An Investigation of Premature Discharges from Residential Addiction Treatment Centers in the United States in 2019

  • Charlotte C. Phillips, Ph.D Clinical Mental Health Counseling, Grand Canyon University, Phoenix, AZ, USA.
Keywords: substance abuse treatment, addiction, premature discharge

Abstract

The purpose of this study was to identify predictors associated with the length of stay in patients prematurely discharged from residential addiction treatment facilities in the United States.  This study sought to provide a more in-depth understanding regarding which patients may be at a greater risk for a shortened length of stay and to help fill the gap in the literature pertaining to the length of stay and related variables in prematurely discharged patients.  The research methodology for this study was a quantitative, non-experimental design using pre-existing, secondary data from the Substance Abuse and Mental Health Administrations Treatment Episode Data Set-Discharge (TEDS-D) from the year 2019.  The Treatment Episode Data Set-Discharge is a collection of data reported on a national level regarding discharges from substance abuse treatment facilities. Data analysis included an examination of the relationship between the predictor variables, the number of times a patient has been admitted to treatment, admission wait time, gender, and age, with the criterion variable, length of stay for an N = 49080.  The data was ex post facto; therefore, this was a non-experimental design that utilized secondary analyses of pre-existing data to answer the research questions.  A significant relationship was discovered to exist between the criterion/dependent variable, length of stay, predictor/independent variables days waiting for admission, the number of prior treatment episodes, and gender.  When controlling for days waiting to include only those waiting one or more days for treatment admission, a subsequent significant relationship was found.  This study examined variables that serve as predictive of length of stay in patients who were prematurely discharged from residential addiction treatment facilities under the premise of having been administratively discharged or in the event that the patient left treatment against professional advice.  

References

A. H. S. Harris, S. Gupta, T. Bowe, L. S. Ellerbe, T. E. Phelps, A. D. Rubinsky, … J. Trafton. (2015). “Predictive validity of two process-of-care quality measures for residential substance use disorder treatment.” Addiction Science and Clinical Practice. [On- line]. 10(22), pp. 1-8. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672518/pdf/13722_2015_Article_42.pdf.

M. L. Banks, & S. S. Negus. (2017). “Insights from preclinical choice models on treating drug addiction.” Trends in Pharmacological Sciences. [On- line]. 38(2), pp. 181-194.

R. Mutter, M. Ali, K. Smith, & A. Strashny. (2015). “Factors associated with substance use treatment completion in residential facilities.” Drug and Alcohol Dependence. [On- line]. 154, pp. 291-295. Available: https://www.ncbi.nlm.nih.gov/pubmed/26210736.

H. W. Andersson, A. Steinsbekk, E. Walderhaug, E. Otterholt, & T. Nordfjaern. (2018). “Predictors of dropout from inpatient substance use treatment: A prospective cohort study.” Substance Abuse: Research and Treatment. [On- line]. 12, pp. 1-10.

H. H. Brorson, E. A. Arnevik, K. Rand-Hendriksen, & F. Duckert. (2013). “Drop-out from addiction treatment: A systematic review of risk factors.” Clinical Psychology Review. [On- line]. 33, pp. 1010 –1024. Available: http://dx.doi.org/ 10.1016/j.cpr.2013.07.007.

K. A. Hoffmann, J. H. Ford, C. J. Tillotson, D. Choi, & D. McCarty. (2011). “Days to treatment and early retention among patients in treatment for alcohol and drug disorders.” Addictive Behaviors. [On- line]. 36, pp. 643-647.

Substance Abuse and Mental Health Services Administration. “Screening, Brief Intervention and Referral to Treatment (SBIRT).” Internet: https://www.samhsa.gov/sbirt, Sept. 15, 2017 [Dec. 1, 2021].

National Institute on Drug Abuse. “Principles of drug addiction treatment: A research-based guide.” Internet: https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/675-principles-of-drug-addiction-treatment-a-research-based-guide-third-edition.pdf, Jan. 2018 [Dec. 1, 2021].

Substance Abuse and Mental Health Services Administration, Center for Behavorial Statistics and Quality. “Treatment Episode Data Set 9TEDS): 2019 National Admissions to Substance Abuse Treatment Services.” Internet: https://www.datafiles.samhsa.gov/sites/default/files/field-uploads-protected/studies/TEDS-D-2019/TEDS-D-2019-datasets/TEDS-D-2019-DS0001/TEDS-D-2019-DS0001-info/TEDS-D-2019-DS0001-info-codebook.pdf, 2019, [Dec. 1, 2021].

D. C. Johnson, W. D. Mathews, A. Mause, & D. H. Gustafson. (2019). “Using smartphones to improve treatment retention among impoverished substance-using Appalachian women: a naturalistic study. Substance abuse: research and treatment. [On- line]. 13, pp. 1-10. Available: https://pubmed.ncbi.nlm.nih.gov/31312084/.

H. M. Thompson, W. Faig, N. A. VanKim, B. Sharma, M. Afshar, & N. S. Karnik, (2020). “Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service.” Plos one. [On- line]. 15(10).

D. E. Baker, K. A. Edmonds, M. L. Calvert, S. M. Sanders, A. J. Bridges, M. A. Rhea, & S. Kosloff. (2020). “Predicting attrition in long-term residential substance use disorder treatment: A modifiable risk factors perspective.” Psychological Services. [On- line]. 17(4), pp. 473. Available: http://pubmed.ncbi.nlm.nih.gov.

R. N. Lipari, S. L. Van Horn. (2017). “Trends in substance use disorders among adults aged 18 or older.” The CBHSQ Report. Rockville (MD): Substance Abuse and Mental Health Services Administration, 1-10. Available: https:/www.ncbi.nlm.nih.gov/books/NBK447253/.

C. Timko, N. R. Schultz, J. Britt, M. A. Cucciare. (2016). “Transitioning from detoxification to substance use disorder treatment: Facilitators and barriers.” Journal of Substance Abuse Treatment. [On- line]. 70, pp. 64-72. Available: https://pubmed.ncbi.nlm.nih.gov/27692190/.

L. S. Ellerbe, L. Manfredi, S. Gupta, T. E. Phelps, T. R. Bowe, A. D. Rubinsky, .,… A. H. Harris. (2017). “VA residential substance use disorder treatment program providers’ perceptions of facilitators and barriers to performance on pre-admission processes.” Addiction Science Clinical Practice. [On- line]. 12(1), pp. 1-11. Available: https://doaj.org/article/3b302c9cfece4944a748a6c3b343e71d.

M. J. Stark. (1992). “Dropping out of substance abuse treatment: A clinically oriented review.” Clinical Psychology Review. [On- line] 12, pp. 93–116. Available: http:// dx.doi.org/10.1016/0272-7358(92)90092-M.

T. Wickizer, C. Maynard, A. Atherly, M. P. H. M. Frederick, T. Koepsell, A. Krupski, & K. Stark. (1994). “Completion rates of clients discharged from drug and alcohol treatment programs in Washington State.’ American Journal of Public Health. [On- line]. 84(2), pp. 215-221. Available: https://www.semanticscholar.org/paper/Completion-rates-of-clients-discharged-from-drug-in-Wickizer-Maynard/26dff39d675b68dbd9a017b8242adcf5f02b9418.

B. Osborne, P. J. Kelly, B. Larance, L. D. Robinson, R. Ivers, F. P. Deane, & D. Kelly. (2020). “Substance use and co-occurring physical health problems: file review of a residential drug and alcohol treatment service.” Journal of dual diagnosis. [On- line]. 16(2), pp. 250-259. Available: https://www.semanticscholar.org/paper/Substance-Use-and-Co-occurring-Physical-Health-File-Osborne-Kelly/bc14604e87ec4e7b24fa86f899e336edce7de62b.

G. J. Stahler, J., Mennis, & J. P. DuCette. (2016). “Residential and outpatient treatment completion for substance use disorders in the US: Moderation analysis by demographics and drug of choice.” Addictive Behaviors. [On- line]. 58, pp. 129-135. Available: https://pubmed.ncbi.nlm.nih.gov/26925821/.

B. Maughan, & E. A. Becker. (2019). “Mortality after discharge from publicly funded substance abuse treatment in Texas, 2006-2012.” Texas Public Health Journal. [On- line]. 69(4). Available: https://pubmed.ncbi.nlm.nih.gov/31520924/.

H. G. Cheng & M. R. Phillips. (2014). “Secondary analysis of existing data: opportunities and implementation.” Shanghai Archives of Psychiatry. [On- line]. 26(6), pp. 371–375. Available: http://doi.org/10.11919/j.issn.1002-0829.214171.

A. F. Ernst & C. J. Albers. (2017). “Regression assumptions in clinical psychology research practice—a systematic review of common misconceptions.” PeerJ. [On- line]. 5. Available: http://doi.org/10.7717/peerj.3323.

L. A. Doerfler, D. Melle, T. McLaughlin, & W. H. Fisher. (2016). “Do Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) scores predict readmission to an inpatient substance abuse treatment program for adolescents?” Journal of Child & Adolescent Substance Abuse. [On- line]. 25(6), pp. 516-521. Available: https://www.tandfonline.com/doi/abs/10.1080/1067828X.2015.1111822?journalCode=wcas20.

D. Loveland & H. Driscoll. (2014). “Examining attrition rates at one specialty addiction treatment provider in the United States: A case study using a retrospective chart review.” Substance Abuse Treatment, Policy, and Prevention. [On- line]. 9(41), pp. 1-13. Available: https://substanceabusepolicy.biomedcentral.com/articles/10.1186/1747-597X-9-41.

R. Grahn, D. Chassler, & L. Lundgren. (2014). “Repeated addiction treatment use in Sweden: A national register database study.” Substance Use & Misuse. [On- line]. 49(13), pp. 1764-1773. Available: https://www.ncbi.nlm.nih.gov/pubmed/24963556.

S. Choi, S. M. Adams, S. A. Morse, & S. MacMaster. (2015). “Gender differences in treatment retention among individuals with co-occurring substance abuse and mental health disorders.” Substance Use & Misuse. [On- line]. 50, pp. 653-663. Available: https://www.foundationsrecoverynetwork.com/wp-content/uploads/Gender-Differences-in-Treatment-Retention-Among-Individuals-with-Co-Occurring-Substance-Abuse-and-Mental-Health-Disorders.pdf.

Published
2022-04-25
How to Cite
Charlotte C. Phillips, Ph.D. (2022). An Investigation of Premature Discharges from Residential Addiction Treatment Centers in the United States in 2019 . International Journal of Sciences: Basic and Applied Research (IJSBAR), 62(2), 29-47. Retrieved from https://gssrr.org/index.php/JournalOfBasicAndApplied/article/view/13988
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Articles