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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us
The 1998 TEDS data indicate changes in substance abuse patterns, but these may merely reflect changing priorities in the treatment system rather than changes in drug abuse behavior. In addition, the TEDS data are aggregated through state systems that have unique characteristics. For example, while TEDS includes a large proportion of treatment facilities, it does not include all such facilities. Most but not all states are able to report admissions to public and private facilities, but some only report admissions supported by public funds. State-to-state variations in data also may include differences in the completeness of reporting, as well as in the ability to distinguish between initial admissions and transfers from one service to another in the course of a single treatment episode. Thus, admission rates for each drug type are available for each state and by geographic region, but state-by-state or regional comparisons must be made with extreme caution.
Special topics can be explored through analysis of TEDS data. Examples include adolescent admissions and their characteristics, multiple drug use and implications for treatment, patterns of use in racial and ethnic subgroups whose members present themselves for treatment, and routes of drug administration, especially for heroin and cocaine.
In addition to TEDS, SAMHSA conducts the Uniform Facility Data Set Survey, which provides information on location, characteristics, services, and use of drug and alcohol treatment facilities throughout the United States. It also conducts a single-day census of people in treatment. Data elements that form the core of the survey include organizational setting, service orientation, services available, clients in treatment by type of care, capacity, and annual revenue sources and amounts. The data are used to analyze general treatment services trends and to conduct comparative analyses among regions and states and the nation as a whole. In 1998, these analyses were based on the responses of 13,455 facilities (an increase of 35 percent over the previous year’s response rate), and the 1,038,738 people found to be in treatment on the referent date for the single-day census.
SAMHSA and the National Institute on Drug Abuse have also sponsored a series of treatment outcome studies since 1976. These have been single studies conducted over an extended period of time. None of these studies, however, was of clients drawn from a nationally representative sample of treatment facilities.
In 1995, the ONDCP asked SAMHSA to conduct a study that would involve a nationally representative sample of the treatment system. This request was addressed in two stages, the first of which involved a representative probability sample survey drawn from a comprehensive list of organized substance abuse treatment programs, the Drug Services Research Survey (DSRS). The second stage was the Services Research Outcome Study,