Lev S. Sverdlov, MD, PhD¹, Thomas M. Brady, PhD², Leigh A. Henderson, PhD³, Sameena Salvucci, PhD³, Serge Sverdlov, BS⁴, and Hannah Kyeyune, MS³. (1) Synectics for Mnagement Decisions, Inc., 1901 North Moore Street, Suite 900, Arlington, VA 22209, 703-807-2319, levs@smdi.com, (2) Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Parklawn Bldg, 5600 Fishers Lane, Suite 16-105, Rockville, MD 20857, (3) Synectics for Management Decisions, Inc., 1901 North Moore Street, Suite 900, Arlington, VA 22209, (4) California Institute of Technology, P.O. Box 6300, Pasadena, CA 91125

Outpatient treatment is the most common type of care for substance abuse clients. Retention measured as length of stay in treatment (LOS), and completion of planned treatment (COMPLETION) are important measures of the effectiveness of treatment. Research suggests that LOS, as well as COMPLETION, is associated with better post-discharge outcomes. Previous studies demonstrated the association of LOS and COMPLETION with multiple clinical, demographic, and social factors. This study focused on analysis of the association between LOS, number of therapeutic encounters (ENCOUNTERS), and COMPLETION. Using the Alcohol and Drug Services Study (ADSS), a nationwide survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), this study analyzed 2,978 records representing 1,082,596 clients discharged from outpatient non-methadone treatment. The 2 x 2 classification of clients by LOS and ENCOUNTERS revealed four groups differentially associated with COMPLETION: (1) short stay in treatment, few ENCOUNTERS; (2) long stay in treatment, few ENCOUNTERS; (3) short stay in treatment, many ENCOUNTERS and (4) long stay in treatment, many ENCOUNTERS. The 3rd degree polynomial probit regression of COMPLETION by LOS and ENCOUNTERS revealed the existence of an “optimal zone” in which the probability of COMPLETION was maximized. The association of COMPLETION with the intensity and volume of treatment will be reported. The concept of “Treatment-Outcome Complex” characterizing relationships between outcome and treatment measures in observational studies will be introduced. The findings will be discussed in the context of the optimization of the effectiveness of substance abuse treatment.

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