FACT SHEET Women in Treatment February 2011 The data in this fact sheet are based on clients in publicly funded and/or monitored alcohol and other drug treatment services in California during State Fiscal Year 2008-09. These data are reported in the California Outcome Measurement System - Treatment (CalOMS-TX), unless otherwise noted. Substance abuse and addiction is by far the number one women s health problem, causing illness, injury and death and contributing to a whole host of related social problems, says Susan Foster, the director of policy research for the National Center on Addiction and Substance Abuse (CASA) at Columbia University. There are important gender differences in substance use disorders that are meaningful for screening, diagnosis, and course of illness, as well as treatment. Further, Physicians are less likely to consider and diagnose addiction in women than in men. Based on the 2008 National Survey on Drug Use and Health (NSDUH), an estimated 22.2 million persons aged 12 or older in the United States were classified with substance dependence or abuse in the 12 months prior to the survey (9.0 percent of the population aged 12 or older). The prevalence of substance use disorders for females was 6.2 percent. Substances include alcohol and illicit drugs, such as marijuana, cocaine, heroin, hallucinogens, inhalants, as well as the non-medical use of prescription drugs. Women in Treatment This fact sheet provides a snapshot of California s female clients in publicly funded and/or monitored treatment programs for alcohol and other drugs (AOD) treatment. The fact sheet was prepared using California Outcome Measurement System Treatment (CalOMS-TX) data for State Fiscal Year (SFY) 2008-09. Data on clients AOD abuse are collected at admission and compared with data collected at discharge to measure client outcomes, treatment effectiveness, and the impact that treatment has on the lives of clients. These data are collected each time a client is admitted or discharged from an AOD treatment service. The data used for this fact sheet are based on client admissions and discharges, not unique client counts. A client is counted more than once if the client had more than one treatment admission and discharge during the selected reporting period. Admissions to detoxification services are excluded. Detoxification by itself does not constitute complete substance abuse treatment. It is very short term (usually several days to less than a week) and is often repeated numerous times. Therefore, including detoxification admissions would bias statistics in this fact sheet. 1 Based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (American Psychiatric Association [APA], 1994).
ADMISSION STATISTICS During SFY 2008-09 there were approximately 182,900 admissions to non-detoxification publicly funded and/or monitored treatment programs of which 69,400 (38%) were female clients. Under 18 18-25 26-35 36-45 46-55 Over 55 Women in Treatment by Age 0% 5% 10% 15% 20% 25% 30% 3% 12% 14% 20% Of the total admissions for females: 23% 28% 51% were 26 to 45 years old. 20% were college-age women (18-25 years old). 12% were under 18 years old. Almost half were white. 17% were African American. 2% were American Indian or Alaskan Native. 2% were Asian or Pacific-Islander. 5% were multi-racial. 24% identified their race as other. In addition to race, CalOMS clients are asked to identify their ethnicity; 34 percent were identified as Hispanic (i.e., Mexican American, Cuban, Puerto Rican, and other Hispanic categories). Hispanic Not Hispanic 12% were employed at the time of admission. 63% were unemployed and 25% were not in the labor force (i.e., not seeking work). 46% had less than 12 years of education, 37% had 12 years of education or had obtained their GED, and 17% reported some college education. Less than 12 years Ethnicity 0% 20% 40% 60% 80% 12 years or GED More than 12 years 34% Education 66% 0% 10% 20% 30% 40% 50% 17% 37% 46% Race 0% 10% 20% 30% 40% 50% 60% Employment Status 0% 10% 20% 30% 40% 50% 60% 70% White Other 24% 48% Unemployed, seeking work 63% African American American Indian or Alaskan Native Asian or Pacific Islander 2% 2% 17% Employed Not in labor force 12% 25% Multi racial 5%
62% had minor children. 44% were Medi-Cal beneficiaries. 15% were homeless. 19% reported at least one type of disability. 6% were pregnant. CalWORKs recipients accounted for 9% of the admissions. Primary Drug of Abuse Methamphetamine (37%) was by far the most common primary drug of abuse for female clients admitted to treatment, followed by alcohol (21%) and marijuana/ hashish (16%). Type of Service/Modality 59% were admitted to outpatient treatment programs and 8% were admitted to a Day Care Rehabilitative treatment program. Residential treatment accounted for 24%. 8% were admitted to a Narcotic Treatment Program (NTP). Type of Treatment Services Outpatient Residential Narcotic Replacement 0% 10% 20% 30% 40% 50% 60% 70% 8% 24% 59% Primary Drug of Abuse for Women Admitted to Treatment Day Care Rehabilitative 8% 0% 5% 10% 15% 20% 25% 30% 35% 40% Methamphetamine Alcohol Marijuana/Hashish Heroin Cocaine/Crack Other Source of Referral 21% 16% 11% 9% 6% 37% 43% were referred from the criminal justice system. Self referred was the next highest source of referral at 31%. Over 26% were referred by other sources. Source of Referral 0% 10% 20% 30% 40% 50% DISCHARGE STATISTICS Discharge information is collected each time a client leaves the treatment service into which she was admitted. Clients are counted each time they are discharged from a treatment service during the fiscal year. During SFY 2008-09, more than 64,300 women were discharged from AOD treatment. Of those: 38% stayed in treatment between 91 and 365 days. 29% stayed in treatment 31 to 90 days. 28% stayed in treatment up to 30 days. Days in Treatment 0% 10% 20% 30% 40% Criminal Justice Referred 43% 30 days or less 28% Self-Referred 31% 31-60 days 61-90 days 13% 16% Other Sources 26% 91-365 38% More than 365 days 5%
35% completed their treatment plan and related goals. 20% did not complete treatment, but were referred to a different program to continue with treatment services. 44% were administrative discharges. An administrative discharge occurs when a client ceases to appear for treatment services in which they are enrolled. Under such circumstances, providers determine the last date the client was seen and complete an abbreviated discharge record to indicate that the client left treatment prior to her planned discharge date. Abstinence from the primary drug increased 61 percent. The number using their primary drug between 1 and 20 days decreased 55 percent. The number using their primary drug 21 days or more decreased by 67 percent. 100% 50% 0% -50% -100% Changes in Primary Drug Use 61% Abstinence Used 1-20 Days Used 21+ Days -55% -67% Completed Tx, Referred Completed Tx, Not Referred Incomplete, Satisfactory, Referred Incomplete, Satisfactory, Not Referred Incomplete, Unsatisfactory, Referred Incomplete, Unsatisfactory, Not Referred Discharge Status Death/Incarceration Changes during Treatment 0% 10% 20% 30% 40% 15% 20% This section reports the changes in primary drug use and other life domains for female clients in treatment. Changes during treatment were calculated by comparing data on the clients addiction related problems in the 30 days prior to admission to the same measures in the 30 days prior to discharge. In SFY 2008-09, outcome data were collected from more than 30,900 female clients who were discharged treatment. Outcome data were not collected on the 44 percent of discharges who left before completing treatment. Since the following data is collected only for clients who either complete treatment or are referred to another treatment service, the results are biased toward positive outcomes. 2% 9% 11% 11% 31% Involvement in the criminal justice system decreased by 75 percent at discharge, as measured by one or more arrests in the prior 30 days. During treatment, use of social-support recovery activities increased by 44 percent. Research shows that increases in socialsupport recovery activities are positively related to improved client outcomes and improved long-term recovery. Health problems of female clients in treatment decreased by 35 percent at discharge compared to admission. The incidence of homelessness decreased by 20 percent. 60% 40% 20% 0% -20% -40% -60% -80% -100% -75% Changes During Treatment 44% 1 or More Arrests Use of Social Support Activities Health Problems -35% Homelessness -20%
The following changes during treatment are based on the clients situation at admission and discharge, rather than the 30 days prior. Employment was 36% higher at discharge compared to admission. Enrollment in school increased 62%. Participating in job training increased 93%. 100% 80% 60% 40% 20% 0% Changes During Treatment 93% 62% 36% Employment School Enrollment Job Training