Comparing and Evaluating Substance Use Treatment Utilization Estimates from the National Survey on Drug Use and Health and Other Data Sources

Abstract

This report presents an evaluation of the coverage, overlap, biases, strengths, and weaknesses of three sources of data on the receipt of specialty substance use treatment: the National Survey on Drug Use and Health (NSDUH), the National Survey of Substance Abuse Treatment Services (N-SSATS), and the Treatment Episode Data Set (TEDS). NSDUH is an annual survey of a representative sample of persons aged 12 or older at their places of residence. N-SSATS is an annual census of all known drug and alcohol abuse treatment facilities in the United States. TEDS is a compilation of data detailing the demographic and substance use characteristics of admissions to and discharges from substance use treatment. Methodological differences among these data sources that may contribute to differences in estimates are described. Specialty substance use treatment measures compared include numbers and characteristics of persons treated in a given year, single-day treatment counts, numbers of admissions in a given year, and estimates of the numbers of persons who needed substance use treatment but did not receive it.NSDUH estimates of persons treated in a given year were significantly higher than the estimate from TEDS. Single-day treatment counts from NSDUH were similar to those from N-SSATS, and both were significantly higher than those from TEDS. N-SSATS counts of annual admissions were significantly higher than counts derived from TEDS data. The consistently lower counts in TEDS appear to be due to coverage differences in the three data systems. TEDS is mainly limited to those persons whose treatment was publicly funded, whereas N-SSATS includes a census of all facilities regardless of funding, and NSDUH includes persons who are treated in both privately and publicly funded facilities.Precise agreement among the data sources is not expected, and this lack of agreement does not reduce the importance of NSDUH, N-SSATS, and TEDS in contributing to our understanding of specialty substance use treatment in the United States. The analyses presented in this report provide a strong basis for improving the interpretation of results from these three studies. This will facilitate developing clear guidance for future analyses to better answer some basic questions about substance use treatment, such as how many persons receive treatment in a year, how large is the gap between treatment received and treatment needed, and how have the numbers of persons receiving and needing treatment changed over time.