half (53 percent) were in

non-hospital residential-only facilities, and the other half (47 percent) were in facilities with a

combination of residential treatment and some other type of care. Of the methadone clients, the

majority (76 percent) were treated in outpatient methadone-only facilities. Of outpatient
8

non-methadone clients, the majority (78 percent) were treated in outpatient non-methadone-only

facilities, while 22 percent were treated in combination facilities.

2.1.2 Facility Ownership

In terms of facility ownership, almost two thirds (64 percent) of discharged clients were

in treatment at private non-profit facilities. About 20 percent of the discharged clients were in

treatment at public facilities, and 16 percent were in private for-profit facilities.

There were variations in facility ownership by client type of care. The majority of the

non-hospital residential clients (71 percent) were treated at private non-profit facilities. Similarly,

about 63 percent of outpatient non-methadone clients were treated in private non-profit facilities.

Among outpatient methadone clients, however, a lower level, an estimated 41 percent, were

treated in private non-profit facilities.

2.1.3 Facility Public Revenue

In addition to type of care and ownership, facility receipt of public revenue is a facility

characteristic of interest. Although related to ownership to some degree, a facility's percentage of

public revenue is worth viewing separately. Across all types of care, 44 percent of clients were in

facilities that received 51 to 90 percent of their funding from public sources. Public revenue

included Medicaid, Medicare, other Federal Government funds (e.g., VA and CHAMPUS), and

other public funds, such as block grants, public contracts, and grants. Some 30 percent of clients

were in facilities with up to a half (0 to 50 percent) of their revenue from public funding, and 24

percent of clients were in facilities with higher levels of public revenue (91 to 100 percent).

Distribution of facility percentage of public revenue by client type of care was also

examined. The most interesting result concerning percentage of public revenue was that although

over 30 percent of the discharged outpatient methadone clients had been treated in private

for-profit facilities, only 9 percent had been treated in facilities with less than 50 percent of their

funding from public sources.

2.2 Substance Type, by Client Type of Care

Discharged clients were categorized into a substance type depending on the substances

their treatment record indicated that they were abusing at admission—alcohol abuse only, drug

abuse only, or a combined alcohol and drug abuse at the time of admission. Table 2.A shows the

crossing of client substance type by client type of care. The column for total discharged clients

indicates that the majority of discharged clients (54 percent) were in treatment for combined

alcohol and drug abuse. Some 29 percent were in treatment for alcohol abuse only, and 15

percent were in treatment for drug abuse only. The pattern is similar for all client types of care

except for the outpatient methadone group. The majority of methadone clients (57 percent) were

in treatment for drug abuse only. This estimated proportion is a conservative estimate because 18

percent of discharged methadone client records did not indicate the combination of substances

being abused.
9

Table 2.A Percentage Distribution of Substance Type, by Client Type of Care for

Discharged Clients, 1997 - 1998

6-Month Discharged Client Groups

Total, All

Discharged Clients

Client Type of Care

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

Non-Methadone

Client Sample Size (n) 5,005 880 467 3,658

National 6-Month

Estimate

1,114,530

(104,353)

349,853

(67,041)

60,336

(15,295)

704,341

(73,147)

Substance Type 100.0 100.0 100.0 100.0

Alcohol abuse only 28.6 (2.49) 20.7 (5.70) 2.4 (1.26)* 34.8 (2.98)

Drug abuse only 15.1 (1.17) 16.4 (2.60) 56.7 (4.69) 10.8 (1.16)

Combined alcohol and 

drug abuse 53.7 (2.29) 62.2 (4.55) 23.0 (7.94)* 52.2 (3.03)

Unknown 2.6 (0.54) 0.7 (0.43)* 18.0 (4.62) 2.3 (0.74)*

Note: Standard errors are in parentheses.

Note: Discharge data represent substance abuse treatment discharges during a sample 6-month period between

February 1997 and December 1998 for each sampled facility. Weighted discharges provide a national

estimate of discharges for a 6-month period.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.

Comparing discharged non-hospital residential to discharged outpatient non-methadone

clients, the majority in each group was treated for a combined alcohol and drug problem;

however, there was a higher proportion of clients in outpatient non-methadone care who were

treated for alcohol abuse only than in non-hospital residential care.

2.3 Client Demographics and Background Information

As noted earlier, only selected items on the client record abstract form were abstracted for

the discharged outpatient methadone client records. Based on this limited set of variables,

estimates for most items in Table 2.3 could be provided, but not for the items in Table 2.4.

2.3.1 Age

The mean age of the clients in the discharged client sample was 34 years, and the median

age was 33 years. The age groupings were quite similar across the client types of care. Generally,

for each client type of care, the majority of clients were between the ages of 25 to 39. Overall,

about an equal proportion fell into the 20 to 24 and under 20 age groups (about 10 percent each).

About a fifth of the discharged clients were in their 40s. Only 8 percent of discharged clients

were 50 years old or older. [Table 2.3].
10

Outpatient methadone clients were somewhat different from outpatient non-methadone

clients. A smaller proportion (5 percent) of methadone clients were aged 20 to 24 compared with

outpatient non-methadone clients (12 percent). Discharged outpatient methadone clients were on

average older than discharged outpatient non-methadone clients.

2.3.2 Race

Overall, 64 percent of discharged clients were white, 22 percent were black, and 5 percent

fell in the "other" category. About 10 percent of the client records did not have information on

race. [Table 2.3].

In non-hospital residential type of care, 57 percent of the discharged clients were white,

and a third (33 percent) were black. Among discharged outpatient non-methadone clients, 69

percent were white, and 16 percent were black. In outpatient methadone type of care, 15 percent

of the abstracts did not have information on race, 44 percent of the clients were white, 29 percent

of the clients were black (CV $ 0.3), and 11 percent were "other."

2.3.3 Ethnicity

About 11 percent of discharged clients were known to be Hispanic, 60 percent were

non-Hispanic, and 29 percent of the client records did not mention ethnicity. [Table 2.3].

The pattern was similar for all client types of care, with the exception that in outpatient

methadone type of care, there was a higher percentage of Hispanic clients (28 percent) than in

non-hospital residential care (8 percent). The percentages of Hispanic clients in outpatient

methadone and outpatient non-methadone types of care were not significantly different.

2.3.4 Gender

About 74 percent of discharged clients were men and 25 percent of discharged clients

were women. The patterns were similar regardless of the client type of care, except for outpatient

methadone where 56 percent of the discharged clients were men and 44 percent were women.

[Table 2.3].

2.3.5 Education

An estimated 31 percent of discharged clients had not graduated from high school, while

34 percent had a high school diploma or a GED as their highest level of education. Beyond that,

17 percent of clients had some college, and 5 percent had a graduated from college or had a

higher level of education. This general pattern was true for non-hospital residential and

outpatient non-methadone discharged clients. [Table 2.3].

2.3.6 Employment Status

Nearly 42 percent of discharged clients were unemployed, 28 percent were employed full

time, and 13 percent were employed part time (or their records indicated that they were employed
11

but did not specify whether it was part time or full time). Of the discharged clients, 11 percent

were of "other" employment status, such as retired or incarcerated. [Table 2.3].

There were employment variations by client type of care. Discharged outpatient

non-methadone clients were most likely to be employed full time (34 percent), while discharged

outpatient methadone clients were the least likely to be employed full time (16 percent).

Unemployment was higher among discharged non-hospital residential (56 percent) and outpatient

methadone (55 percent) clients than among outpatient non-methadone clients (34 percent).

2.3.7 SSI Status

Overall, approximately 42 percent of the client records abstracted had no information on

supplemental security income (SSI) benefits. Only 6 percent of client records indicated that the

clients were receiving SSI benefits at admission, and 53 percent indicated that they were not

receiving SSI benefits. Of the different client types of care, outpatient methadone clients were 3

times as likely to receive SSI benefits as outpatient non-methadone clients. The percentage of

clients receiving SSI benefits at admission was not significantly different for methadone and

residential clients. [Table 2.3].

2.3.8 Marital Status

The majority (71 percent) of discharged clients were not married. A slightly higher

proportion of non-hospital residential clients were unmarried compared with outpatient

non-methadone clients. [Table 2.4].

2.3.9 Parental Status

Overall, about 56 percent of discharged clients had children. The pattern was similar for

all types of care. However, only 23 percent of clients had noted in their client record that they

lived with their children. Some 58 percent had noted in their record that they did not live with

their children, and 19 percent of the client records did not have information on whether the client

lived with his or her children. [Table 2.4].

2.3.10 Living Arrangement

The majority of discharged clients lived with either their spouse/partner (27 percent) or

with family or friends (36 percent). Some 13 percent lived alone, 8 percent had no stable living

arrangement, and 5 percent were in correctional facilities or another type of institution. [Table

2.4].

Comparing clients in residential and outpatient non-methadone types of care, more

residential clients did not have a stable living arrangement. Outpatient non-methadone clients

were more likely to be living with their spouse or partner than non-hospital residential clients.
12

2.3.11 Marital Status, Parental Status, and Living Arrangement, by Gender

Among discharged residential and outpatient non-methadone clients, an equal proportion

of men and women were married, but a higher proportion of women (69 percent) had children at

admission than men (53 percent). In addition, a considerably higher proportion of women than

men had children living with them at admission (38 vs. 19 percent). [Table 2.B].

A higher percentage of men than women had no stable living arrangement, and a higher

percentage of women than men tended to be living with family or friends.

2.4 Primary Source of Referral

Substance abuse clients enter the treatment system through different referral sources.

Among discharged clients, the majority of the referrals were either criminal justice referrals (42

percent) or self-referrals (24 percent), with an additional 12 percent of clients who were referred

from health care or social service agencies. Only a small proportion of clients were referred to

treatment by other treatment facilities (9 percent), family or friends (6 percent), or employers (3

percent). [Table 2.5].

Variations by client type of care show that although half of the outpatient non-methadone

clients were referred to treatment by the criminal justice system, only about a third (31 percent)

of non-hospital residential clients were in treatment through this type of referral. Residential

clients were referred to treatment in about equal proportions by the criminal justice system and

through self-referral (about a third each). A very small proportion of methadone clients got into

the treatment system through the criminal justice system (6 percent, CV $ 0.3). Only 5 percent of

discharged methadone clients were referred to treatment by health care or social service agencies

compared with 12 to 14 percent of clients in other types of care. The majority of methadone

clients (62 percent) were self-referred.

2.5 Criminal Justice Information

Involvement with the criminal justice system is one of the problems often associated with

substance abuse. Overall, 39 percent of clients had driving while impaired (DWI) or driving

under the influence (DUI) arrests prior to admission; 53 percent had other types of arrests prior to

admission; 34 percent had a prison or jail record prior to admission; and 46 percent entered

treatment as a condition of probation or parole. [Table 2.6].

A higher proportion of discharged outpatient non-methadone clients than non-hospital

residential clients had DWI/DUI arrests prior to admission and entered treatment as a condition

of probation or parole. The proportions of clients who had arrests other than for DWI/DUI and

the proportions with a prison or jail record were similar in non-hospital residential care and in

outpatient non-methadone care. A higher proportion of outpatient methadone clients had prison

or jail records prior to admission (46 percent) than outpatient non-methadone clients (30

percent).
13

Table 2.B Percentage Distribution of Discharged Residential and Outpatient

Non-Methadone Clients by Marital Status, Parental Status, and Living

Arrangement, by Gender, 1997 - 1998

Client Characteristic

Gender

Male Female

Client Sample Size (n) 3,382 1,135

National 6-Month Estimate 792,749

(73,711)

255,935

(33,425)

Marital Status at Admission [Q17] 100.0 100.0

Married 25.5 (2.59) 25.8 (3.14)

Not married 71.2 (2.48) 72.1 (3.05)

Unknown 3.3 (1.12)* 2.2 (0.067)*

Have Child(ren) at Admission [Q18] 100.0 100.0

Yes 52.6 (2.07) 69.4 (3.98)

No 31.9 (2.05) 23.3 (3.44)

Unknown 15.6 (2.46) 7.4 (1.66)

Living with Child(ren) at Admission [Q19] 100.0 100.0

Yes 18.5 (1.95) 38.4 (3.12)

No 61.4 (2.82) 47.1 (3.40)

Unknown 20.2 (2.87) 14.5 (2.54)

Living Arrangement at Admission [Q20] 100.0 100.0

No stable arrangement 8.7 (1.33) 5.1 (1.27)

With spouse/partner 26.4 (2.39) 30.7 (2.96)

With family or friends 34.2 (2.12) 41.8 (2.58)

Alone 13.2 (1.46) 11.8 (2.68)

Correctional facility or other institution 5.6 (1.45) 2.6 (0.72)

Unknown 12.0 (2.83) 8.0 (2.22)

Note: Standard errors are in parentheses.

Note: Discharge data represent substance abuse treatment discharges during a sample 6-month period between

February 1997 and December 1998 for each sampled facility. Weighted discharges provide a national

estimate of discharges for a 6-month period.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.

2.6 Substance Use and Substance Abuse History

The following section presents information on the substances ever used by clients,

substances used in the 30 days prior to admission, the mean age at first use, substance of choice

at admission, and history of prior substance abuse treatment. As before, not all items can be

estimated for methadone discharge clients.
14

2.6.1 Substances Ever Used

Most discharged clients had used alcohol at some point in their lives prior to admission

(91 percent). Furthermore, 63 percent of clients had used marijuana, 51 percent had used crack or

cocaine, and 24 percent had used heroin and/or other opiates. In addition, 24 percent had used

amphetamines, 21 percent had used hallucinogens, and 15 percent had used sedatives. Inhalants

were used by only 6 percent of discharged clients. [Table 2.7].

Variations by client type of care among discharged clients indicate that outpatient

non-methadone clients were the least likely to have ever used crack/cocaine or opiates. Of

outpatient non-methadone clients, 44 percent of clients compared with 62 percent of non-hospital

residential and 69 percent of outpatient methadone had used crack/cocaine. Furthermore, only 16

percent of this population had used opiates compared with 29 percent of non-hospital residential

and 96 percent of outpatient methadone clients, according to their records. As would be expected,

far more outpatient methadone clients had used opiates compared with clients in other types of

care. Although the majority of clients in treatment had used alcohol at some time prior to

admission, clients in non-hospital residential and outpatient non-methadone treatment were more

likely to have used alcohol than clients in outpatient methadone treatment. Lifetime marijuana

use was fairly similar for all client types of care (overall, 63 percent of discharged clients had

used the substance).

2.6.2 Substances Used in 30 Days Prior to Admission

The patterns of substance use in the 30 days prior to admission were similar to patterns of

"ever used." Half of all discharged clients had used alcohol in the 30 days prior to admission. In

addition, 20 percent of clients had used marijuana, 20 percent had used crack/cocaine, and 11

percent had used heroin and other opiates in the 30 days prior to admission. [Table 2.8].

In the 30 days prior to admission, a significantly lower percentage of outpatient

non-methadone clients used crack/cocaine (14 percent) than non-hospital residential (30 percent)

or outpatient methadone clients (34 percent). In contrast, the great majority of the discharged

methadone clients used opiates in the 30 days prior to admission (76 percent) compared with 13

of non-hospital residential and 4 percent of outpatient non-methadone clients.

2.6.3 Mean Age at First Use

The initiation of substance use tends to occur during the teenage years or early 20s. On

average, inhalants and alcohol were used at an earlier age; the mean age at first use was 15 years

for each. Amphetamines, marijuana, hallucinogens, and over-the-counter drugs, on average, were

first used during the later teenage years (age 16 to 19 years). In contrast, the mean age at first use

for cocaine and heroin was 22 years for both drugs. The patterns were similar by client type of

care. [Table 2.9].
15

2.6.4 Substance of Choice at Admission

Nearly 48 percent of clients entered treatment with alcohol as their primary substance of

choice. Some 16 percent entered treatment with crack/cocaine as their substance of choice at

admission, 12 percent entered with marijuana as their substance of choice, and 6 percent entered

with heroin or some other opiate as their primary substance of choice at admission. [Table 2.10].

In residential type of care, nearly a quarter of the clients were in treatment with

crack/cocaine as their substance of choice, while 41 percent had specified alcohol as their

substance of choice. In outpatient non-methadone type of care, fewer clients had crack/cocaine as

their substance of choice (11 percent), while a higher proportion had specified alcohol as their

substance of choice (51 percent).

2.6.5 Injection Drug Use

Among discharged clients, 11 percent were known to have injected drugs at some time in

their lifetime. A higher proportion of non-hospital residential clients (18 percent) indicated

lifetime injection drug use than outpatient non-methadone clients (8 percent). Lifetime injection

drug use (IDU) was not mentioned in the treatment record for 40 percent of the clients. [Table

2.C].

Table 2.C Percentage Distribution of Lifetime Injection Drug Use (IDU), by Discharged

Client Type of Care, 1997 - 1998

Total, All

Discharged Clients

Client Type of Care

Non-Hospital

Residential

Outpatient

Methadone

Outpatient NonMethadone

Client Sample Size (n) 5,005 880 467 3,658

National 6-Month 

Estimate

1,114,530

(104,353)

349,853

(67,041)

60,336

(15,295)

704,341

(73,147)

Total Clients 100.0 100.0 100.0 100.0

Percentage of Clients 

Who Were Ever

IDUs [Q58a]1

Yes 11.4 (1.59) 17.5 (3.95) 8.4 (1.77)

No 48.3 (3.83) 49.5 (5.74) 47.7 (4.48)

Unknown 40.3 (3.81) 33.1 (3.81) 43.9 (4.49)

Note: Standard errors are in parentheses.

Note: Discharge data represent substance abuse treatment discharges during a sample 6-month period between

February 1997 and December 1998 for each sampled facility. Weighted discharges provide a national

estimate of discharges for a 6-month period.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
16

2.6.6 Treatment History

Multiple treatment episodes are common for substance abuse clients on their path to

recovery. Half of the discharged clients were known to have been in substance abuse treatment at

some point in their lives prior to admission. A higher proportion of discharged non-hospital

residential clients (60 percent) had prior treatment compared with discharged outpatient

non-methadone clients (45 percent). The average number of years over which treatment episodes

were reported for all discharged clients was 4 years. [Table 2.11].

Some 30 percent of discharged clients had been in substance abuse treatment in the 12

months prior to admission, with roughly an equal proportion for non-hospital residential clients

and outpatient non-methadone clients. The mean number of treatment episodes within 12 months

prior to admission to the sampled episode was one.

2.7 Medical Information

Substance abuse treatment clients often have other medical problems in addition to being

chemically dependent. Among discharged clients, 10 percent were known to have had a medical

hospitalization within the 12 months prior to treatment episode. Client records revealed the

following medical conditions: 8 percent indicated high blood pressure, 5 percent indicated heart

disease, 4 percent indicated liver disease, and 4 percent indicated hepatitis or jaundice. Some 31

percent of clients had medications prescribed (excluding methadone) during treatment. A review

of client treatment records indicated that 6 percent of women were known to be pregnant at

admission or during treatment. The percentages of clients with selected medical conditions are

likely to be conservative because not all medical conditions were listed on client records. [Table

2.12].

A difference found by client type of care was that the proportion of residential clients (57

percent) who had medications prescribed during treatment was much higher than the proportion

of outpatient non-methadone clients who had medication prescribed (18 percent).

2.8 Mental Health Characteristics

About a quarter of clients (24 percent) had a history of psychological disorder prior to

admission, and 32 percent of clients had a psychological disorder noted at admission or during

treatment. However, only 5 percent of clients were known to have had a residential and/or

hospital inpatient mental health admission in the 12 months prior to admission. In addition, 12

percent of clients were dually diagnosed at the time of discharge, 10 percent of clients were

known to have been taking anti-depressants, and 2 percent were known to have been prescribed

anti-psychotics. As with medical conditions, the estimates for mental health characteristics are

likely to be conservative because it is unlikely that all mental health information was noted on

the client record. [Table 2.13].
17

2.9 Services Information

Provision of services to substance abuse clients is an essential part of treatment. There are

two broad categories of services, treatment and support services. Treatment services described

here are generally those services that are directly oriented toward treating alcohol or drug abuse,

while support services are generally those services that are directed toward problems associated

with substance abuse or toward keeping the client in treatment. The following section presents

information on selected treatment and support services received by clients during treatment.

2.9.1 Treatment Services

The selected treatment services received by most discharged clients in treatment were

group therapy (79 percent) and individual therapy (71 percent). Comprehensive

assessment/diagnosis was received by 65 percent of the discharged clients, self-help/mutual help

services in connection with the treatment were received by 49 percent of clients, and aftercare

was received by 26 percent of clients. For each of the services studied except acupuncture and

methadone dosing, a significantly larger proportion of non-hospital residential clients received

the service compared with outpatient non-methadone clients. [Tables 2.D and 2.14].

Table 2.D Percentage of Discharged Clients Receiving Counseling and Self-Help

Services, by Client Type of Care, 1997 - 1998

Treatment Services [Q67a-t]

Total, All Discharged

Clients

Client Type of Care

Non-Hospital

Residential

Outpatient NonMethadone

Client Sample Size (n) 5,005 880 3,658

National 6-Month Estimate 1,114,530

(104,353)

349,853

(67,041)

704,341

(73,147)

Counseling and Self-Help 

Services

Individual therapy 70.9 (4.16) 80.6 (4.85) 66.1 (4.73)

Group therapy 78.8 (3.06) 81.6 (5.10) 77.4 (4.28)

Family counseling 18.5 (2.41) 28.4 (5.55) 13.5 (2.41)

Self-help/mutual help 

groups 49.0 (4.84) 65.0 (5.32) 41.1 (5.33)

Note: Standard errors are in parentheses.

Note: Discharge data represent substance abuse treatment discharges during a sample 6-month period between

February 1997 and December 1998 for each sampled facility. Weighted discharges provide a national

estimate of discharges for a 6-month period.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
18

2.9.2 Treatment Completion and Number of Counseling Sessions, by Client Type of

Care

For substance abusers, treatment completion is an important step in the recovery process.

Overall, a slight majority (53 percent) of discharged clients had completed their planned

treatment. A higher proportion of non-hospital residential clients (67 percent) completed

treatment than outpatient non-methadone clients (46 percent). [Table 2.15].

The analysis also compares the median number of counseling sessions received by

treatment completers and non-completers by type of care. Clients who completed treatment

received a greater number of therapy sessions. Treatment completers had a median of 3 sessions

of individual therapy compared with 2 sessions by non-completers. The median number of group

therapy sessions received by completers was 14 compared with 7 sessions for non-completers.

Clients who completed treatment had a median total number of counseling sessions of 16

compared with a median of 6 for clients who did not complete treatment. Any analysis of the

number of counseling sessions by client type of care should be made with caution because most

estimates for the number of counseling sessions for clients in residential care were unstable.

2.9.3 Support Services

Among the support services studied, HIV/AIDS counseling/support/education was

received by the most clients (42 percent of all discharged clients). The following support services

were received by a significantly larger proportion of non-hospital residential clients than

outpatient non-methadone clients: HIV/AIDS counseling/support/education, employment

counseling/training, academic education/GED, and medical care. The difference in services was

most evident in the provision of medical care. Some 45 percent of non-hospital residential clients

received medical care while in treatment compared with 7 percent of outpatient non-methadone

clients. [Table 2.16].

2.10 Methadone Treatment Practices

Methadone dosage and methadone take-home practices, as documented in methadone

client treatment records and abstracted in ADSS Phase II, are presented below. Methadone dose

information is provided for methadone clients at several points during their treatment episode.

The mean daily dosage of methadone for methadone clients at their first treatment was 35

milligrams (mg). The mean daily dosage was 47 mg at 2 weeks after the first treatment and 51

mg at 1 month before the last treatment. At the last treatment, the mean daily dosage for

discharged methadone clients was 38 mg. [Table 2.17].

Take-home supplies of methadone, such as for a weekend, are permitted for some clients

who have been in treatment for a while and who have shown that they are responsible in handling

narcotic drugs. This usually means that they have negative drug tests, attend the clinic regularly,

and have not demonstrated any behavioral problems. Based on information in client records, an

estimated 43 percent of discharged methadone clients had been permitted take-home supplies of

methadone at some point during their treatment episode. [Table 2.17].
19

Note that estimates for methadone dosage for in-treatment methadone clients are

discussed in Chapter 3.

2.11 Average Length of Stay, Duration of Treatment, and Reason for

Discharge

This section presents information on the average length of stay in treatment, average

duration of treatment, and reason for discharge by client type of care. An episode's "length of

stay" value, calculated from the admission date to the discharge date, was generally longer than

its "duration of treatment" value, calculated from the date of the first visit to the date of the last

visit. This was due to a possible lag between an admission date and the date the first treatment

was received, and, more likely, a lag between the last treatment date and the date when an end of

treatment was recognized and a formal discharge was made.

The mean length of stay for all discharged clients was 133 days, or about 4.4 months. The

median for the same variable was only 65 days (about 2 months). Having a mean more than twice

the median indicates a highly skewed distribution with a number of extremely long stays.

Findings were similar for the abstracted episodes' mean and median duration of treatment, but

these measures, as described above, were shorter than for length of stay measures. The mean

duration of treatment for all discharged clients was 105 days, and the median was 42 days. [Table

2.18].

 Length of stay (and duration of treatment) varied with client type of care. Outpatient

methadone clients had the longest average length of stay with a mean of 520 days (17.3 months)

and a median of 168 days (5.6 months). Residential clients had the shortest average length of stay

with a mean of 45 days and a median of 16 days. Outpatient non-methadone clients had a mean

length of stay of 144 days (4.8 months) and a median stay of 94 days (3.5 months).

The percentage of discharged clients who completed treatment also is presented. Overall,

53 percent of clients completed their planned treatment. About a quarter of the clients left

treatment due to their own choice, 9 percent left due to administration choice, and 6 percent were

referred or transferred to another program. An additional 7 percent left for other or unknown

reasons. [Table 2.18].

Residential clients completed treatment at a higher rate than outpatient non-methadone

clients (67 vs. 46 percent, respectively). Conversely, outpatient non-methadone clients were more

likely to leave treatment prematurely by their own choice (i.e., to drop out) (30 vs. 17 percent,

respectively). The "reason for discharge" information was not abstracted for methadone clients.

2.12 Aftercare Information

This analysis also presents information on the level of aftercare services planned for

clients after discharge, as indicated in their treatment records. Overall, 43 percent of the clients

had an aftercare plan specified in their records. A larger percentage of residential clients had an

aftercare plan (61 percent) than did outpatient non-methadone clients (34 percent). [Table 2.19].
20

Specific aftercare services tended not to be noted on client records. Therefore, the

estimates for aftercare services are very conservative. With that caveat, it is noted that about a

third of discharged clients were slated to attend self-help groups, and 15 percent were to have

received relapse prevention services. About 10 percent were expected to receive individual

counseling, and 10 percent were to receive group counseling. Family counseling and support

services, such as employment counseling or legal services, were noted in the aftercare plans for a

very low proportion of clients (below 6 percent for each). Generally, aftercare services were

planned more often for non-hospital residential clients than for outpatient non-methadone clients.

2.13 Expected Primary Source of Payment

Payment for substance abuse treatment is made through various sources. Across all client

types of care, 31 percent of discharged clients' records indicated that the expected primary source

of payment for treatment was client self-pay, 15 percent indicated private health insurance as the

primary payer, 9 percent indicated Medicaid, 2 percent noted Medicare, and 13 percent gave

some other source. Some 15 percent of treatment records did not indicate the primary source of

payment. [Table 2.20].

As to differences by discharged client type of care, a larger percentage of outpatient

non-methadone clients (36 percent) was expected to pay for treatment out of pocket than

outpatient methadone clients (29 percent) and non-hospital residential clients (22 percent).

Outpatient methadone clients (32 percent) were more likely than residential and outpatient nonmethadone clients to have Medicaid listed as the expected primary source of payment.
21

Table 2.1 Abstract Sample Size, National Estimate of Substance Abuse Treatment

Clients, and Percentage Distribution by Client Type of Care, ADSS Phase II

Client Record Abstract Study, 1997 - 1999

Client Type of Care

Number of

Abstracts in

6-Month

Sample (n)

Weighted National Estimate

Number of Discharges,1

6-Month Estimate (N) Percentage Distribution (%)

a. Discharge Sample

Total, All Types of Care 5,005 1,114,530 100.0

Non-hospital residential 880 349,853 31.4

Outpatient methadone 467 60,336 5.4

Outpatient non-methadone 3,658 704,341 63.2

b. In-Treatment Methadone Client Sample

ADSS In-Treatment Methadone

Client Study

Number of

Abstracts in

Sample (n)

Weighted National Estimate for Number of Clients in

Outpatient Methadone Treatment on the 1-Day

Sample Date2

 (Point-Prevalence Estimate) (N)

In-treatment methadone clients 

(outpatient care) 925 172,795 1 Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. 2 In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date between

August 1997 and February 1999 for each sampled methadone facility. Approximately 70 percent of the pointprevalence clients were sampled in 1997, representing 76 percent of the weighted estimate. Weighted

in-treatment methadone clients provide a national estimate of methadone clients in treatment on a given day. The

in-treatment methadone client study includes methadone clients "in treatment" or on the active treatment roster

on the 1-day sample date of each facility.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
22

Table 2.2 Percentage Distribution of Clients by Selected Facility Characteristics, by

Client Type of Care, 1997 - 1999

Facility Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Facility Type of Care 100.0 100.0 100.0 100.0 100.0

Non-hospital residential only 16.5 52.6 - - -

Outpatient methadone only 4.1* - 75.5 - 82.6

Outpatient non-methadone 

only 49.6 - 3.4* 78.3 -

Combination facilities1 29.8 47.4 21.1* 21.7 17.4* 

Facility Ownership 100.0 100.0 100.0 100.0 100.0

Private for-profit 15.9 2.5* 33.4* 21.1 25.6* 

Private non-profit 64.4 71.2 41.2 63.0 51.1

Public 19.7 26.3* 25.4* 16.0 23.3* 

Facility Public Revenue 100.0 100.0 100.0 100.0 100.0

0 - 50% 29.5 29.9* 9.2* 31.0 15.2* 

51- 90% 44.4 35.9* 52.6 48.0 38.0

91 - 100% 23.8 31.7* 36.3* 18.8 46.7

Unknown 2.3* 2.5* 1.94* 2.2* -

Note: Percentages may not add to 100.0 due to rounding.

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Combination facilities are comprised of 50 percent with outpatient non-methadone and inpatient hospital care,

37 percent with outpatient non-methadone and residential care, 5 percent with outpatient methadone and

outpatient non-methadone care, and 8 percent with other combinations of care.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
23

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24

Table 2.3 Mean and Median Age and Percentage Distribution of Clients by Selected

Client Characteristics, by Client Type of Care, 1997 - 1999

Client Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

NonHospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Average Age

Mean age 34.1 34.4 36.8 33.7 38.3

Median age 33.4 35.6 33.0 33.7 38.0

Age in Years [Q12-13] 100.0 100.0 100.0 100.0 100.0

Under 20 9.2 8.4* 0.5* 10.4 0.7* 

20-24 10.3 8.9 4.6 11.5 4.7

25-29 14.4 14.5 13.4 14.4 10.4

30-34 18.4 19.0 21.5 17.8 16.6

35-39 18.9 19.6 21.4 18.3 22.9

40-44 12.2 13.8 19.7 10.8 23.8

45-49 7.7 8.2* 11.8 7.1 13.4

50-54 4.0 3.9 4.1* 4.0 4.4* 

55 or over 4.1 3.5* 1.6* 4.7 3.0

Unknown 0.8* 0.3* 1.5* 1.0* 0.3* 

Race [Q15] 100.0 100.0 100.0 100.0 100.0

White 63.7 57.2 44.2 68.6 49.6

Black 21.7 32.7 29.3* 15.5 27.0

Other 4.8 3.9* 11.0 4.7* 9.8* 

Unknown 9.9 6.2* 15.4 11.3 13.6* 

Ethnicity [Q16] 100.0 100.0 100.0 100.0 100.0

Hispanic 11.1 8.2* 28.1 11.0 26.6

Not Hispanic 59.7 63.9 51.8 58.2 56.7

Unknown 29.3 27.9 20.2* 30.8 16.7* 

Gender [Q14] 100.0 100.0 100.0 100.0 100.0

Male 74.2 76.9 56.2 74.3 62.2

Female 25.3 22.9 43.7 25.0 37.7

Unknown 0.5* 0.2* 0.1* 0.7* 0.1* 

(continued)
Table 2.3 Mean and Median Age and Percentage Distribution of Clients by Selected Client

Characteristics, by Client Type of Care, 1997 - 1999 (continued)

Client Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

NonHospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

25

Education at Admission [Q21]1 100.0 100.0 100.0 100.0

Less than high school 31.0 34.8 31.7 40.4

High school graduate/GED 34.0 37.3 35.3 33.8

Some college 17.0 17.2 18.2 17.4

College graduate or higher 4.6 4.9 4.8 4.4* 

Unknown 13.4 5.8* 9.9 4.1

Employment at Admission 

[Q23] 100.0 100.0 100.0 100.0 100.0

Employed full time (35 

hr/wk or more) 28.0 18.4 15.7 33.8 19.7

 Employed part time or 

unknown level 12.8 6.1 14.0 16.0 12.5

 Unemployed 41.9 56.2 54.9 33.6 51.8

Other status (e.g., retired, 

incarcerated) 10.9 14.9 10.0* 8.9 12.6

 Unknown 6.6 4.3* 5.4* 7.8 3.5* 

Receiving SSI Benefits at 

Admission [Q11] 100.0 100.0 100.0 100.0 100.0

Yes 5.8 7.9 12.0 4.3 45.7

No 52.7 52.8 47.5 53.1 18.6

Unknown 41.5 39.3 40.5 42.6 35.7

Note: Percentages may not add to 100.0 due to rounding.

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
26

Table 2.4 Percentage Distribution of Clients by Marital Status, Parental Status, and

Living Arrangement, by Client Type of Care, 1997 - 1999

Client Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Marital Status at Admission 

[Q17]1 100.0 100.0 100.0 100.0

Married 25.5 21.0 27.7 30.1

Not married 71.2 77.4 68.1 67.2

Unknown 3.3 1.5* 4.2* 2.7* 

Have Child(ren) at Admission 

[Q18]1 100.0 100.0 100.0 100.0

Yes 56.4 59.0 55.1 68.6

No 29.8 31.0 29.2 23.1

Unknown 13.8 10.0 15.7 8.3

Living with Child(ren) at 

Admission [Q19]1 100.0 100.0 100.0 100.0

Yes 23.2 18.4 25.6 32.2

No 57.8 63.8 54.8 49.9

Unknown 19.0 17.8 19.6 17.9

Living Arrangement at 

Admission [Q20]1 100.0 100.0 100.0 100.0

No stable arrangement 7.8 13.6 5.0 2.4

With spouse/partner 27.3 20.0 30.9 35.0

With family or friends 35.9 32.0 37.8 37.7

Alone 12.7 12.5 12.9 13.7

Jail or prison or other

institution 4.8 9.8* 2.4 0.3* 

Unknown 11.4 12.2* 11.1 10.8

Note: Percentages may not add to 100.0 due to rounding.

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
27

Table 2.5 Percentage Distribution of Clients by Primary Source of Referral, by Client

Type of Care, 1997 - 1999

Primary Referral Source

[Q9]

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Primary Referral Source 

[Q9] 100.0 100.0 100.0 100.0 100.0

Other treatment facility 8.9 10.7 11.0 7.8 18.7

Criminal justice system 42.3 31.3 5.6* 50.8 4.0* 

Self 23.7 32.6 61.6 16.1 51.8

Family/friends 5.9 6.5* 8.8* 5.4 12.5* 

Employer 2.7 0.9* 0.1* 3.8 -

Health care or social 

service agencies 12.2 14.1 5.0 11.9 5.5

Unknown 4.3 4.0* 7.9* 4.2 7.7

Note: Percentages may not add to 100.0 due to rounding.

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
28

Table 2.6 Percentage Distribution of Clients by Criminal Justice System Status, by Client

Type of Care, 1997 - 1999

Criminal Justice System

Status

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

DWI/DUI Arrests Prior to 

Admission [Q25]1 100.0 100.0 100.0 100.0

Yes 39.4 23.4 47.3 8.3

No 26.7 29.6 25.3 42.4

Unknown 33.9 47.0 27.4 49.3

Other Arrests Prior to 

Admission [Q26]1 100.0 100.0 100.0 100.0

Yes 52.7 57.4 50.3 59.7

No 22.5 19.5 24.0 23.4

Unknown 24.9 23.2 25.7 16.9

Prison or Jail Record Prior 

to Admission [Q27] 100.0 100.0 100.0 100.0 100.0

Yes 33.5 37.9 45.7 30.3 38.2

No 29.5 26.5 32.3 30.8 35.2

Unknown 37.0 35.7 22.0 39.0 26.6

Receiving Substance Abuse 

Treatment as a

Condition of Probation

or Parole [Q28]1 100.0 100.0 100.0 100.0

Yes 46.2 33.1 52.7 6.3

No 34.0 42.9 29.6 61.2

Unknown 19.8 24.0 17.7 32.5

Note: Percentages may not add to 100.0 due to rounding.

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
29

Table 2.7 Percentage of Clients Ever Using Each Substance Prior to Admission, by Client

Type of Care, 1997 - 1999

Substance [Q40-Q56]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Substance Used Ever

Crack2

/cocaine 50.8 61.9 69.1 43.8 71.5

Opiates (heroin/nontreatment methadone/

other opiates) 24.4 28.7 95.5 16.2 98.7

Sedatives2

 (barbiturates, 

benzodiazepines, other

sedatives or hypnotics) 14.9 17.1 13.8 33.0

Amphetamines2 23.5 24.0 23.2 16.1

Marijuana, hashish, THC 63.3 60.2 55.7 65.5 52.4

Hallucinogens2 20.7 21.9 20.2 16.2

Inhalants2 5.8 6.6 5.4 1.6* 

Over-the-counter2 1.5 0.9* 1.8 2.0* 

Alcohol 91.4 91.3 60.4 94.2 63.6

Other drugs2 2.6 3.4* 2.2 4.0* 

Not specified2 0.8* 0.2* 1.0* 0.5* 

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Clients may be counted in more than one substance category. 2 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
30

Table 2.8 Percentage of Clients Using Each Substance During the 30 Days Prior to

Admission, by Client Type of Care, 1997 - 1999

Substance [Q40-Q56]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Substance Used Prior 30 

Days

Crack2

/cocaine 20.2 30.3 33.6 14.1 25.9

Opiates (heroin/nontreatment methadone/

other opiates) 10.7 13.0 75.9 4.0 69.7

Sedatives2

 (barbiturates, 

benzodiazepines, other

sedatives or hypnotics) 4.0 5.8 3.0 9.0* 

Amphetamines2 6.1 7.7 5.2* 1.2* 

Marijuana, hashish, THC 20.2 23.3 16.8* 19.0 9.6

Hallucinogens2 1.9 2.3* 1.7 0.3* 

Inhalants2 0.5* 1.0* 0.3* 0.1* 

Over-the-counter2 0.4* 0.1* 0.6* 0.3* 

Alcohol 50.4 62.7 25.3* 46.4 17.7

Other drugs2 1.1 1.5* 0.8* 1.6* 

Not specified2 27.4 17.9 32.1 17.9

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Clients may be counted in more than one substance category. 2 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
31

Table 2.9 Mean Age at First Use of Substance, by Client Type of Care, 1997 - 1999

Substance [Q40-Q56]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

NonHospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Mean Age in Years

Substance Used

Crack2

/cocaine 22.3 23.1 22.5 21.6 23.4

Opiates (heroin/nontreatment methadone/

other opiates 22.4 22.8 22.2 22.2 20.9

Sedatives2

 (barbiturates, 

benzodiazepines, other

sedatives or hypnotics) 21.4 22.0 21.1 22.4

Amphetamines2 19.1 20.2 18.6 19.5

Marijuana, hashish, THC 15.8 15.1 15.6 16.1 16.0

Hallucinogens2 16.9 17.0 16.9 17.5

Inhalants2 14.7 14.7 14.7 14.2

Over-the-counter2 18.7 12.4* 19.1 19.5

Alcohol 15.3 14.8 15.4 15.6 15.3

Other drugs2 21.5 24.1 19.7 21.6

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Age calculated among clients with reported use. Client may be counted in more than one substance category. 2 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
32

Table 2.10 Percentage Distribution of Clients by Substance of Choice at Admission, by

Client Type of Care, 1997 - 1999

Substance of Choice [Q57]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

NonHospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Total Clients 100.0 100.0 100.0 100.0

Substance of Choice

Crack/cocaine 15.5 23.7 11.3 1.3*

Opiates (heroin/nontreatment methadone/

other opiates 5.6 10.2* 3.4 89.4

Sedatives (barbiturates, 

benzodiazepines, other

sedatives or hypnotics) 0.3* 0.3* 0.2* 0.3*

Amphetamines 3.2 4.3* 2.6 -

Marijuana, hashish, THC 11.9 8.7* 13.5 -

Hallucinogens 0.3* 0.6* 0.1* 0.1*

Inhalants 0.2* 0.2* 0.2* -

Over-the-counter 0.2* 0.4* 0.0* 0.1*

Alcohol 47.8 41.3 51.1 0.1*

Other drugs 0.1* - 0.1* -

Unknown 15.0 10.3 17.4 8.6*

Note: Percentages may not add to 100.0 due to rounding.

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
33

Table 2.11 Percentage of Clients with Prior Substance Abuse Treatment History and

Characteristics of Treatment History, by Client Type of Care, 1997 - 1999

Treatment History

Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Percentage of Clients with 

Prior Substance Abuse

Treatment History [Q63]1 49.7 59.9 44.7 74.7

Mean number of treatment 

episodes at any time prior

to admission [Q63]1

For all clients 1.9 2.7 1.4 3.0

For clients with prior 

substance abuse treatment

history 2.7 3.6 2.2 3.4

Average number of years 

over which treatment

episodes were reported

[Q64]1 4.3 4.9 4.0 6.1

Percentage of Clients with 

Substance Abuse

Treatment History in the

12 Months Prior to

Admission [Q65]1 29.5 31.8 28.3 49.2

Mean number of treatment 

episodes in the 12 months

prior to admission [Q65]1

For all clients 0.9 1.0 0.9 0.9

For clients with substance 

abuse episode(s) in the

past 12 months 1.3 1.4 1.3 1.1

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
34

Table 2.12 Percentage of Clients with Selected Medical Characteristics, by Client Type of

Care, 1997 - 1999

Medical Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

NonHospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Had a Medical 

Hospitalization in the 12

Months Prior to Admission

[Q29]1 10.0 12.5 8.8 10.7

Had Medical Condition(s) 

Prior to Admission or

During Treatment [Q30]1

AIDS or HIV seropositive 0.7* 0.9* 0.5* 8.1

STD (other than AIDS) 2.2 3.1 1.7 11.4

Hepatitis or jaundice 4.0 5.6 3.3 18.9

Positive TB test 2.1 4.0* 1.2* 9.4

Active TB 0.2* 0.3* 0.2* 0.9* 

TB, not otherwise specified 0.4* 0.4* 0.4* 1.0* 

Heart disease 4.8 5.7 4.4 4.4* 

High blood pressure 7.5 7.7 7.4 11.6

Liver disease 3.9 6.5* 2.7 5.8

Convulsions 2.9* 4.2* 2.2* 2.4

Had Medications Prescribed 

During Treatment

Excluding Methadone

[Q68]1 30.7 56.9 17.7 41.2

Pregnancy Status of Female 

Clients at Admission [Q36]

or During Treatment

[Q37]1 100.0 100.0 100.0 100.0 100.0

Pregnant 6.2 9.6* 4.3* 4.9 12.4

Not pregnant 64.0 74.2 65.6 59.2 62.8

Unknown/Not mentioned in 

record 29.8 16.2 30.1* 36.0 24.8

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December 1998 for

each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month period. In-treatment

methadone data represent the 1-day point-prevalence client cohort on a sample date between August 1997 and February

1999 for each sampled methadone facility. Weighted in-treatment methadone clients provide a national estimate of

methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should be

interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of Applied

Studies.
35

Table 2.13 Percentage of Clients with Selected Mental Health Characteristics, by Client

Type of Care, 1997 - 1999

Psychological Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Had Residential and/or 

Hospital Inpatient Mental

Health Admission in 12

Months Prior to Admission

[Q35]1 5.4 6.8* 4.7 1.9* 

Had History of Psychological 

Disorder(s) Prior to

Admission [Q31] 23.7 30.8 20.3 20.4 20.7

Had Psychological 

Disorder(s) at Admission

or During Treatment

[Q33]1 32.1 39.2 28.7 30.3

Taking Anti-Depressant or 

Anti-Psychotic

Prescription Medications

at Admission [Q32]1

Anti-depressant2 10.3 12.9 9.1 9.4

Anti-psychotic2 1.8 2.6* 1.4* 0.7* 

None 49.2 59.5 44.1 59.7

Unknown 39.4 26.4 45.9 30.3

Dual-Diagnosis Client at 

Discharge [Q75]1 12.0 16.8 9.7 3

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients. 2 Note that clients can be taking both anti-depressants and anti-psychotics. 3 Question 75 is a discharge question and not relevant for the in-treatment methadone clients who are still in

treatment.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
36

Table 2.14 Percentage of Clients Receiving Selected Treatment Services, by Client Type

of Care, 1997 - 1999

Treatment Service [Q67a-t]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Treatment Services

Methadone dosing 0.3* 0.8* 0.1* 99.2

Individual therapy 70.9 80.6 66.1 97.2

Group therapy 78.8 81.6 77.4 56.2

Family counseling 18.5 28.4 13.5 9.3* 

Self-help/mutual help 

groups 49.0 65.0 41.1 35.6

Comprehensive 

assessment/diagnosis 64.6 75.3 59.3 75.2

Detoxification 14.5 36.3 3.7 15.5

Combined substance abuse 

and mental health

treatment 18.7 26.9 14.7 19.3* 

Acupuncture 1.3* 0.6* 1.7* 1.4* 

Outcome follow-up 15.8 30.6 8.4 0.6* 

Aftercare 25.7 41.9 17.6 3.5* 

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
37

Table 2.15 Percentage of Clients Completing Treatment and Median Number of

Counseling Sessions by Completion Status, by Client Type of Care, 1997 -

1998

Completion Status

6-Month Discharged Client Group

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658

National 6-Month Estimate 1,114,530 349,853 60,336 704,341

Percentage Completing Treatment 

[Q73]1 52.6 66.6 45.7

Median Number of Counseling Sessions 

Received [Q67]1

By Completers

Individual therapy 3 4 3

Group therapy 14 11* 15

Family therapy 2* 2* 2*

Total number of counseling sessions 16 12* 17

By Non-Completers

Individual therapy 2 3* 2

Group therapy 7 14* 7

Family therapy 2* 3* 1

Total number of counseling sessions 6 10* 6

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
38

Table 2.16 Percentage of Clients Receiving Selected Support Services, by Client Type of

Care, 1997 - 1999

Support Service [Q67a-t]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Support Services

HIV/AIDS counseling/

support/education 41.9 54.1 35.8 82.2

Employment counseling/

training 6.8 14.1 3.1* 21.9

Academic education/GED 4.9* 11.7* 1.5* 3.2* 

Medical care 19.7 44.5 7.3 53.8

TB screening 28.0 41.6 21.2 73.7

TB treatment 0.4* 0.7* 0.3* 3.3* 

Prenatal care 0.7* 1.6* 0.3* 1.8* 

Psychological testing 14.4 18.8* 12.2 24.4* 

Smoking cessation 5.4* 12.7* 1.8* 2.9* 

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
39

Table 2.17 Methadone Treatment Practices (Mean Daily Methadone Dose and

Percentage of Clients Who Received Take-Home Methadone) for Discharged

Methadone Clients, 1997 - 1998

Methadone Treatment Practices Discharged Methadone Clients

Client Sample Size (n) 467

National 6-Month Estimate 60,336

Methadone Treatment - Mean Daily Dose (mg) [Q69a-d]

At first treatment 35.0 mg

Two weeks after first treatment 47.0

One month before last treatment 51.2

At last treatment 37.7

Percentage of Clients Who Received Take-Home Methadone 

[Q70] 42.5%

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
40

Table 2.18 Average Length of Stay, Average Duration of Treatment, and Reason for

Discharge, by Client Type of Care, 1997 - 1998

Completion Status

6-Month Discharged Client Group

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658

National 6-Month Estimate 1,114,530 349,853 60,336 704,341

Average Length of Stay (Days) [Q5-

Q2]1

Mean (days) 133.0 44.8 519.8 143.9

Median (days) 65.0 16.0* 168.0 94.0

Average Duration of Treatment 

(Days)2

 [Q4-Q3]

Mean (days) 104.7 40.4 509.3 103.5

Median (days) 42.0 14.0* 154.0* 62.0

Percentage Distribution of Reasons for 

Discharge [Q73] 100.0% 100.0% 100.0%

Completed planned treatment 52.6 66.6 45.7

Did not complete treatment:

Referred/transferred to another

program 6.4 4.8* 7.2

Facility administration choice 8.6 7.8* 9.0

Client choice (drop out) 25.6 17.3 29.6

Other 4.1 1.6* 3.2

Unknown 2.8 2.0* 5.3

Note: Percentages may not add to 100.0 due to rounding.

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Length of stay is calculated from admission date to discharge date. 2 Duration of treatment is calculated from date of first visit to date of last visit as noted in the client's treatment

record.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
41

Table 2.19 Percentage of Discharged Clients with Aftercare Plan and Selected Aftercare

Services, by Client Type of Care, 1997 - 1998

Aftercare Plan/Service

6-Month Discharged Client Group

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658

National 6-Month Estimate 1,114,530 349,853 60,336 704,341

Percentage of Clients with Aftercare 

Plan [Q76]1 42.7 61.0 33.6

Percentage of Clients with Selected 

Services in Aftercare Plan [Q77a-g]1

Individual therapy 10.2 18.2* 6.2

Group therapy (not including relapse 

prevention) 10.2 14.5 8.0

Relapse prevention 14.8 22.1 11.1

Family counseling 5.6 10.3* 3.2* 

Self-help groups 33.1 50.5 24.5

Support services (e.g., employment 

counseling) 3.7 7.2* 1.9

Note: Percentages may not add to 100.0 due to rounding.

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
42

Table 2.20 Percentage Distribution of Clients by Expected Primary Source of Payment,

by Client Type of Care, 1997 - 1999

Expected Primary Payment

Source [Q10]

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

NonHospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Client Sample Size (n) 5,005 880 467 3,658 925

National 6-Month Estimate 1,114,530 349,853 60,336 704,341 172,795

Expected Primary Payment 

Source [Q10] 100.0 100.0 100.0 100.0 100.0

No payment 4.9* 2.6* 2.0* 6.2* 0.6* 

Client self-payment 31.0 21.5 28.8 35.9 31.0* 

Private health insurance 15.2 15.0* 4.8* 16.2 3.9* 

Criminal justice system 10.2* 11.7* - 10.3* 0.3* 

Medicaid 8.8 6.8* 32.2 7.9 45.6

Medicare 2.4 3.7* 0.5* 1.9* 1.0* 

Other 12.7 23.2* 18.5* 7.0 6.7* 

Unknown 14.8 15.6* 13.3* 14.6 10.8

Note: Percentages may not add to 100.0 due to rounding.

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
43

Chapter 3. Findings on ADSS In-Treatment Methadone

Clients

The analyses conducted for the discharged cohort were also conducted for the

in-treatment methadone clients, who comprise a cross section of clients in treatment on the

sample date for each facility. However, information about treatment completion, discharge, and

aftercare were not yet determined for clients still in treatment and thus were not available for

abstraction. Table 2.1 in Chapter 2 indicates that the 925 in-treatment methadone abstracts

represented a point-prevalence national estimate of 172,795 in-treatment methadone clients.

3.1 In-Treatment Methadone Clients, by Facility Characteristics

The last column of Table 2.2 in Chapter 2 shows that 83 percent of in-treatment

methadone clients were treated at outpatient facilities that treated only methadone clients. The 17

percent who were not treated at methadone-only facilities were treated at facilities that offered

both outpatient methadone and outpatient non-methadone treatment.

The majority of in-treatment methadone clients (51 percent) were treated at facilities that

had private non-profit ownership. Most were treated in facilities that were largely funded by

public revenue. Some 47 percent were in facilities with public revenue for 91 to 100 percent of

their funding, and 38 percent were in treatment at facilities that had 51 to 90 percent public

revenue.

3.2 Client Demographics and Background Information

The last columns of Tables 2.3 and 2.4 in Chapter 2 show the demographic and

background client characteristics for the ADSS Phase II in-treatment methadone clients.

3.2.1 Age, Race, Ethnicity, and Gender

Both the mean and median age of in-treatment methadone clients was 38 years. About 15

percent were under 30 years old. Some 40 percent of this cohort were in their 30s; 37 percent

were in their 40s; and about 7 percent were 50 or older. Note that the estimates for the under 20

and age 50 to 54 groups are unstable due to high coefficients of variation (CVs). Half of the

in-treatment methadone clients were white, and about a quarter were black. Some 27 percent of

in-treatment methadone clients were Hispanic. About 38 percent were female. [Table 2.3].

3.2.2 Education, Employment, and SSI Status

Forty percent of in-treatment methadone clients had less than a high school education, 34

percent had graduated from high school or had earned their GED, and 17 percent had some

college. Nearly 52 percent of in-treatment methadone clients were unemployed. Some 20 percent

were employed full time, and 12 percent were either employed part time or indicated an unknown

level. Close to a half (46 percent) of in-treatment methadone clients were receiving supplemental

security income (SSI) benefits at admission. [Table 2.3].
44

3.2.3 Family Status and Living Arrangement

About 67 percent of in-treatment methadone clients were not married, 30 percent were

married, and the remaining 3 percent had unknown marital status. [Table 2.4].

In-treatment methadone clients were more likely to have children than not (69 vs. 23

percent). However, about 50 percent of the clients did not live with their children at admission.

The majority of in-treatment methadone clients either lived with family or friends or with their

spouse or partner (38 percent and 35 percent, respectively). A small percentage lived alone (14

percent) or had no stable living arrangement (2 percent).

3.3 Primary Source of Referral

Over one half (52 percent) of in-treatment methadone clients were self-referred, and

almost a fifth (19 percent) were referred from another treatment facility. The percentage of

referrals from health care or social service agencies was low (6 percent). Referrals by family and

friends accounted for 13 percent, while criminal justice referrals were low at 4 percent (note that

the CVs for both of these estimates were high). [Table 2.5].

3.4 Criminal Justice Information

Only 8 percent of in-treatment methadone clients had driving while impaired (DWI) or

driving under the influence (DUI) arrests prior to admission. Some 60 percent had arrests other

than DWI/DUI arrests prior to admission, and 38 percent had a prison or jail record prior to

admission. Although 61 percent of in-treatment methadone clients did not enter treatment as a

condition of probation or parole, 6 percent did, and 32 percent had treatment records that did not

note whether treatment was a condition of the criminal justice system. [Table 2.6].

3.5 Substance Use and Substance Abuse History

The following section presents information on the substances that had ever been used by

in-treatment methadone clients prior to admission, the clients' substance use in the 30 days prior

to their admission, their mean age at first use, their indicated substance of choice at admission,

and their prior drug treatment history.

3.5.1 Substances Ever Used

As expected, the records of almost all in-treatment methadone clients (99 percent)

reported use of some type of opiate at some point in their lives. A high percentage (72 percent)

had also used crack or cocaine. Alcohol and marijuana were other substances that had been used

by a majority of in-treatment methadone clients (64 and 52 percent, respectively). Sedatives were

used by a third of in-treatment methadone clients, while 16 percent had ever used amphetamines

and 16 percent had used hallucinogens. [Table 2.7].
45

3.5.2 Substances Used in 30 Days Prior to Admission

Substances used among in-treatment methadone clients 30 days prior to admission were

similar to those that they reported having ever used in their lifetime. In the month prior to

entering treatment, the majority of in-treatment methadone clients used some type of opiate (70

percent). Opiate use was followed by crack or cocaine use (26 percent), alcohol use (18 percent),

and marijuana use (10 percent). [Table 2.8].

3.5.3 Mean Age at First Use

Among in-treatment methadone clients, the initiation of the use of most substances

usually occurred during their teenage years. The mean age at first use of inhalants was 14 years.

Alcohol was used for the first time, on average, by this cohort at age 15. Marijuana use started,

on average, at age 16 and hallucinogens use at age 18. Amphetamines and over-the-counter drugs

were used for the first time by in-treatment methadone clients at age 20. The use of opiates

started, on average, at the age of 21, while crack or cocaine was first used, on average, at age 23

and sedatives at age 22. [Table 2.9].

3.5.4 Substance of Choice at Admission

Opiates were the substance of choice for most in-treatment methadone clients (89

percent). A high percentage was expected because methadone treatment was developed as a

treatment for long-term heroin addiction. About 9 percent of the in-treatment methadone clients

had records that did not indicate their substance of choice at admission. [Table 2.10].

3.5.5 Injection Drug Use

About 73 percent of in-treatment methadone clients were known to have injected drugs at

some time prior to admission, and 48 percent were known to be injection drug users (IDUs) at

admission. An estimated 37 percent were engaging in injection drug use on a daily basis. These

estimates are probably conservative because a considerable percentage of abstracted in-treatment

methadone client records did not contain detailed information on injection drug use. [Table 3.A].

3.5.6 Treatment History

The ADSS client record abstract study collected information noted in the clients' records

about prior substance abuse treatment episodes. Nearly 75 percent of in-treatment methadone

clients had had prior substance abuse treatment some time before admission. The average

number of years over which treatment episodes were reported for in-treatment methadone clients

was 6 years. Among in-treatment methadone clients, the average number of prior treatment

episodes was three. [Table 2.11].

Nearly half (49 percent) of the in-treatment methadone clients had been in treatment

during the 12 months prior to admission. The mean number of treatment episodes during the 12

months prior to admission was one.
46

Table 3.A Percentage Distribution of In-Treatment Methadone Clients, by Injection

Drug Use (IDU), 1997 - 1999

Injection Drug Use In-Treatment Methadone Clients

Client Sample Size (n) 925

National 6-Month Estimate 172,795

(32,557)

Percentage of Clients Who Were Ever IDUs [Q58a] 100.0

Yes 73.3 (3.44)

No 11.5 (2.83)

Unknown 15.2 (2.74)

Percentage of Clients Who Were IDUs at Admission [Q58b] 100.0

Yes 48.2 (3.00)

No 14.2 (1.92)

Unknown 37.6 (2.89)

Frequency of Injection Drug Use at Admission [Q58c] 100.0

Daily 37.2 (3.12)

Regularly, not daily 4.0 (1.23)*

Sporadically 0.4 (0.19)*

Unknown 58.5 (3.39)

Note: Standard errors are in parentheses.

Note: In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date between

August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment methadone

clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.

3.6 Medical Information

As with discharged client records, the percentages of in-treatment methadone clients with

selected medical conditions are conservative estimates because client treatment records may not

indicate all medical problems. Among in-treatment methadone clients, 11 percent were known to

have had a medical hospitalization in the 12 months prior to admission. The medical conditions

most noted from in-treatment methadone clients' records were hepatitis or jaundice (19 percent),

high blood pressure (12 percent), sexually transmitted diseases (STDs) other than AIDS (11

percent), a positive TB test (9 percent), AIDS or HIV seropositivity (8 percent), and liver disease

(6 percent). Among in-treatment methadone clients, 41 percent had medications prescribed to

them during treatment (excluding methadone). [Table 2.12].

An estimated 12 percent of the females in the in-treatment methadone group were

pregnant at the time of admission or during treatment. Some 63 percent had records that noted
47

that they were not pregnant, and 25 percent had records that did not mention their pregnancy

status.

3.7 Mental Health Characteristics

As with medical conditions, the estimates for mental health characteristics are likely to be

conservative. About 21 percent of in-treatment methadone clients were known to have a history

of a psychological disorder prior to admission, and 30 percent had a psychological disorder at the

time of admission or during treatment. About 9 percent took anti-depressants at the time of

admission. [Table 2.13].

3.8 Services Information

The following section presents information on services received by in-treatment

methadone clients during treatment.

3.8.1 Treatment Services

The selected treatment services received by most in-treatment methadone clients

according to treatment records were methadone dosing (99 percent), individual therapy (97

percent), comprehensive assessment/diagnosis (75 percent), and group therapy (56 percent). All

other treatment services were received by less than 20 percent of the in-treatment methadone

clients, with the exception of self-help/mutual help groups, which were attended by 36 percent of

the clients. [Table 2.14].

3.8.2 Support Services

Several of the selected support services were received by a majority of in-treatment

methadone clients. HIV/AIDS counseling/support/education was received by 82 percent of these

clients, while 74 percent received TB screening and 54 percent received medical care. In

addition, 22 percent of in-treatment methadone clients received employment counseling/training,

and 24 percent received psychological testing (CV $ 0.3). [Table 2.16].

3.9 Expected Primary Source of Payment

Payment for methadone treatment is derived from a number of sources; however, 46

percent of the records for in-treatment methadone clients indicated that the expected primary

source of payment was Medicaid. [Table 2.20].

3.10 Methadone Treatment Practices

Characteristics of the methadone treatment also were examined for in-treatment

methadone clients. The mean dosage at first treatment (meaning early in the treatment episode)

for in-treatment methadone clients was 43 milligrams (mg) per day and the median dose was 30

mg per day. The distribution for the first treatment is generally skewed toward the lower end. The
48

mean daily dosage at 2 weeks after the first treatment was 57 mg, and the median daily dose was

54 mg. The mean current dose (at the point during treatment when the cross section of intreatment clients was sampled) was 67 mg, and the median current dose was 68 mg. [Table 3.1].

The 75th percentile was 84 mg. Therefore, half of the in-treatment methadone clients had

a current daily dose of 68 mg or higher, and a quarter of them were receiving a daily dose of 84

mg or higher.

Table 3.1 Methadone Treatment Practices (Average Daily Methadone Dose) for

In-Treatment Methadone Clients, 1997 - 1999

Methadone Treatment Practices In-Treatment Methadone Clients

Client Sample Size (n) 925

National 6-Month Estimate 172,795

Daily Dose at First Treatment (mg) [Q69a]

Mean 43.2 mg

25th percentile 29.0

50th percentile 30.0

75th percentile 53.0

Daily Dose at 2 Weeks After First Treatment (mg) [Q69b]

Mean 57.1 mg

25th percentile 40.0

50th percentile 54.0

75th percentile 68.0

Current Dose1

 (mg) [Q69d]

Mean 66.9 mg

25th percentile 49.0

50th percentile 68.0

75th percentile 84.0

Note: In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date between

August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment methadone

clients provide a national estimate of methadone clients in treatment on a given day.

1 The most recent dose at the time the cross section of in-treatment methadone clients was sampled.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
49

Appendix A

Standard Error Tables
50
51

Table 2.1C Standard Errors - National Estimate of Substance Abuse Treatment Clients

and Percentage Distribution by Client Type of Care, ADSS Phase II Client

Record Abstract Study, 1997 - 1999

Client Type of Care

Standard Error for Weighted National Estimate

Number of Discharges,1

6-Month Estimate (N) Percentage Distribution (%)

a. Discharge Sample

Total, All Types of Care 104,352.88 .

Non-hospital residential 67,041.36 4.38

Outpatient methadone 15,294.68 1.35

Outpatient non-methadone 73,147.12 4.71

b. In-Treatment Methadone Client Sample

ADSS In-Treatment Methadone Client Study

Standard Error for Weighted National Estimate for

Number of Clients in Outpatient Methadone Treatment

on the 1-Day Sample Date2

 (Point-Prevalence Estimate)

(N)

In-treatment methadone clients (outpatient care) 32,557.53

1 Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. 2 In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date between

August 1997 and February 1999 for each sampled methadone facility. Approximately 70 percent of the

point-prevalence clients were sampled in 1997, representing 76 percent of the weighted estimate. Weighted

in-treatment methadone clients provide a national estimate of methadone clients in treatment on a given day. The

in-treatment methadone client study includes methadone clients "in treatment" or on the active treatment roster

on the 1-day sample date of each facility.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
52

Table 2.2C Standard Errors - Percentage Distribution of Clients by Selected Facility

Characteristics, by Client Type of Care, 1997 - 1999

Facility Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Facility Type of Care

Non-hospital residential only 3.50 8.85 . . .

Outpatient methadone only 1.31* . 8.93 . 6.25

Outpatient non-methadone 

only 4.14 . 2.53* 4.75 .

Combination facilities1 3.64 8.85 8.93* 4.75 6.25*

Facility Ownership

Private for-profit 3.53 2.74* 15.82* 4.96 14.10*

Private non-profit 5.21 12.83 11.68 5.71 11.13

Public 4.68 12.65* 13.58* 4.38 13.39*

Facility Public Revenue

0 - 50% 6.11 12.12* 7.25* 5.64 11.19*

51- 90% 5.55 11.79* 10.63 6.11 9.33

91 - 100% 4.47 10.45* 10.98* 5.07 9.58

Unknown 1.80* 2.74* 2.08* 2.15* .

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Combination facilities are comprised of 50 percent with outpatient non-methadone and inpatient hospital care,

37 percent with outpatient non-methadone and residential care, 5 percent with outpatient methadone and

outpatient non-methadone care, and 8 percent with other combinations of care.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
53

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54

Table 2.3C Standard Errors - Mean and Median Age and Percentage Distribution of

Clients by Selected Client Characteristics, by Client Type of Care, 1997 -

1999

Client Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Average Age

Mean age 0.40 1.06 0.53 0.59 0.94

Median age 0.42 0.98 0.67 0.53 1.24

Age in Years [Q12-13]

Under 20 1.63 3.58* 0.34* 1.76 0.40*

20-24 0.86 1.89 1.29 1.10 0.81

25-29 1.18 2.50 3.24 1.22 1.42

30-34 0.77 1.53 2.69 1.15 2.81

35-39 1.08 2.15 2.76 1.24 3.30

40-44 1.23 2.24 4.31 1.12 2.86

45-49 0.89 2.56* 1.38 0.81 2.41

50-54 0.47 0.88 1.33* 0.65 1.34*

55 or over 0.58 1.30* 0.66* 0.84 0.75

Unknown 0.28* 0.23* 0.98* 0.41* 0.21*

Race [Q15]

White 2.83 5.48 8.66 3.59 9.08

Black 2.88 6.01 9.70* 2.50 7.16

Other 1.29 2.15* 2.73 1.44* 3.55*

Unknown 2.07 2.68* 4.58 2.88 4.55*

Ethnicity [Q16]

Hispanic 2.07 2.90* 7.65 2.55 6.55

Not Hispanic 5.92 8.40 6.40 7.17 4.23

Unknown 5.23 8.19 6.81* 5.81 5.60*

Gender [Q14]

Male 1.39 3.71 2.89 2.00 3.25

Female 1.36 3.65 2.89 1.85 3.24

Unknown 0.21* 0.17* 0.09* 0.31* 0.07*

Education at Admission

[Q21]1

Less than high school 1.48 3.24 1.90 3.65

High school graduate/GED 1.43 2.73 1.73 1.17

Some college 1.31 2.03 1.48 2.31

College graduate or higher 0.60 1.37 0.75 1.36*

Unknown 1.39 2.07* 2.05 1.01

(continued)
Table 2.3C Standard Errors - Mean and Median Age and Percentage Distribution of

Clients by Selected Client Characteristics, by Client Type of Care, 1997 - 1999

(continued)

Client Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

55

Employment at Admission

[Q23]

Employed full time (35 

hr/wk or more) 2.98 5.29 4.27 3.13 4.53

Employed part time or 

unknown

level 1.45 1.54 3.79 2.12 2.61

Unemployed 2.87 6.27 8.01 2.30 5.05

Other status (e.g., retired, 

incarcerated) 1.53 3.49 3.40* 1.43 2.52

Unknown 1.15 1.65* 3.66* 1.63 1.27*

Receiving SSI Benefits at 

Admission [Q11]

Yes 5.36 5.80 9.55 6.67 6.64

No 0.81 1.28 3.34 0.75 2.28

Unknown 5.30 5.97 9.42 6.31 7.16

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
56

Table 2.4C Standard Errors - Percentage Distribution of Clients by Marital Status,

Parental Status, and Living Arrangement, by Client Type of Care, 1997 -

1999

Client Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Marital Status at Admission

[Q17]1

Married 2.28 4.12 2.12 2.75

Not married 2.18 4.12 2.14 2.94

Unknown 0.99 0.57* 1.37* 0.81*

Have Child(ren) at Admission 

[Q18]1

Yes 2.00 4.55 2.18 2.65

No 1.71 3.59 1.80 3.04

Unknown 2.23 2.93 2.90 1.49

Living with Child(ren) at 

Admission [Q19]1

Yes 1.67 4.10 1.64 3.20

No 2.05 4.62 2.17 3.96

Unknown 2.70 4.67 3.01 4.01

Living Arrangement at 

Admission [Q20]1

No stable arrangement 1.17 2.07 1.21 0.70

With spouse/partner 1.87 3.99 1.96 2.63

With family or friends 1.89 3.77 1.77 2.85

Alone 1.51 3.74 1.39 1.49

Jail or prison or other 

institution 1.09 3.28* 0.61 0.19*

Unknown 2.50 4.87* 2.58 2.11

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
57

Table 2.5C Standard Errors - Percentage Distribution of Clients by Primary Source of

Referral, by Client Type of Care, 1997 - 1999

Primary Referral Source

[Q9]

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Primary Referral Source 

[Q9]

Other treatment facility 1.48 2.33 2.53 2.19 4.73

Criminal justice system 3.26 7.08 3.00* 3.68 1.32*

Self 2.51 4.93 4.57 2.10 5.09

Family/friends 0.90 2.04* 4.47* 0.91 4.67*

Employer 0.43 0.48* 0.09* 0.61 .

Health care or social service 

agencies 1.45 2.67 1.47 1.78 1.34

Unknown 0.72 1.25* 3.06* 0.76 1.04

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the one-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
58

Table 2.6C Standard Errors - Percentage Distribution of Clients by Criminal Justice

System Status, by Client Type of Care, 1997 - 1999

Criminal Justice System

Status

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

DWI/DUI Arrests Prior to 

Admission [Q25]1

Yes 2.02 2.23 3.07 2.00

No 1.93 3.50 2.55 5.54

Unknown 2.66 4.12 2.97 5.98

Other Arrests Prior to 

Admission [Q26]1

Yes 2.88 7.64 3.29 3.36

No 2.76 5.49 2.89 4.07

Unknown 2.83 4.51 3.60 3.26

Prison or Jail Record 

Prior to Admission [Q27]

Yes 2.87 5.88 4.93 3.84 2.86

No 3.26 6.08 3.88 3.73 4.28

Unknown 3.15 4.86 3.88 3.91 3.75

Receiving Substance Abuse 

Treatment as a Condition

of Probation or Parole

[Q28]1

Yes 3.17 6.55 3.75 1.62

No 3.32 7.59 2.90 6.08

Unknown 2.67 4.42 3.17 6.79

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
59

Table 2.7C Standard Errors - Percentage of Clients Ever Using Each Substance Prior to

Admission, by Client Type of Care, 1997 - 1999

Substance [Q40-Q56]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Substance Used Ever

Crack2

/cocaine 2.75 5.93 4.96 2.55 3.78

Opiates (heroin/nontreatment methadone/

other opiates) 2.49 4.84 3.13 1.93 0.50

Sedatives2

 (barbiturates, 

benzodiazepines, other

sedatives or hypnotics) 1.16 2.17 1.55 5.56

Amphetamines2 2.79 4.87 3.55 4.34

Marijuana, hashish, THC 2.46 6.03 6.71 3.52 4.57

Hallucinogens2 1.78 4.27 2.08 3.46

Inhalants2 1.04 1.92 1.15 0.74*

Over-the-counter2 0.37 0.44* 0.51 1.46*

Alcohol 1.00 2.17 5.70 1.04 3.52

Other drugs2 0.60 1.14* 0.66 1.23*

Not specified2 0.28* 0.17* 0.38* 0.36*

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Clients may be counted in more than one substance category. 2 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
60

Table 2.8C Standard Errors - Percentage of Clients Using Each Substance During the 30

Days Prior to Admission, by Client Type of Care, 1997 - 1999

Substance [Q40-Q56]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Substance Used Prior 30 

Days

Crack2

/cocaine 2.18 5.35 6.07 1.93 2.71

Opiates (heroin/nontreatment methadone/

other opiates) 1.55 3.54 5.46 0.60 4.37

Sedatives2

 (barbiturates, 

benzodiazepines, other

sedatives or hypnotics) 0.64 1.34 0.74 2.96*

Amphetamines2 1.62 2.16 1.86* 0.39*

Marijuana, hashish, THC 1.57 4.23 5.73* 1.76 1.91

Hallucinogens2 0.42 1.08* 0.41 0.25*

Inhalants2 0.20* 0.52* 0.11* 0.08*

Over-the-counter2 0.15* 0.08* 0.20* 0.33*

Alcohol 2.77 5.58 8.04* 3.52 2.38

Other drugs2 0.32 0.66* 0.25* 0.56*

Not specified2 2.65 4.58 3.52 3.45

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Clients may be counted in more than one substance category. 2 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
61

Table 2.9C Standard Errors - Mean Age at First Use of Substance, by Client Type of

Care, 1997 - 1999

Substance [Q40-Q56]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Standard Error for Mean Age in Years

Substance Used

Crack2

/cocaine 0.35 0.56 0.39 0.50 0.54

Opiates (heroin/nontreatment methadone/

other opiates) 0.52 0.80 0.94 0.68 0.48

Sedatives2

 (barbiturates, 

benzodiazepines, other

sedatives or hypnotics) 0.69 1.78 0.57 0.68

Amphetamines2 0.69 0.95 0.68 0.88

Marijuana, hashish, THC 0.17 0.29 0.41 0.19 0.41

Hallucinogens2 0.29 0.66 0.19 1.19

Inhalants2 0.67 1.13 0.76 0.69

Over-the-counter2 1.88 4.55* 2.13 3.62

Alcohol 0.21 0.37 0.46 0.29 0.28

Other drugs2 1.31 2.75 1.59 2.59

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Age calculated among clients with reported use. Client may be counted in more than one substance category. 2 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
62

Table 2.10C Standard Errors - Percentage Distribution of Clients by Substance of Choice

at Admission, by Client Type of Care, 1997 - 1999

Substance of Choice [Q57]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Substance of Choice

Crack/cocaine 1.95 3.56 1.77 0.51*

Opiates (heroin/nontreatment methadone/

other opiates 1.16 3.23* 0.69 4.61

Sedatives (barbiturates, 

benzodiazepines, other

sedatives or hypnotics) 0.08* 0.19* 0.10* 0.26*

Amphetamines 0.85 2.05* 0.66 .

Marijuana, hashish, THC 1.55 2.95* 1.70 .

Hallucinogens 0.10* 0.29* 0.06* 0.08*

Inhalants 0.12* 0.18* 0.16* .

Over-the-counter 0.13* 0.37* 0.04* 0.17*

Alcohol 2.74 5.48 2.72 0.14*

Other drugs 0.06* . 0.09* .

Unknown 2.88 2.03 3.89 4.70*

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
63

Table 2.11C Standard Errors - Percentage of Clients with Prior Substance Abuse

Treatment History and Characteristics of Treatment History, by Client

Type of Care, 1997 - 1999

Treatment History

Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Percentage of Clients with 

Prior Substance Abuse

Treatment History [Q63]1 3.05 3.55 4.12 2.65

Mean number of treatment 

episodes at any time prior

to admission [Q63]1

For all clients 0.21 0.51 0.10 0.25

For clients with prior 

substance abuse treatment

history 0.30 0.70 0.10 0.25

Average number of years 

over which treatment

episodes were reported

[Q64]1 0.29 0.55 0.33 0.87

Percentage of Clients with 

Substance Abuse

Treatment History in the

12 Months Prior to

Admission [Q65]1 2.23 3.20 3.03 3.19

Mean number of treatment 

episodes in the 12 months

prior to admission [Q65]1

For all clients 0.06 0.12 0.05 0.04

For clients with substance 

abuse episode(s) in the

past 12 months 0.06 0.16 0.04 0.04

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December 1998 for

each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month period. In-treatment

methadone data represent the 1-day point-prevalence client cohort on a sample date between August 1997 and February

1999 for each sampled methadone facility. Weighted in-treatment methadone clients provide a national estimate of

methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should be

interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of Applied

Studies.
64

Table 2.12C Standard Errors - Percentage of Clients with Selected Medical

Characteristics, by Client Type of Care, 1997 - 1999

Medical Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Had a Medical 

Hospitalization in the 12

Months Prior to

Admission [Q29]1 0.87 1.97 1.36 2.20

Had Medical Condition(s) 

Prior to Admission or

During Treatment [Q30]1

AIDS or HIV seropositive 0.24* 0.47* 0.24* 1.41

STD (other than AIDS) 0.40 0.86 0.41 3.16

Hepatitis or jaundice 0.80 1.51 0.72 2.12

Positive TB test 0.62 1.58* 0.37* 2.61

Active TB 0.08* 0.16* 0.09* 0.41*

TB, not otherwise specified 0.13* 0.33* 0.14* 0.71*

Heart disease 0.76 1.53 1.03 1.74*

High blood pressure 1.16 1.68 1.30 2.44

Liver disease 0.94 2.22* 0.49 1.37

Convulsions 1.01* 1.98* 1.18* 0.63

Had Medications Prescribed 

During Treatment

Excluding Methadone

[Q68]1 3.54 7.46 2.07 4.47

Pregnancy Status of Female 

Clients at Admission

[Q36] or During

Treatment [Q37]1

Pregnant 1.05 2.92* 1.79* 1.07 3.12

Not pregnant 4.22 5.46 9.73 5.27 4.97

Unknown/Not mentioned in 

record 4.48 3.95 9.82* 5.64 3.80

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December 1998 for

each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month period. In-treatment

methadone data represent the 1-day point-prevalence client cohort on a sample date between August 1997 and February

1999 for each sampled methadone facility. Weighted in-treatment methadone clients provide a national estimate of

methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should be

interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of Applied

Studies.
65

Table 2.13C Standard Errors - Percentage of Clients with Selected Mental Health

Characteristics, by Client Type of Care, 1997 - 1999

Psychological Characteristic

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Had Residential and/or 

Hospital Inpatient Mental

Health Admission in 12

Months Prior to

Admission [Q35]1 0.91 2.31* 0.91 0.81*

Had History of Psychological 

Disorder(s) Prior to

Admission [Q31] 1.54 2.93 4.83 1.82 2.31

Had Psychological 

Disorder(s) at Admission

or During Treatment

[Q33]1 2.12 4.03 2.52 3.21

Taking Anti-Depressant or 

Anti-Psychotic

Prescription Medications

at Admission [Q32]1

Anti-depressant2 1.26 2.45 1.34 1.31

Anti-psychotic2 0.48 0.87* 0.47* 0.32*

None 3.12 4.74 3.02 4.39

Unknown 3.75 5.48 3.63 4.78

Dual-Diagnosis Client at 

Discharge [Q75]1 2.08 4.79 1.62 3

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients. 2 Note that clients can be taking both anti-depressants and anti-psychotics. 3 Question 75 is a discharge question and not relevant for the in-treatment methadone clients who are still in

treatment.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
66

Table 2.14C Standard Errors - Percentage of Clients Receiving Selected Treatment

Services, by Client Type of Care, 1997 - 1999

Treatment Service [Q67a-t]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Treatment Services

Methadone dosing 0.20* 0.61* 0.04* 0.37

Individual therapy 4.16 4.85 4.73 1.49

Group therapy 3.06 5.10 4.28 8.60

Family counseling 2.41 5.55 2.41 2.97*

Self-help/mutual help 

groups 4.84 5.32 5.33 7.76

Comprehensive 

assessment/diagnosis 4.43 6.33 4.58 7.10

Detoxification 4.02 10.66 1.02 4.50

Combined substance abuse 

and mental health

treatment 2.53 5.23 2.69 6.42*

Acupuncture 0.68* 0.55* 0.95* 1.97*

Outcome follow-up 3.06 7.06 2.08 0.39*

Aftercare 4.14 8.26 3.54 3.08*

Note: Discharge data represent discharges during a sample 6-month period between February 1997and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
67

Table 2.15C Standard Errors - Percentage of Clients Completing Treatment and Median

Number of Counseling Sessions by Completion Status, by Client Type of

Care, 1997 - 1998

Completion Status

6-Month Discharged Client Group

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 6-Month 

Estimate 104,352.88 67,041.36 15,294.68 73,147.12

Percentage Completing Treatment [Q73]1 3.34 4.94 3.30

Median Number of Counseling Sessions 

Received [Q67]1

By Completers

Individual therapy 0.43 0.91 0.45

Group therapy 1.53 10.69* 1.04

Family therapy 1.47* 3.56* 1.70*

Total number of counseling sessions 1.65 6.62* 0.96

By Non-Completers

Individual therapy 0.26 1.93* 0.25

Group therapy 0.85 16.31* 0.80

Family therapy 0.81* 3.15* 0.37

Total number of counseling sessions 0.71 7.25* 0.62

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
68

Table 2.16C Standard Errors - Percentage of Clients Receiving Selected Support

Services, by Client Type of Care, 1997 - 1999

Support Service [Q67a-t]1

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Support Services

HIV/AIDS counseling/

support/education 4.59 8.19 4.89 3.70

Employment counseling/

training 1.30 3.69 0.99* 5.52

Academic education/GED 1.59* 4.73* 0.67* 1.10*

Medical care 2.86 8.24 1.21 8.88

TB screening 4.60 8.68 5.47 6.25

TB treatment 0.16* 0.34* 0.17* 1.25*

Prenatal care 0.22* 0.63* 0.15* 0.85*

Psychological testing 3.15 6.72* 2.61 8.70*

Smoking cessation 2.57* 7.25* 0.78* 1.76*

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date

between August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment

methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
69

Table 2.17C Standard Errors - Methadone Treatment Practices (Mean Daily Methadone

Dose and Percentage of Clients Who Received Take-Home Methadone) for

Discharged Methadone Clients, 1997 - 1998

Methadone Treatment Practices Discharged Methadone Clients

Standard Error for National 6-Month Estimate 15,294.68

Methadone Treatment - Mean Daily Dose (mg) [Q69a-d]

At first treatment 2.07 mg

Two weeks after first treatment 3.31

One month before last treatment 4.51

At last treatment 3.97

Percentage of Clients Who Received Take-Home Methadone 

[Q70] 7.76%

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and December

1998 for each sampled facility. Weighted discharges provide a national estimate of discharges for a 6-month

period.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
70

Table 2.18C Standard Errors - Average Length of Stay, Average Duration of Treatment,

and Reason for Discharge, by Client Type of Care, 1997 - 1998

Completion Status

6-Month Discharged Client Group

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 6-Month 

Estimate 104,352.88 67,041.36 15,294.68 73,147.12

Average Length of Stay (Days) [Q5-Q2]1

Mean (days) 12.09 8.02 130.67 12.89

Median (days) 8.72 5.15* 50.16 8.57

Average Duration of Treatment (Days)2

[Q4-Q3]

Mean (days) 11.01 7.88 136.02 9.47

Median (days) 7.15 4.83* 58.62* 6.42

Percentage Distribution of Reasons for 

Discharge [Q73]

Completed planned treatment 3.34% 4.94% 3.30%

Did not complete treatment:

Referred/transferred to another

program 0.94 1.48* 1.10

Facility administration choice 1.46 2.78* 1.58

Client choice (drop out) 2.41 2.71 3.08

Other 0.68 0.93* 0.83

Unknown 0.55 0.74* 0.66

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and

December 1998 for each sampled facility. Weighted discharges provide a national estimate of discharges

for a 6-month period.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Length of stay is calculated from admission date to discharge date. 2 Duration of treatment is calculated from date of first visit to date of last visit as noted in the client's treatment

record.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
71

Table 2.19C Standard Errors - Percentage of Discharged Clients with Aftercare Plan and

Selected Aftercare Services, by Client Type of Care, 1997 - 1998

Aftercare Plan/Service

6-Month Discharged Client Group

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 6-Month 

Estimate 104,352.88 67,041.36 15,294.68 73,147.12

Percentage of Clients with Aftercare Plan 

[Q76]1 4.18 6.98 3.85

Percentage of Clients with Selected 

Services in Aftercare Plan [Q77a-g]1

Individual therapy 2.38 5.59* 1.18

Group therapy (not including relapse 

prevention) 1.54 2.77 1.67

Relapse prevention 3.06 5.89 2.86

Family counseling 1.35 3.37* 1.08*

Self-help groups 3.61 5.42 3.44

Support services (e.g., employment 

counseling) 0.78 2.34* 0.56

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and

December 1998 for each sampled facility. Weighted discharges provide a national estimate of discharges

for a 6-month period.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

1 Question not abstracted for discharged methadone clients.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
72

Table 2.20C Standard Errors - Percentage Distribution of Clients by Expected Primary

Source of Payment, by Client Type of Care, 1997 - 1999

Expected Primary Payment

Source [Q10]

6-Month Discharged Client Group

1-Day Cross

Section of

In-Treatment

Methadone

Clients

Client Type of Care

Total, All

Discharged

Clients

Non-Hospital

Residential

Outpatient

Methadone

Outpatient

NonMethadone

Standard Error for National 

6-Month Estimate 104,352.88 67,041.36 15,294.68 73,147.12 32,557.53

Expected Primary Payment 

Source [Q10]

No payment 2.05* 1.10* 0.84* 2.98* 0.43*

Client self-payment 3.73 6.27 8.25 4.51 10.45*

Private health insurance 2.71 5.55* 2.04* 2.70 1.70*

Criminal justice system 3.55* 5.02* . 5.55* 0.35*

Medicaid 1.51 3.41* 7.02 1.42 10.68

Medicare 0.58 1.70* 0.27* 0.86* 0.48*

Other 3.11 7.70* 8.91* 1.66 5.05*

Unknown 3.12 5.27* 4.47* 3.77 3.03

Note: Discharge data represent discharges during a sample 6-month period between February 1997 and

December 1998 for each sampled facility. Weighted discharges provide a national estimate of discharges

for a 6-month period. In-treatment methadone data represent the 1-day point-prevalence client cohort on a

sample date between August 1997 and February 1999 for each sampled methadone facility. Weighted intreatment methadone clients provide a national estimate of methadone clients in treatment on a given day.

* The coefficient of variation (CV) for this estimate is greater than or equal to 0.3, indicating this number should

be interpreted with caution.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
73

Table 3.1C Standard Errors - Methadone Treatment Practices (Average Daily

Methadone Dose) for In-Treatment Methadone Clients, 1997 - 1999

Methadone Treatment Practices In-Treatment Methadone Clients

Standard Error for National 6-Month Estimate 32,557.53

Daily Dose at First Treatment (mg) [Q69a]

Mean 2.52 mg

25th percentile 0.29

50th percentile 2.57

75th percentile 6.66

Daily Dose at 2 Weeks After First Treatment (mg) [Q69b]

Mean 2.81 mg

25th percentile 1.85

50th percentile 2.18

75th percentile 5.07

Current Dose1

 (mg) [Q69d]

Mean 3.36 mg

25th percentile 3.69

50th percentile 4.42

75th percentile 2.75

Note: In-treatment methadone data represent the 1-day point-prevalence client cohort on a sample date between

August 1997 and February 1999 for each sampled methadone facility. Weighted in-treatment methadone

clients provide a national estimate of methadone clients in treatment on a given day.

1 The most recent dose at the time the cross section of in-treatment methadone clients was sampled.

Source: Alcohol and Drug Services Study, Phase II Client Record Abstract data (weighted). SAMHSA, Office of

Applied Studies.
74