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Chapter 2 Overview of Total Sample. GAIN Coordinating Center (11/21/2012). Normal , IL: Chestnut Health Systems. November 2012 . Available from www.gaincc.org/slides.

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chapter 2 overview of total sample

Chapter 2Overview of Total Sample

GAIN Coordinating Center (11/21/2012).

Normal, IL: Chestnut Health Systems. November 2012.

Available from www.gaincc.org/slides

Created for: Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) under contract number 270-2012-00001

samhsa csat full gain outcome data set
SAMHSA/CSAT Full GAIN Outcome Data Set

Sample: The 2011 SAMHSA/CSAT data set includes data on 29,782 clients from 230 local evaluations, recruited between 1997-2011 who were due for at least one follow-up and available in the last quarterly data set of 2011.

Levels of Care: Outpatient, Intensive Outpatient, Short-term & Moderate/Long-term Residential, Corrections-Based Treatment and Post-Treatment Continuing Care

Instrument: Global Appraisal of Individual Needs (GAIN) (see www.gaincc.org/gaini) Versions 3 (CYT & ATM) and 5.1 through 5.6

Follow-up: 89% with one or more follow-ups at 3, 6, 9 & 12 months post intake, and 66% with two or more

Funding: SAMHSA/CSAT contracts 270-07-0191 and 270-2012-00001 and 230 individual grants

(see Detailed Acknowledgement)

risk and protective factors
Risk and Protective Factors
  • The following slides present information on demographics, and risk and protective factors for clients at intake, including:
    • Demographics
    • Substance use
    • Risk behaviors
    • Victimization
    • Mental health disorders
    • Physical health problems
    • Crime and violence
    • Sources of stress and strengths
    • Costs
    • Summary indices (problem prevalence, quality of life, general satisfaction)
    • Non-client characteristics (program, level of care,

and type of treatment)

slide4
Age

26+ Years9.4% (n=2,804)

Under 15 Years (<15)

13.8%

(n=4,105)

18 -25 Years13.4% (n=3,976)

15-17 Years63.5% (n=18,897)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,782)

gender
Gender

Other0.03% (n=10)

Females 27% (n= 8,172)

Males 73% (n=21,599)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,781)

slide6
Race

African American

15.8% (n=4,702)

Multi-racial 13.4% (n=4,003)

Hispanic28.7% (n=8,555)

Other3.9% (n=1,152)

White38.1% (n=11,355)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,767)

demographic characteristics
Demographic Characteristics

SAMHSA/CSAT data dominated by male, minority, age 15 to 17

*Any Hispanic ethnicity separate from race group

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,782)

environment
Environment

*n = 14,789

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,502)

current risk of homelessness
Current Risk of Homelessness

At Risk 10.4% (n=3,073)

Currently Homeless 4.3% (n=1,261)

Group or Institution 10.7% (n=3,174)

Housed 74.7% (n=22,138)

substance problem recognition
Substance Problem Recognition

* n=13,112

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,722)

substance severity by time period
Substance Severity by Time Period

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,684)

past 90 day primary substance
Past 90 Day Primary Substance

Opioids

4.9% (n=1,353)

Other Drugs

2.3%

(n=644)

Amphetamines 6.8% (n=1,898)

Alcohol 26.4% (n=7,327)

Cocaine

5.2% (n=1,432)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,716)

substance use problems
Substance Use Problems

*Count of 8 items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,362)

pattern of weekly use 13 90 days
Pattern of Weekly Use (13+/90 days)

*Not a weekly measure; any in past 90 days

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,615)

substance use disorders in past year by major substances
Substance Use Disorders in Past Year by Major Substances

*n=10,897

**Not counted in Any SUD Diagnosis. Abuse is not an option for Tobacco.

SAMHSA 2011 GAIN Summary Analytic Data Set (n=24,413)

tobacco diagnosis
Tobacco Diagnosis

Never Used

20%

(n=5,354)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,384)

recovery environment peers
Recovery Environment - Peers

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,179)

recovery environment home
Recovery Environment - Home

*Past 90 days

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,179)

hiv risk scale past year at intake needle use
HIV Risk Scale* Past Year at Intake: Needle Use

* Mean of 36 items from the next four slides. Intake only.

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,905)

hiv risk scale past year at intake sex
HIV Risk Scale* Past Year at Intake: Sex

* Mean of 36 items. Intake only.

**n=8,246

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,079)

hiv risk scale past year at intake victimization
HIV Risk Scale* Past Year at Intake: Victimization

* Mean of 36 items. Intake only.

**n=18,224

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,378)

hiv risk scale past year at intake trauma
HIV Risk Scale* Past Year at Intake: Trauma

*Mean of 36 items. Available at intake only.

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,422)

hiv risk change index in past 90 days at intake
HIV Risk Change Index* in Past 90 Days at Intake

*Count of 7 items listed. Can be used to measure change.

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,114)

number of sex partners
Number of Sex Partners*

*In the past 90 days

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,751)

severity of victimization scale
Severity of Victimization Scale

*n=18,224

**Mean of 15 items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,646)

past year mental health disorders
Past Year Mental Health Disorders

Both 32.8% (n=9,727)

Neither 37.3% (n=11,059)

Externalizing Disorders Only

20.6% (n=6,128)

Internalizing Disorders Only

9.3% (n=2,770)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,684)

co occurring psychiatric problems
Co-Occurring Psychiatric Problems

*(n=22,106)

** Count of Conduct Disorder, ADHD/ADD Major Depressive Disorder, Traumatic Stress Disorder, and Generalized Anxiety Disorder

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,588)

homicidal suicidal thoughts
Homicidal/Suicidal Thoughts

*Mean of 5 items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,551)

para suicidal index
Para-suicidal Index

*Sum of 4 items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=22,107)

family history of health problems
Family History of Health Problems

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,345)

past 90 day health problems
Past 90 Day Health Problems

Low Problems

54.3% (n=16,019)

High Problems

8.8% (n=2,604)

Moderate Problems

36.8% (n=10,854)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,477)

quarterly cost of health care utilization
Quarterly Cost of Health Care Utilization
  • Using the GAIN, we are able estimate the quarterly cost to society of tangible services (e.g., hospital visits, emergency room visits, etc.) in 2011 dollars for the 90 days before intake.
  • For the 29,782 clients served in 230 sites between 1998-2011, the average Quarterly Cost of Health Care Utilization (HCU) per client:
    • in the quarter before they entered treatment, was $2,525 and totaled $71,908,959 across clients.
    • in the year before they entered treatment, was $10,099 per client and totaled $287,635,836 across clients.
hcu cost to society 2011 dollars
HCU Cost to Society – 2011 Dollars

*Quarterly Health Care Utilization 2011 dollars w/ SA TX based onFrench, M.T., Popovici, I., & Tapsell, L. (2008). The economic costs of substance abuse treatment: Updated estimates and cost bands for program assessment and reimbursement. Journal of Substance Abuse Treatment, 35, 462-469.

health care utilization cost
Health Care Utilization Cost

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,481)

past year crime and violence
Past Year Crime and Violence

Low

41.2% (n=12,241)

High

35.1% (n=10,411)

Moderate 23.7% (n=7,051)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,703)

past year crime justice involvement
Past Year Crime & Justice Involvement

*Dealing, manufacturing, prostitution, gambling (does not include simple possession or use)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,737)

type of crime
Type of Crime

* Violent crime includes assault, rape, murder, and arson.

** Other crime includes vandalism, possession of stolen goods, forgery, and theft.

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,377)

cost of crime in the past year
Cost of Crime in the Past Year
  • Using the GAIN we are able estimate the cost to society associated with economic losses due to criminal activity (e.g., vandalism, forgery, theft, assault, arson, rape, murder) in 2011 dollars for the year prior to intake.
  • Of the 29,782 clients served in 230 sites between 1998-2011, the average Cost of crime per client, in the year before they entered treatment, was $276,153 and totaled $756,797,1245 across clients.
cost of crime 2011 dollars
Cost of Crime – 2011 Dollars*

*Cost of Crime 2011 dollars w/ SA TX based on McCollister, K. E., French, M. T., & Fang, H. (2010). The

cost of crime to society: New crime-specific estimates for policy and program evaluation. Drug and Alcohol Dependence, 108(2)(1-2), 98-109.

cost of crime
Cost of Crime

SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,405)

intensity of justice system involvement
Intensity of Justice System Involvement

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,617)

recency of system involvement
Recency of System Involvement

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,578)

count of major clinical problems at intake
Count of Major Clinical Problems at Intake

*Based on count of self reporting criteria to suggest alcohol, cannabis, or other drug disorder, depression, anxiety, trauma, suicide, ADHD, CD, victimization, violence/ illegal activity

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,832)

gain initial profile behavior change scales at intake
GAIN-Initial Profile:Behavior Change Scales at Intake

* n =12,440

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,162)

sources of stress personal
Sources of Stress: Personal

SAMHSA 2011 GAIN Summary Analytic Data Set (n=14,797)

sources of stress other
Sources of Stress: Other

*Sum of 15 items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=14,413)

treatment readiness
Treatment Readiness

*Sum of 9items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,086)

self help activities scale
Self-Help Activities Scale

*Mean of 19 items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=8,321)

individual strengths
Individual Strengths

*Sum of 10 items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,996)

general social support strengths
General Social Support Strengths

*Sum of 9items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=14,649)

spiritual social support index
Spiritual Social Support Index

* Sum of 7 items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=13,086)

potential mentors in the recovery environment
Potential Mentors in the Recovery Environment

Home

Critical

gap in connection to recovery community

School or Work

Social Peers

*Sum of 12 items

SAMHSA 2011 GAIN Summary Analytic Data Set (n=27,385)

quarterly cost to society
Quarterly Cost to Society
  • Using the GAIN we are able estimate the cost to society of tangible services (e.g., health care utilization, days in detention, probation, parole, days of missed school) in 2011 dollars for the 90 days before intake.
  • Of the 29,782 clients served in 230 sites between 1998-2011, the average Quarterly Cost to Society (QCS) per client:
    • in the quarter before they entered treatment, was $4,997 and totaled $133,373,852 across clients.
    • in the year before they entered treatment, was $19,989 per client and a total of $533,495,408 across clients.
quarterly cost to society 2011 dollars
Quarterly Cost to Society – 2011 Dollars*

*Quarterly cost to society 2011 dollars w/ SA TX based onDennis, M. L., French, M. T., McCollister, K. E., & Scott, C. K. (2011). The economic costs of quarterly monitoring and recovery management checkups for adults with chronic substance use disorders. Journal of Substance Abuse Treatment, 41, 201-207.

quarterly cost to society1
Quarterly Cost to Society

SAMHSA 2011 GAIN Summary Analytic Data Set (n=26,924)

problem prevalence index
Problem Prevalence Index
  • Summarizes days of problems across domains: substance use, internalizing disorders, externalizing disorders, physical health risk behaviors, criminal involvement, vocational problems, and environmental concerns.
  • Calculation: the average of the percent of days with problems (of past 90) on each of 23 items across 8 areas. The resulting score is multiplied by 100 to get an index score from 0 to 100.
  • Interpretation: continuous; where higher values represent more problems across multiple domains.
  • Triage groups: Low (0-5), Moderate (6-24) or High (25-100) based on roughly 50%, 40% and 10% of the clinical population.
quality of life
Quality of Life
  • Summarizes quality of life represented by fewer reported problems during the past year in school problems, work problems, health problems, sources of stress, risk behavior, internal disorders, external disorders, substance disorders, and crime/violence.
  • Calculation: the sum of 9 screeners from the GAIN-Q version 3 (reversed to Low=2, Moderate=1, and High=0) divided by the range (18), and multiplied by 100 to get a score from 0 to 100.
  • Interpretation:continuous; where higher values represent greater quality of life.
  • Triage groups: Low (0-36), Moderate (37-69) or High (70-100) groups.
general satisfaction index
General Satisfaction Index
  • Summarizes life satisfaction in 6 areas (sexual relationship, living situation, family relationships, school/work, free time, and getting help with problems). This index is optional.
  • Calculation: sum of these dichotomous items.
  • Interpretation: continuous; where higher values represent greater satisfaction with life situations.
  • Triage groups: Low problems (5-6), Moderate problems (3-4) or High problems (0-2) groups.High satisfaction corresponds to low problems.
    • However, for the purposes of this presentation, the groups are not reversed, so in the following slides, low satisfaction scores (0-2) are in the low group, and high satisfaction scores (5-6) are in the high group.
cross validation of four summary indices
Cross Validation of Four Summary Indices

Beneficial

Problematic

*GSI groups are usually reversed (low satisfaction scores (0-2) are in the high problem group); here low satisfaction scores are in the low group, and high satisfaction scores are in the high group.

SAMHSA 2011 GAIN Summary Analytic Data Set (n=22,163)

general satisfaction index by problem prevalence index
General Satisfaction Index by Problem Prevalence Index

Problems are subjectively unpleasant and are associated with lower satisfaction

SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,218)

general satisfaction index by quality of life
General Satisfaction Index by Quality of Life

Quality of life is subjectively pleasant and is associated with higher satisfaction

SAMHSA 2011 GAIN Summary Analytic Data Set (n=12,278)

general satisfaction index by quarterly cost to society
General Satisfaction Index by Quarterly Cost to Society

Higher costs are subjectively unpleasant and are associated with lower satisfaction

SAMHSA 2011 GAIN Summary Analytic Data Set (n=11,146)

funder
Funder

SAMHSA Adult: 2.6%

(n=774; 2 grants)

SAMHSA CJ Adult: 10.7%

(n=3,186; 26 grants)

Collaboratively Funded 3.3% (n=979; 9 grants)

SAMHSA Adolescent Treatment (AT): 67.6% (n=20,123; 161 grants)

SAMHSA

Criminal Justice (CJ) Adolescent: 15.8% (n=4,720;

32 grants)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,782)

grant program in chronological order of first grant cohort
Grant Program in Chronological Order of first grant cohort

1997-2001, Cannabis Youth Treatment (CYT)

1998-2003, Adolescent Treatment Models (ATM)

2002-2007, Strengthening Communities – Youth (SCY)

2002-2011, Targeted Capacity Expansion (TCE; TCE/HIV)

2003-2006, Adolescent Residential Treatment (ART)

2003-2008, Effective Adolescent Treatment (EAT)

2004-2010, Young Offender Reentry Program (YORP)

2005-2010, Juvenile Treatment Drug Court (DC)

2006-2011, Adolescent Assertive Family Treatment (AAFT)

2006-2009, Family Drug Court (FDC)

2007-2011, Office of Juvenile Justice and Delinquency Prevention RWJF (OJJDP)

2008-2011, Adult Treatment Drug Court (ATDC)

2008-2011, Brief Interventions and Referrals to Treatment (OJJDP-BIRT)

2009-2011, Offender Re-entry Program (ORP)

2009-2011, Reclaiming Futures-Juvenile Drug Court (RF-JDC)

2011-2011, Juvenile Treatment Drug Court (JTDC)

grant program
Grant Program

Other Justice Grants:RF/BIRT, FDC, JTDC, RF/JDC, OJJDP (n=1,243; 14 grants)

ART: Adolescent Residential Treatment (n=1,636; 13 grants)

ATM: Adolescent Treatment Models (n=1,455; 10 grants)

TCE: Targeted Capacity Expansion (n=3,017; 15 grants)

CYT: Cannabis Youth Treatment (n=600; 4 grants)

EAT: Effective Adolescent Treatment (n=6,393; 37 grants)

YORP: Young Offender Re-entry Program (n=2,278; 10 grants)

ORP:Offender Re-entry Program (n=2,449; 21 grants)

DC: Juvenile

TreatmentDrug Court (n=1,768; 11 grants)

ATDC: Adult Treatment Drug Court (n=1,147; 11 grants)

AAFT: Adolescent Assertive

Family Treatment (n= 5,497; 75 grants)

SCY: Strengthening

Communities-Youth (n=2,299; 9 grants)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=29,782)

level of care
Level of Care

LTR: Long Term Residential 8.4% (n=2,418)

STR: Short Term Residential 1.2% (n=334)

CC-OP: Continuing Care – Outpatient 7.1% (n=2,030)

OP: Outpatient 70.5% (n=20,263)

IOP: Intensive Outpatient 12.9% (n=3,704)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,749)

type of treatment
Type of Treatment

Local Tx Manual: Specific Manualized Treatment 6.6% (n=1,895)

Other:Non-Manualized Treatment 17.8% (n=5,140)

A-CRA/ACC: Adolescent Community Reinforcement Approach/ Assertive Continuing Care 28.2% (n=8,144)

MET/CBT: Motivational Enhancement Therapy/Cognitive-Behavioral Therapy 36.5%

(n=10,543)

Other EBTx: Evidence Based Treatment 10.9% (n=3,158)

SAMHSA 2011 GAIN Summary Analytic Data Set (n=28,880)

outcomes
Outcomes
  • The following slides present information on the outcomes of substance abuse treatment, including:
    • Abstinence
    • Recovery
    • GAIN change scales over time (SPSm, CWS, HPS, EPS, EmPS, TPSl, IAS, TRI, SES, SATI, MHTI, PHTI, CJSI)
    • GPRA outcomes (vocationally engaged, housed, no justice system involvement, social consequences, abstinence, and social connectedness) and
    • NOMS outcomes (treatment initiation, engagement and continuing care; no problems with: health, mental health, family, illegal activity; abstinent, vocationally engaged and housed).
  • Data on follow up rates, months to last follow up, and number of follow ups per client are provided in the Methods Appendix.
days of use in the past 90 days by substance
Days of Use in the Past 90 Days by Substance

Days Used in Past 90 –solid line

Days Used in Past 90 – dashed line

*There is no pre-ce information available for tobacco

SAMHSA 2011 GAIN SA Data Set subset to those with 1+ Follow ups

percent change in 6 month abstinence
Percent Change in 6 Month Abstinence
  • Percent change in 6 month abstinence is calculated as
    • % abstinent at 6 month minus % abstinent at intake
  • Abstinence increased 19% from 43% at intake to 62% at 6-months.

SAMHSA 2011 GAIN SA Data Set subset to those with 6-Month Follow up (n=20,173)

relative percent change in 6 month abstinence
Relative Percent Change in 6 Month Abstinence
  • Relative percent change in 6 month abstinence is calculated as:
    • (% abstinent at 6 month minus % abstinent at intake) divided by % abstinent at intake
    • Relative percent of change can be large (i.e., greater than 100%) if baseline abstinence is low.
  • Abstinence increased by almost half (44%) against the intake value. (19% increase/43% at intake).

SAMHSA 2011 GAIN SA Data Set subset to those with 6-Month Follow up (n=20,173)

past month aod abstinence over time
Past Month AOD Abstinence Over Time

*Interpolated

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

slide73

Recovery Over Time*

* Recovery defined as no past month use, abuse, or dependence symptoms while living in the community.

**Interpolated

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

gpra outcomes over time
GPRA Outcomes Over Time

*Interpolated

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

change in gpra outcomes intake to last wave
Change in GPRA Outcomes (Intake to Last Wave*)

Vocationally Engaged

Socially Connected

Housing

No Justice System Involvement

No

Social Consequences

Abstinence

*Last wave is the last follow-up

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

noms outcome number of treatment received outcomes met
NOMS Outcome: Number of Treatment Received Outcomes Met*

*Based on a count of initiation within 14 days, evidence based practice, engagement for at least 6 weeks, and any continuing care.

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=24,637)

noms outcome estimated treatment episode cost by treatment modality
NOMS Outcome: Estimated Treatment Episode Cost by Treatment Modality
  • *Used in slides; ** Inter-quartile range of actual costs in 2006 dollars
  • Source: French, M.T., Popovici, I., & Tapsell, L. (2008). The economic costs of substance abuse treatment: Updated estimates and cost bands for program assessment and reimbursement. Journal of Substance Abuse Treatment, 35, 462-469.
samhsa outcome treatment cost bands
SAMHSA Outcome: Treatment Cost Bands

Below Band

5%

(N=872)

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=17,847)

selected noms outcomes over time
Selected NOMS Outcomes Over Time

*Interpolated **Past month

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

change in selected noms outcomes intake to last wave
Change in Selected NOMS Outcomes (Intake to Last Wave)

Past Month Abstinent

No Health Problems

No MH Problems

No Family Problems

No Illegal Activity

Vocationally Engaged*

Housed

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

*Past month

noms outcomes no problems at intake
NOMS Outcomes: No Problems at Intake

* Variable measures the last 30 days. All others measure the past 90 days.

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

noms outcomes outcome status at last wave
NOMS Outcomes: Outcome Status at Last Wave

*This variable measures the last 30 days. All others measure the past 90 days.

**The blue bar represents an increase of 50% or no problem.

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

noms outcomes count of positive outcomes last fu intake

*Based on count of reductions or no problem in the following variables: Substance use frequency, Abuse/Dependence Sx (past 30d), Physical Health (past 90d), Mental Health (past 90d), Nights of Psychiatric Inpatient (past 90d), Illegal Activity (past 90d), Arrests (past 90d), Housed in Community (past 90d), Family/Home Problems (past 90d), Vocational Problems (past 30d), Social

Support/Engagement (past 90d), Recovery Environment Risk (past 90d), Quarterly Cost to Society (past 90d), In Work/School (past 90d) at last wave Minus No problems at intake with these variables.

NOMS Outcomes: Count of Positive Outcomes* (Last FU–Intake)

77% have one or more improved areas

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups (n=25,498)

past month substance problems scale groups over time
Past Month Substance Problems Scale Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

current withdrawal scale groups over time
Current Withdrawal Scale Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

health problems scale groups over time
Health Problems Scale Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

emotional problems scale groups over time
Emotional Problems Scale Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

employment problems scale groups over time
Employment Problems Scale Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

employment problems scale groups over time subset to those employed
Employment Problems Scale Groups Over Time – Subset to Those Employed

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

training problems scale groups over time
Training Problems Scale Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

training problems scale groups over time subset to those in school training
Training Problems Scale Groups Over Time – Subset to Those in School/Training

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

illegal activities scale groups over time
Illegal Activities Scale Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

treatment resistance index groups over time
Treatment Resistance Index Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

self efficacy scale groups over time
Self-Efficacy Scale Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

substance abuse treatment index groups over time
Substance Abuse Treatment Index Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

mental health treatment index groups over time
Mental Health Treatment Index Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

physical health treatment index groups over time
Physical Health Treatment Index Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups

criminal justice system index groups over time
Criminal Justice System Index Groups Over Time

SAMHSA 2011 GAIN SA Data Set subset to 1+ Follow ups