title: Residential and outpatient treatment completion for substance use disorders in the U.S.: Moderation analysis by demographics and drug of choice.
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 to a greater degree for older clients, Whites, and opioid abusers, as compared to younger clients, non-Whites, and alcohol and other substance users, respectively.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, United States. Electronic address: jstahler@temple.edu.
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Stahler
authors.affiliation: Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, United States. Electronic address: jmennis@temple.edu.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Mennis
authors.affiliation: Department of Psychological Studies in Education, Temple University, Philadelphia, PA 19122, United States. Electronic address: jducette@temple.edu.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: DuCette
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology / Q000628:therapy; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000628:therapy; D016208:Databases, Factual; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000628:therapy; D010349:Patient Compliance / Q000208:ethnology / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000208:ethnology / Q000706:statistics & numerical data*; D012114:Residential Treatment / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000628:therapy*; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Dropout; Outpatient; Residential; Retention; Treatment completion