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Alcohol and Drug Services Study (ADSS), 1996-1999: [United States] (ICPSR 3088) RSS

Alternate Title:  ADSS, 1996-1999

Principal Investigator(s):

Summary:

The Alcohol and Drug Services Study (ADSS) was a national study of substance abuse treatment facilities and clients. The study was designed to develop estimates of the duration and costs of treatment and to describe the post-treatment status of substance abuse clients. ADSS continues and extends upon data collected in the Drug Services Research Survey, 1990: [United States] (ICPSR 3393) and the Services Research Outcome Study, 1995-1996: [United States] (ICPSR 2691) with a more complete sampling frame, an enhanced sampling design, and more detailed measures of treatment services provided, the costs of treatment, and clients in treatment. ADSS was implemented in three phases. In Phase I, a nationally representative sample of treatment facilities was surveyed to assess characteristics of treatment services and clients including treatment type, costs, program capacity, the number of clients served, waiting lists, and services provided to special populations. In Phase II, records were abstracted from a sample of clients in a subsample of Phase I facilities. This phase included four sub-components: (1) the Main Study, an analysis of abstracted records to assess the treatment process and characteristics of discharged clients, (2) the Incentive Study, which assessed the impact of varying financial payments on follow-up interview participation among non-methadone outpatient clients, (3) the In-Treatment Methadone Client study (ITMC), which assessed the treatment process of methadone maintenance, and (4) the comparison study of Early Dropout clients (EDO), which provided a proxy comparison group of records from substance abusers that went untreated. Phase III involved follow-up personal interviews with Phase II clients who could be located. This interview sought to determine post-treatment status in terms of substance use, economic condition, criminal justice involvement, and further substance abuse treatment episodes. Urine testing was conducted to validate self-reported drug use. Drugs included in the survey were alcohol, marijuana, cocaine, crack cocaine, heroin, barbiturates, benzodiazepines, amphetamines, non-prescribed use of prescription medications, abuse of over-the-counter medications, and other drugs. ADSS also included a cost study, which involved obtaining additional financial information from the Phase II facilities. A computerized desktop audit was used in the cost study to conduct consistency and accuracy checks on selected questionnaire data from Phases I and II. Variables were subsequently updated to represent the most accurate data available. Additional analysis variables were then created using combinations of the revised Phase I and II data.

Access Notes

Dataset(s)

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DS1:  Phase I Facility Interview - Download All Files (43,840 KB)
DS2:  Phase II Administrator Interview - Download All Files (6,080 KB)
DS3:  Phase II Main/Incentive Abstract - Download All Files (34,896 KB)
DS4:  Phase II In-Treatment Methadone Abstract - Download All Files (8,992 KB)
DS5:  Phase II Early Dropout Abstract - Download All Files (4,880 KB)
DS6:  Phase III Main Study Follow-Up - Download All Files (23,104 KB)
DS7:  Phase III In-Treatment Methadone Follow-Up - Download All Files (17,336 KB)
DS8:  Phase III Early Dropout Follow-Up - Download All Files (9,488 KB)
DS9:  Phase I Finite Population Correction Factors - Download All Files (567 KB)
Documentation:
Data:
DS10:  Phase I Stratified Jackknife Factors - Download All Files (565 KB)
Documentation:
Data:
DS11:  Phase II/III Stratified Jackknife Factors - Download All Files (564 KB)
Documentation:
Data:
DS12:  Cost Study - Download All Files (8,872 KB)
Documentation:
Analyze Online:
SDA

Study Description

Citation

United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Office of Applied Studies. Alcohol and Drug Services Study (ADSS), 1996-1999: [United States]. ICPSR03088-v5. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2009-04-01. doi:10.3886/ICPSR03088.v5

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Export Citation:

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Funding

This study was funded by:

  • United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Office of Applied Studies (283-92-8331)

Scope of Study

Subject Terms:   AIDS, alcohol abuse, drug abuse, drug treatment, health care services, HIV, intervention, methadone maintenance, substance abuse, substance abuse treatment, treatment compliance, treatment outcome, treatment programs

Geographic Coverage:   United States

Time Period:  

  • 1996--1999

Unit of Observation:   facility, treatment client, treatment modality

Universe:   (1) Substance abuse treatment facilities in the United States registered in the Substance Abuse and Mental Health Services Administration's National Master Facility Inventory of known facilities. (2) Clients engaged in substance abuse treatment in these facilities.

Data Types:   survey data

Data Collection Notes:

The study was conducted by the Schneider Institute for Health Policy, Brandeis University. Westat, Inc. collected and prepared the data.

ADSS files underwent disclosure analysis by SAMHDA in order to ensure that the identities of facilities and clients were protected. This involved reviewing the data files for potential risks as well as examining any external threats to confidentiality, such as other data sources that could be linked to ADSS. Such external data sources were found. To address this problem while still creating a public use file of the greatest utility possible, micro-aggregation of certain variables was performed. This involved identifying the problematic variables, sorting records by the first problematic variable, grouping records into three based on their value for this variable, averaging the values for each grouping, and applying the average to the records in each group. This was repeated for each of the problematic variables, which included client count and financial data. Geographic identifiers were also removed. The overall impact of these protection procedures was small and should not affect most analytic uses of the data.

The Phase I facility public use file includes 2,394 of the original 2,395 records. One facility's record was deleted due to the presence of outlying data.

Client records can be matched between corresponding Phase II and Phase III abstract and follow-up data files using the CASEID variable. Facility data can be matched across the Phase I-III and cost study data files using the FACID variable.

The unit of analysis for the Phase I facility (Part 1) and Phase II administrator (Part 2) data is the facility. Data from the Phase II and III abstract and follow-up files (Parts 3-8) are analyzed at the client level. Analyses for the cost study (Part 12) are conducted at the modality or "type of care" level within facilities.

Please note that the unit of time for some variables in the facility file is specified in a separate variable, and these units are distinctly different from each other. For example, to analyze length of treatment, the researcher needs to examine two variables: QUANTITY VAR NAME and UNIT VAR NAME. QUANTITY specifies the "quantity" of treatment length while UNIT specifies the unit of QUANTITY such as days, weeks, months, years, or sessions.

The Finite Population Correction Factor and the two Stratified Jackknife Factor data files are provided for use with the WesVar and SUDAAN statistical software, and are not intended for use with other statistical packages. WesVar was developed by Westat Incorporated and SUDAAN is a product of the Research Triangle Institute. These three files are being distributed as received from the principal investigator and have not been tested by SAMHDA.

The data from the follow-up Incentive Study in Phase III are not released as part of this public use collection.

Methodology

Sample:   The Alcohol and Drug Services Study utilized a complex multistage sampling strategy. In Phase I, 2,395 substance abuse treatment facilities were selected from the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Master Facility Inventory (NMFI) of known facilities. The sample was stratified to reflect the types of care offered within the nation's substance abuse treatment system. Selection strata included: (1) hospitals, (2) non-hospital residential treatment facilities, (3) outpatient-predominantly methadone treatment facilities, (4) outpatient-nonmethadone treatment facilities, (5) outpatient combined methadone and nonmethadone treatment, (6) facilities serving predominantly alcohol abusing clients, and (7) facilities whose type of care could not be determined based on existing information at the time of sampling. Excluded from the sampling frame were halfway houses lacking paid counselors, solo practitioners, treatment programs in jails and/or correctional facilities, Department of Defense and Indian Health Service facilities, and facilities that were prevention or intake and referral only. Selection was based on probability proportional to size (PPS), with a minimum of 300 facilities to be selected per stratum. Sampling in Phase II consisted of several stages. First, the country was partitioned into approximately 400 geographic primary sampling units (PSUs) from which a representative sample of 62 were selected on the basis of demographic and economic characteristics. Within these 62 PSUs, a stratified subsample of Phase I facilities (n = 306) was selected using PPS. The subsample utilized exclusionary criteria that eliminated 12 facilities: (a) facilities that had ceased operation prior to March 1, 1997, (b) facilities designated as hospitals (i.e., stratum 1), and (c) facilities in which 100 percent of clients were treated for alcohol abuse only. To ensure adequate sample size, sampled facilities were matched with "shadow" facilities. Shadow facilities were then used to replace 46 refusing facilities, producing a final sample size of 280. Shadows were not used for facilities found to be ineligible (e.g., closed). Following interviews with administrators in the participating facilities, two types of client records were randomly sampled: (1) clients who were discharged for any reason at least one day after their date of treatment initiation, and (2) clients still actively engaged in methadone treatment. Persons whose treatment episode was clearly limited to mental health, family counseling, or other non-substance abuse services were not considered substance abuse treatment clients and were excluded from the sampling frame, even if they had prior history of substance abuse treatment. The client must have been the substance abuser him- or herself and not a family member or other person receiving treatment in relation to the substance abuser. In addition to the random sample, a non-probability convenience sample of early dropout discharges (EDO) from outpatient programs was drawn as the comparison group. Early dropout clients were defined as clients who had been through assessment or an intake battery but completed no more than one day or one session of treatment. The comparison group was selected from cooperating facilities, to serve as a proxy for untreated substance abusers. In Phase III, clients randomly selected in the previous phase were approached for interview. Discharged clients younger than 18 years old at the time of interview and clients in the main study discharged group who were classified as methadone patients were excluded from this phase. The cost study included facilities from Phase II, and the design included splitting data by modality for facilities with more than one type of care (multi-modality).

Weight:   The Phase I sampling design incorporated a stratified random probability sample. Weights were developed for the Phase I sample to facilitate overall and by stratum estimates of facility- and client-level characteristics of the nation's substance abuse treatment system. Final Phase I weights were constructed in a multistep process involving calculation of initial base weights, trimming to guard against excessive influence by a few highly loaded facilities, adjustment for facility nonresponse, and poststratification adjustment to initial frame counts. Because the Phase I sample was selected using a complex multistage design, resampling is the appropriate method of calculating the stability of computed statistics. Replicate weights based on the stratified jackknife procedure (JKn) are included in the ADSS Phase I dataset for the purpose of standard error calculations.

Mode of Data Collection:   record abstracts, mail questionnaire, telephone interview

Response Rates:   Of the original 294 eligible facilities, 60 refused to participate, yielding a response rate of 79.6 percent.

Extent of Processing:  ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major statistical software formats as well as standard codebooks to accompany the data. In addition to these procedures, ICPSR performed the following processing steps for this data collection:

  • Performed consistency checks.
  • Standardized missing values.
  • Created online analysis version with question text.
  • Performed recodes and/or calculated derived variables.
  • Checked for undocumented or out-of-range codes.

Version(s)

Original ICPSR Release:  

Version History:

  • 2009-04-01 Question text was added into the codebooks for parts 1 through 8. The SAS transport (XPORT) and SPSS portable files were replaced with a SAS CPORT and SPSS system file. Additionally, a tab-delimited excel data file was included for download for each dataset.
  • 2007-07-17 New files were added to one or more datasets. These files included one or more of the following: Stata setup, SAS transport, SPSS portable, Stata system, SAS supplemental syntax, and Stata supplemental syntax files. This process affected some column locations, as a result, codebooks were updated to reflect correct new column locations.
  • 2006-06-09 The frequency output and metadata LRECL number corrected for Part 1: Phase 1 Facility Data
  • 2005-11-04 On 2005-03-14 new files were added to one or more datasets. These files included additional setup files as well as one or more of the following: SAS program, SAS transport, SPSS portable, and Stata system files. The metadata record was revised 2005-11-04 to reflect these additions.
  • 2004-06-10 The ADSS cost study data (Part 12) were added to the ADSS public use collection with a separate codebook.
  • 2003-11-03 Three new data files were added to the ADSS collection: Phase I Finite Population Correction Factors (Part 9), Phase I Stratified Jackknife Factors (Part 10), and Phase II/III Stratified Jackknife Factors (Part 11). These factor files are intended for use with the WesVar and SUDAAN statistical software only. These three files are being distributed as received from the principal investigator and have not been tested by SAMHDA. Minor revisions were made to the Phase I facility codebook.

Related Publications

Variables

Browse Matching Variables

DS1: Phase I Facility Interview

A10. NUM CERT. IN S A TRT
How many of your staff are certified in substance abuse treatment?
B2REA1. NUM MALE RES CLIENTS
Total substance abuse treatment clients as of October 1, 1996 RESIDENTIAL CLIENTS
B2REA2. NUM FEMALE RES CLIENTS
Total substance abuse treatment clients as of October 1, 1996 RESIDENTIAL CLIENTS
B2REA3. NUM RES CLIENTS GENDER UNK
Total substance abuse treatment clients as of October 1, 1996 RESIDENTIAL CLIENTS
B2REB1. NUM WHITE RES CLIENTS
Total substance abuse treatment clients as of October 1, 1996 RESIDENTIAL CLIENTS
B2REB2. NUM BLACK RES CLIENTS
Total substance abuse treatment clients as of October 1, 1996 RESIDENTIAL CLIENTS
B2REB3. NUM HISPANIC RES CLIENTS
Total substance abuse treatment clients as of October 1, 1996 RESIDENTIAL CLIENTS
B2REB4. NUM ASIAN RES CLIENTS
Total substance abuse treatment clients as of October 1, 1996 RESIDENTIAL CLIENTS
B2REB5. NUM NATIVE AMER RES CLIENTS
Total substance abuse treatment clients as of October 1, 1996 RESIDENTIAL CLIENTS __________
B2REB6. NUM RES UNK RACIAL ORIGIN
Total substance abuse treatment clients as of October 1, 1996 RESIDENTIAL CLIENTS

DS2: Phase II Administrator Interview

Q45C. HOW MANY OF THESE PROVIDE S.A. TX-FINANCIAL STATEMENT
How many of these provide substance abuse treatment?
Q1. TOTAL CLIENTS CURRENTLY IN S.A. TX AT THIS FACILITY
How many total clients are currently in substance abuse treatment at this facility?
Q55. WHAT ARE THE 12-MONTH TOTAL SUB ABUSE TX COSTS
What are the 12-month total substance abuse treatment costs for this facility? If these data are obtained from a financial report in thousands of dollars, add three zeros to convert to dollars. Count only costs related to substance abuse treatment.
Q51A. OFFERED COMPREHENSIVE ASSESSMENT/DIAGNOSIS
Does this substance abuse treatment facility offer any of the following services to any substance abuse clients? Comprehensive assessment / diagnosis
Q51B. OFFERED CHILD CARE
Does this substance abuse treatment facility offer any of the following services to any substance abuse clients? Child care
Q51C. OFFERED TRANSPORTATION
Does this substance abuse treatment facility offer any of the following services to any substance abuse clients? Transportation
Q51E. OFFERED INDIVIDUAL THERAPY
Does this substance abuse treatment facility offer any of the following services to any substance abuse clients? Individual therapy
Q51F. OFFERED GROUP THERAPY, NOT RELAPSE PREV
Does this substance abuse treatment facility offer any of the following services to any substance abuse clients? Group therapy
Q51G. OFFERED RELAPSE PREVENTION GROUPS
Does this substance abuse treatment facility offer any of the following services to any substance abuse clients? Relapse prevention groups
Q51H. OFFERED FAMILY COUNSELING
Does this substance abuse treatment facility offer any of the following services to any substance abuse clients? Family counseling

DS3: Phase II Main/Incentive Abstract

DS4: Phase II In-Treatment Methadone Abstract

DS5: Phase II Early Dropout Abstract

DS6: Phase III Main Study Follow-Up

BEFORE (SEG 2) EVER RECV. TX OR COUNSEL FOR ALCOHOL OR DRUGS
Now, I am going to ask about any substance abuse treatment or counseling that you received at any time before you entered treatment at (FACILITY NAME) on (SEGMENT 2 START DATE). Before (SEGMENT 2 START DATE) did you ever receive treatment or counseling for your use of alcohol or drugs? Do not include self-help groups such as Alcoholics Anonymous (AA), Cocaine Anonymous (CA), or Narcotics Anonymous (NA). If No -> Go To B50

DS7: Phase III In-Treatment Methadone Follow-Up

BEFORE (SEG 2) EVER RECV. TX OR COUNSEL FOR ALCOHOL OR DRUGS
Now, I am going to ask about any substance abuse treatment or counseling that you received at any time before you entered treatment at (FACILITY NAME) on (SEGMENT 2 START DATE). Before (SEGMENT 2 START DATE) did you ever receive treatment or counseling for your use of alcohol or drugs? Do not include self-help groups such as Alcoholics Anonymous (AA), Cocaine Anonymous (CA), or Narcotics Anonymous (NA). If No -> Go To B50

DS8: Phase III Early Dropout Follow-Up

BEFORE (SEG 2) EVER RECV. TX OR COUNSEL FOR ALCOHOL OR DRUGS
Now, I am going to ask about any substance abuse treatment or counseling that you received at any time before you entered treatment at (FACILITY NAME) on (SEGMENT 2 START DATE). Before (SEGMENT 2 START DATE) did you ever receive treatment or counseling for your use of alcohol or drugs? Do not include self-help groups such as Alcoholics Anonymous (AA), Cocaine Anonymous (CA), or Narcotics Anonymous (NA). If No -> Go To B50

DS12: Cost Study

150. PHASEI-AVERAGE LENGTH OF STAY
Phase I - Average length of stay. 146 / 147. NC3 and SC3 - Phase I - Average Length of Stay and Source Identifier Phase I Instrument Reference Source: For each type of care provided at this substance abuse treatment facility, please estimate the average length of time that clients remained in substance abuse treatment over the most recent 12-month period.
26. PHASE II-TOTAL COSTS
Phase II - Total costs. 22 / 23. NQ55 and SQ55 - Phase II - Total Costs and Source Identifier Phase II Instrument Reference Source: What are the 12-month total substance abuse treatment costs for this facility? If these data are obtained from a financial report in thousands of dollars, add three zeros to convert to dollars. Count only costs related to substance abuse treatment.
28. POST-AUDIT PHASE II-TOTAL REVENUES
Phase II - Total revenues. 24 / 25. NQ52 and SQ52 - Phase II - Total Revenue and Source Identifier Phase II Instrument Reference Source: What is the 12-month substance abuse treatment revenue or funding for this facility? Include all sources such as client payments, insurance, contracts, grants, government funds, budget allocations, and donations. If possible, count only income related to substance abuse treatment.
152. PHASEI-TOTAL COSTS
Phase I - Total costs. 148 / 149. ND14 and SD14 - Phase I - Total Costs and Source Identifier Phase I Instrument Reference Source: What are the total substance abuse treatment costs for this facility? Report 12-month costs. If these data are obtained from a financial report in thousands of dollars, add three zeros to convert to dollars. Count only costs related to substance abuse treatment.
24. PHASE II-RES BED CAPACITY
Phase II - Residential bed capacity - total beds. 20 / 21. NQB and SQB - Phase II - Residential bed capacity (total beds) and Source Identifier Phase II Instrument Reference Sources: 5a. How many hospital inpatient beds for substance abuse treatment does this facility have? 5b. How many of those are for inpatient detoxification? 5c. How many of those are for inpatient rehabilitation? 12a. How many non-hospital residential beds for substance abuse treatment does this facility have? 12b. How many of those are for residential detoxification? 12c. How many of those are for residential rehabilitation?
154. POST-AUDIT PHASE I-TOTAL REVENUES
Phase I - Total revenues. 150 / 151. ND7 and SD7 - Phase I - Total Revenue and Source Identifier Phase I Instrument Reference Source: What is the total substance abuse treatment revenue of funding for this facility? Report revenue or funding for the most recent 12-month period available, or you may repeat the 12-month period used in the UFDS survey. Include all sources such as client payments, insurance, contracts, grants, government funds, budget allocations, and donations. Count only revenue or funding related to substance abuse treatment.
62. PHASE II-HOURLY RATE FTE PHYSICIANS
Phase II - Hourly wages for full-time staff. 58 / 59. NQ49a and SQ49a - Phase II - Hourly wages for full-time staff Physicians and Source Identifier Phase II Instrument Reference Source: What is the average salary paid by this substance abuse treatment facility for (STAFF TYPE)? Please note if the dollar rate indicated is (YR) yearly, please divide by: 2080 for 40 hr work week, 1950 for 37.5 hr work week, or 1820 for 35 hour work week. The hours per work week can be determined from Q47 - Column # 4 (Total number of hours worked in substance abuse treatment during the last full 7-day period for which you have records).
64. PHASE II-HOURLY RATE FTE NURSES
Phase II - Hourly wages for full-time staff. 60 / 61. NQ49b and SQ49b - Phase II - Hourly wages for full-time staff - RN and Source Identifier Phase II Instrument Reference Source: What is the average salary paid by this substance abuse treatment facility for (STAFF TYPE)? Please note if the dollar rate indicated is (YR) yearly, please divide by: 2080 for 40 hr work week, 1950 for 37.5 hr work week, or 1820 for 35 hour work week. The hours per work week can be determined from Q47 - Column # 4 (Total number of hours worked in substance abuse treatment during the last full 7-day period for which you have records).
66. PHASE II-HOURLY RATE FTE OTHER MED
Phase II - Hourly wages for full-time staff. 62 / 63. NQ49c and SQ49c - Phase II - Hourly wages for full-time staff - Other Medical and Source Identifier Phase II Instrument Reference Source: What is the average salary paid by this substance abuse treatment facility for (STAFF TYPE)? Please note if the dollar rate indicated is (YR) yearly, please divide by: 2080 for 40 hr work week, 1950 for 37.5 hr work week, or 1820 for 35 hour work week. The hours per work week can be determined from Q47 - Column # 4 (Total number of hours worked in substance abuse treatment during the last full 7-day period for which you have records).
68. PHASE II-HOURLY RATE FTE PSYCHOLOGIST
Phase II - Hourly wages for full-time staff. 64 / 65. NQ49d and SQ49d - Phase II - Hourly Wages for full-time staff - Ph.D. Counselors and Source Identifier Phase II Instrument Reference Source: What is the average salary paid by this substance abuse treatment facility for (STAFF TYPE)? Please note if the dollar rate indicated is (YR) yearly, please divide by: 2080 for 40 hr work week, 1950 for 37.5 hr work week, or 1820 for 35 hour work week. The hours per work week can be determined from Q47 - Column # 4 (Total number of hours worked in substance abuse treatment during the last full 7-day period for which you have records).

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