Addiction Medicine: Closing the Gap between Science and Practice

Of those discharges that did not represent a
completed treatment episode, 46.6 percent
dropped out of treatment, 25.9 percent were
transferred to another treatment service (whether
or not the patient attended that program is
unknown), 12.8 percent were terminated by the
program and 4.5 percent were incarcerated. The
remainder failed to complete treatment for some
other reason.* 77

Variations in Treatment Completion by Source of Referral ......................................

Admissions to addiction treatment for which the
source of referral was an employer were the
most likely to complete treatment (57.2 percent
of admissions), followed by referrals from the
criminal justice system (48.1 percent).
Admissions referred by health care providers
and individual sources--including concerned
family members, friends and the self-referred--
were the least likely to complete treatment (34.6
percent and 33.9 percent of admissions,
respectively).^78 Concern about potential loss of
a job or criminal sanctions might help account
for higher rates of treatment completion among
those referred by employers or the criminal
justice system. (Table 7.2)

• i.e., moving, illness or hospitalization, death, other

reason out of patient’s control or the reason for
discharge is unknown or not recorded.

Variations in Treatment Completion by Primary Substance Involved ......................

Patients admitted to treatment with addiction

involving alcohol as the primary substance had

the highest rate of treatment completion (50.7

percent) compared with 39.3 percent involving

marijuana, 35.4 percent involving other illicit

drugs and 35.3 percent involving prescription

drugs. The treatment completion rate for

admissions involving multiple substances was

38.9 percent.^79

Variations in Treatment Completion by Key Patient Characteristics ........................

Male patients admitted to treatment were likelier

than females to complete treatment (48.5 percent

vs. 42.6 percent of admissions). No significant

age-related differences in treatment completion

were found.^80 With regard to racial/ethnic

differences in treatment completion, Hispanics

admitted to treatment were more likely to

complete treatment than were whites or blacks

(46.8 percent vs. 37.9 percent and 35.4 percent

of admissions, respectively).† 81

Link between Funding Source, Type of Service Provided and Treatment Completion ..

Individuals who are privately insured are

substantially less likely to enter addiction

treatment than those with public insurance.‡ 82

Publicly-funded admissions to addiction

treatment are likelier than privately-funded

admissions to be for more intensive services:

† Similarly, a study of patients receiving treatment for

addiction involving alcohol found that black patients

were less likely than white or Hispanic patients to

complete their treatment program, regardless of

whether they were enrolled in non-residential

treatment (17.5 percent vs. 26.7 percent and 29.7

percent, respectively) or residential treatment (30.7

percent vs. 46.1 percent and 42.9 percent,

respectively).

‡ Controlling for type of substance, severity of the

addiction, demographic characteristics, current health

status and whether the individual is a daily cigarette

smoker.

Table 7.2

Treatment Completion by Source of Referral

Source of Referral Percent
Total 42.1
Employers 57.2
Criminal Justice System 48.1
Addiction Treatment Providers 44.5
Schools 41.1
Community Sources 36.6
Health Care Providers 34.6
Individual Referrals 33.9
Source: The Treatment Episode Data Set (TEDS)
discharge data, 2008.