Residential and outpatient treatment completion for substance use disorders in the U.S.: Moderation analysis by demographics and drug of choice

• Published in: Addictive behaviors 2016-07, Vol.58, p.129-135
• Main Authors: Stahler, Gerald J, Mennis, Jeremy, DuCette, Joseph P
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; African Americans - statistics & numerical data; Age Factors; Alcoholism - epidemiology; Alcoholism - therapy; Ambulatory Care - statistics & numerical data; Cocaine-Related Disorders - epidemiology; Cocaine-Related Disorders - therapy; Databases, Factual; Demographics; Dropout; Drug abuse; Drug use; Ethnic Groups - statistics & numerical data; European Continental Ancestry Group - statistics & numerical data; Female; Hispanic Americans - statistics & numerical data; Humans; Logistic Models; Male; Marijuana Abuse - epidemiology; Marijuana Abuse - therapy; Middle Aged; Opioid-Related Disorders - epidemiology; Opioid-Related Disorders - therapy; Outpatient; Outpatient care facilities; Patient Compliance - ethnology; Patient Compliance - statistics & numerical data; Patient Dropouts - ethnology; Patient Dropouts - statistics & numerical data; Psychiatry; Residential; Residential Treatment - statistics & numerical data; Retention; Retrospective Studies; Substance abuse treatment; Substance-Related Disorders - epidemiology; Substance-Related Disorders - therapy; Treatment completion; United States; Young Adult
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2016.02.030

Abstract Background This study investigates the impact of residential versus outpatient treatment setting on treatment completion, and how this impact might vary by demographic characteristics and drug of choice, using a national sample of publicly funded substance abuse programs in the United States. Methods This is a retrospective analysis using data extracted from the 2011 Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Episode Data Set (TEDS-D). A total of 318,924 cases were analyzed using logistic regression, fixed-effects logistic regression, and moderated fixed-effects logistic regression. Results Residential programs reported a 65% completion rate compared to 52% for outpatient settings. After controlling for other confounding factors, clients in residential treatment were nearly three times as likely as clients in outpatient treatment to complete treatment. The effect of residential treatment on treatment completion was not significantly moderated by gender, but it was for age, drug of choice, and race/ethnicity. Residential compared to outpatient treatment increased the likelihood of completion for older clients, Whites, and opioid abusers, but lowered the likelihood of completion for marijuana abusers and non-White clients. Conclusion We speculate that for opioid abusers, as compared to abusers of other drugs, residential treatment settings provide greater protection from environmental and social triggers that may lead to relapse and non-completion of treatment. Greater use of residential treatment should be explored for opioid users in particular.