D rug and A lcohol S ervices I nformation S ystem

The DASIS Report
March 2001
April 26, 2002

New and Repeat Admissions to Substance Abuse Treatment
In Brief

In 1999, about 40 percent of substance abuse treatment admissions were first treatment episodes and 60 percent were repeat treatment episodes Alcohol accounted for about half of new and repeat admissions Abuse of opiates was more common among repeat admissions than new admissions Age at first use of the primary substance varied little among new and repeat treatment admissions

R

elapse to substance use after a period of abstinence is a common pattern among alcoholics and drug abusers. Many substance abusers are readmitted to treatment multiple times before they are able to achieve long-term abstinence. The Treatment Episode Data Set (TEDS) collects data primarily on the 1.6 million annual admissions to substance abuse treatment facilities that receive some public funds. TEDS records represent admissions rather than individuals; a person may be admitted to treatment more than once in a given time period. TEDS data include the number of prior treatment episodes and the age at first use of the primary substance (or first alcohol intoxication).

The DASIS Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report may be downloaded from http://www.samhsa.gov/oas/facts.cfm. Citation of the source is appreciated. Other reports from the Office of Applied Studies are also available on-line: http://www.DrugAbuseStatistics.samhsa.gov/.

DASIS REPORT: NEW AND REPEAT ADMISSIONS TO SUBSTANCE ABUSE TREATMENT

April 26, 2002

Figure 1. Primary Substance of Abuse among First-Time Admissions and Repeat Admissions: 1999
5 or More Previous Admissions

First Time in Treatment

1-4 Previous Admissions

Alcohol Marijuana Cocaine Opiates Stimulants All Other

49% 21% 13% 9% 6% 2%

45% 12% 18% 19% 5% 1%

48% 4% 12% 34% 1% 1%

Source: 1999 SAMHSA Treatment Episode Data Set (TEDS).

This report compares firsttime, or new, treatment admissions with readmissions of persons admitted to treatment 1 to 4 times, and 5 or more times, before the current episode.

Primary Substance
Alcohol accounted for almost half of all 1999 new and repeat admissions (Figure 1). The proportion of admissions for opiates was greater with more treatment episodes; 9 percent of new treatment admissions were for opiates compared with 34 percent for those admitted to treatment 5 or more times before. The proportion of admissions for marijuana decreased as the number of treatment episodes increased. The proportion of admissions for cocaine was fairly constant among new and repeat admissions.

Number of Prior Treatment Episodes
In 1999, more than 40 percent of treatment admissions (some 660,000 admissions) were first treatment episodes (data not shown). More than 45 percent (about 730,000 admissions) were readmissions of people who had been in treatment 1 to 4 times previously. Thirteen percent, or some 200,000, had been in treatment 5 or more times before the current episode.

For new and repeat admissions, the average age at admission for alcohol, cocaine, and opiates was between 35 and 40 years old, and it was 30 years old for stimulants. The average age for first-time admissions for marijuana was 22 years of age compared with 29 years for those admitted 5 or more times previously.

Age at First Use
There was little difference in the age at which use of the primary substance began (or first alcohol intoxication occurred) among first-time and repeat 1999 treatment admissions (Figure 3). However, TEDS data indicate that persons readmitted to treatment after 5 or more previous admissions first used the problem substance 6 months to a year earlier than first-time admissions.

Age at Admission
There was a strong association between age and number of prior treatment episodes for all primary substances in 1999 (Figure 2). The association was most marked for alcohol and marijuana.

April 26, 2002

DASIS REPORT: NEW AND REPEAT ADMISSIONS TO SUBSTANCE ABUSE TREATMENT

Figure 2. Average Age at Admission among First-Time Admissions and Repeat Admissions, by Primary Substance: 1999
40
34 40 36 29 22 24 35 34 35 35 36 37 32 30 31

Figure 3. Average Age at First Use or First Intoxication among First-Time Admissions and Repeat Admissions, by Primary Substance: 1999
40 30
23 23 22 23 22 22

Age at Admission

Age at First Use

30 20 10 0 Alcohol

20
16 15 14 16 14 14

21 20 19

10 0

Marijuana

Cocaine

Opiates

Stimulants

Alcohol

Marijuana Cocaine

Opiates

Stimulants

First Time in Treatment 1-4 Previous Admissions 5 or More Previous Admissions

First Time in Treatment 1-4 Previous Admissions 5 or More Previous Admissions

Duration of Use
In 1999, the average duration of use of the primary substance was longer among those readmitted to treatment than for first-time admissions (Figure 4). There was considerable variation in the average duration of use of different substances

before first entering treatment among 1999 admissions, ranging from 8 years for marijuana to 18 years for alcohol.

Source of Referral
The criminal justice system accounted for a high proportion (47 percent) of first-time treat-

ment admissions in 1999, but it was less important as a referral source among readmissions (data not shown). The proportion of criminal justice referrals was 34 percent among readmissions of persons admitted for treatment 1 to 4 times and 12 percent among readmissions of persons admitted 5 or more times.

Figure 4. Average Duration of Use among FirstTime Admissions and Repeat Admissions, by Primary Substance: 1999
26

25
21

20 Years of Use 15 10 5 0

18 15 10 8 11 12 13 12 10 16 14 11 13

The Drug and Alcohol Services Information System (DASIS) is an integrated data system maintained by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment Episode Data Set (TEDS). TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. Information on treatment admissions is routinely collected by State administrative systems and then submitted to SAMHSA in a standard format. Approximately 1.6 million records are included in TEDS each year. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once.

The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and RTI, Research Triangle Park, North Carolina.
Information and data for this issue are based on data reported to TEDS through April 16, 2001. Access the latest TEDS reports at: www.DrugAbuseStatistics.SAMHSA.gov/

Alcohol

Marijuana Cocaine

Opiates

Stimulants

Access the latest TEDS public use files at: www.icpsr.umich.edu/SAMHDA/teds.html U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Office of Applied Studies www.samhsa.gov

First Time in Treatment 1-4 Previous Admissions 5 or More Previous Admissions