DOI: 10.3886/icpsr03088.v5
title: Alcohol and Drug Services Study (ADSS), 1996-1999: [United States]
title: Version 5

description: The Alcohol and Drug Services Study (ADSS) was a national
study of substance abuse treatment facilities and clients. The study
was designed to develop estimates of the duration and costs of
treatment and to describe the post-treatment status of substance abuse
clients. ADSS continues and extends upon data collected in the Drug
Services Research Survey, 1990: [United States] (ICPSR 3393) and the
Services Research Outcome Study, 1995-1996: [United States] (ICPSR
2691) with a more complete sampling frame, an enhanced sampling
design, and more detailed measures of treatment services provided, the
costs of treatment, and clients in treatment. ADSS was implemented in
three phases. In Phase I, a nationally representative sample of
treatment facilities was surveyed to assess characteristics of
treatment services and clients including treatment type, costs,
program capacity, the number of clients served, waiting lists, and
services provided to special populations. In Phase II, records were
abstracted from a sample of clients in a subsample of Phase I
facilities. This phase included four sub-components: (1) the Main
Study, an analysis of abstracted records to assess the treatment
process and characteristics of discharged clients, (2) the Incentive
Study, which assessed the impact of varying financial payments on
follow-up interview participation among non-methadone outpatient
clients, (3) the In-Treatment Methadone Client study (ITMC), which
assessed the treatment process of methadone maintenance, and (4) the
comparison study of Early Dropout clients (EDO), which provided a
proxy comparison group of records from substance abusers that went
untreated. Phase III involved follow-up personal interviews with Phase
II clients who could be located. This interview sought to determine
post-treatment status in terms of substance use, economic condition,
criminal justice involvement, and further substance abuse treatment
episodes. Urine testing was conducted to validate self-reported drug
use. Drugs included in the survey were alcohol, marijuana, cocaine,
crack cocaine, heroin, barbiturates, benzodiazepines, amphetamines,
non-prescribed use of prescription medications, abuse of
over-the-counter medications, and other drugs. ADSS also included a
cost study, which involved obtaining additional financial information
from the Phase II facilities. A computerized desktop audit was used in
the cost study to conduct consistency and accuracy checks on selected
questionnaire data from Phases I and II. Variables were subsequently
updated to represent the most accurate data available. Additional
analysis variables were then created using combinations of the revised
Phase I and II data.
description: The Phase I sampling design incorporated a stratified random
probability sample. Weights were developed for the Phase I sample to
facilitate overall and by stratum estimates of facility- and
client-level characteristics of the nation's substance abuse treatment
system. Final Phase I weights were constructed in a multistep process
involving calculation of initial base weights, trimming to guard
against excessive influence by a few highly loaded facilities,
adjustment for facility nonresponse, and poststratification adjustment
to initial frame counts. Because the Phase I sample was selected
using a complex multistage design, resampling is the appropriate
method of calculating the stability of computed statistics. Replicate
weights based on the stratified jackknife procedure (JKn) are included
in the ADSS Phase I dataset for the purpose of standard error
calculations.
description: Response Rates: Of the original 294 eligible facilities, 60 refused
to participate, yielding a response rate of 79.6 percent.
description: The Alcohol and Drug Services Study utilized a complex
multistage sampling strategy. In Phase I, 2,395 substance abuse
treatment facilities were selected from the Substance Abuse and Mental
Health Services Administration's (SAMHSA) National Master Facility
Inventory (NMFI) of known facilities. The sample was stratified to
reflect the types of care offered within the nation's substance abuse
treatment system. Selection strata included: (1) hospitals, (2)
non-hospital residential treatment facilities, (3)
outpatient-predominantly methadone treatment facilities, (4)
outpatient-nonmethadone treatment facilities, (5) outpatient combined
methadone and nonmethadone treatment, (6) facilities serving
predominantly alcohol abusing clients, and (7) facilities whose type
of care could not be determined based on existing information at the
time of sampling. Excluded from the sampling frame were halfway houses
lacking paid counselors, solo practitioners, treatment programs in
jails and/or correctional facilities, Department of Defense and Indian
Health Service facilities, and facilities that were prevention or
intake and referral only. Selection was based on probability
proportional to size (PPS), with a minimum of 300 facilities to be
selected per stratum. Sampling in Phase II consisted of several
stages. First, the country was partitioned into approximately 400
geographic primary sampling units (PSUs) from which a representative
sample of 62 were selected on the basis of demographic and economic
characteristics. Within these 62 PSUs, a stratified subsample of Phase
I facilities (n = 306) was selected using PPS. The subsample utilized
exclusionary criteria that eliminated 12 facilities: (a) facilities
that had ceased operation prior to March 1, 1997, (b) facilities
designated as hospitals (i.e., stratum 1), and (c) facilities in which
100 percent of clients were treated for alcohol abuse only. To ensure
adequate sample size, sampled facilities were matched with "shadow"
facilities. Shadow facilities were then used to replace 46 refusing
facilities, producing a final sample size of 280. Shadows were not
used for facilities found to be ineligible (e.g., closed). Following
interviews with administrators in the participating facilities, two
types of client records were randomly sampled: (1) clients who were
discharged for any reason at least one day after their date of
treatment initiation, and (2) clients still actively engaged in
methadone treatment. Persons whose treatment episode was clearly
limited to mental health, family counseling, or other non-substance
abuse services were not considered substance abuse treatment clients
and were excluded from the sampling frame, even if they had prior
history of substance abuse treatment. The client must have been the
substance abuser him- or herself and not a family member or other
person receiving treatment in relation to the substance abuser. In
addition to the random sample, a non-probability convenience sample of
early dropout discharges (EDO) from outpatient programs was drawn as
the comparison group. Early dropout clients were defined as clients
who had been through assessment or an intake battery but completed no
more than one day or one session of treatment. The comparison group
was selected from cooperating facilities, to serve as a proxy for
untreated substance abusers. In Phase III, clients randomly selected
in the previous phase were approached for interview. Discharged
clients younger than 18 years old at the time of interview and clients
in the main study discharged group who were classified as methadone
patients were excluded from this phase. The cost study included
facilities from Phase II, and the design included splitting data by
modality for facilities with more than one type of care
(multi-modality).
description: Datasets: 
DS0: Study-Level Files
DS1: Phase I Facility Interview
DS2: Phase II Administrator Interview
DS3: Phase II Main/Incentive Abstract
DS4: Phase II In-Treatment Methadone Abstract
DS5: Phase II Early Dropout Abstract
DS6: Phase III Main Study Follow-Up
DS7: Phase III In-Treatment Methadone Follow-Up
DS8: Phase III Early Dropout Follow-Up
DS9: Phase I Finite Population Correction Factors
DS10: Phase I Stratified Jackknife Factors
DS11: Phase II/III Stratified Jackknife Factors
DS12: Cost Study
description: (1) Substance abuse treatment facilities in the United
States registered in the Substance Abuse and Mental Health Services
Administration's National Master Facility Inventory of known
facilities. (2) Clients engaged in substance abuse treatment in these
facilities.
description: record abstracts; mail questionnaire; telephone interviewThe study was conducted by the Schneider Institute
for Health Policy, Brandeis University. Westat, Inc. collected and
prepared the data.ADSS files underwent disclosure analysis by
SAMHDA in order to ensure that the identities of facilities and
clients were protected. This involved reviewing the data files for
potential risks as well as examining any external threats to
confidentiality, such as other data sources that could be linked to
ADSS. Such external data sources were found. To address this problem
while still creating a public use file of the greatest utility
possible, micro-aggregation of certain variables was performed. This
involved identifying the problematic variables, sorting records by the
first problematic variable, grouping records into three based on their
value for this variable, averaging the values for each grouping, and
applying the average to the records in each group. This was repeated
for each of the problematic variables, which included client count and
financial data. Geographic identifiers were also removed. The overall
impact of these protection procedures was small and should not affect
most analytic uses of the data.The Phase I facility public use
file includes 2,394 of the original 2,395 records. One facility's
record was deleted due to the presence of outlying data.Client
records can be matched between corresponding Phase II and Phase III
abstract and follow-up data files using the CASEID variable. Facility
data can be matched across the Phase I-III and cost study data files
using the FACID variable.The unit of analysis for the Phase I
facility (Part 1) and Phase II administrator (Part 2) data is the
facility. Data from the Phase II and III abstract and follow-up files
(Parts 3-8) are analyzed at the client level. Analyses for the cost
study (Part 12) are conducted at the modality or "type of care" level
within facilities.Please note that the unit of time for some
variables in the facility file is specified in a separate variable,
and these units are distinctly different from each other. For example,
to analyze length of treatment, the researcher needs to examine two
variables: QUANTITY VAR NAME and UNIT VAR NAME. QUANTITY specifies the
"quantity" of treatment length while UNIT specifies the unit of
QUANTITY such as days, weeks, months, years, or sessions.The
Finite Population Correction Factor and the two Stratified Jackknife
Factor data files are provided for use with the WesVar and SUDAAN
statistical software, and are not intended for use with other
statistical packages. WesVar was developed by Westat Incorporated and
SUDAAN is a product of the Research Triangle Institute. These three
files are being distributed as received from the principal
investigator and have not been tested by SAMHDA.The data from the
follow-up Incentive Study in Phase III are not released as part of
this public use collection.