Alcohol and Drug Services Study (ADSS)

ADSS was a national study of substance use treatment facilities and clients conducted from 1996 to 1999. The study was designed to develop estimates of the duration and costs of substance use treatment and to describe the post-treatment status of clients.

The survey included questions on the use of alcohol, marijuana, cocaine, crack cocaine, heroin, barbiturates, benzodiazepines, and amphetamines; nonprescribed use of prescription medications; misuse of over-the-counter medications; and other drug use or misuse.

ADSS also included a cost study, which involved collecting additional financial information from the Phase II facilities. A computerized desktop audit was used in the cost study to conduct consistency and accuracy checks on selected questionnaire data from Phases I and II. After the audit, variables were updated to represent the most accurate data available. Additional analysis variables were then created using combinations of the revised Phase I and II data.

Scope and Methodology Notes

Geographic Coverage: United States

Unit of Observation: Facility

Data Types: Survey Data

Universe: (1) Substance use treatment facilities in the United States registered in SAMHSA’s National Master Facility Inventory of known facilities; (2) clients engaged in substance use treatment in these facilities

The study was conducted by the Schneider Institute for Health Policy, Brandeis University. Westat, Inc., collected and prepared the data.

ADSS files underwent disclosure analysis by SAMHDA to ensure that the identities of facilities and clients were protected. This involved reviewing the data files for potential risks as well as examining any external threats to confidentiality, such as other data sources that could be linked to ADSS. Such external data sources were found. To address this problem while still creating a public use file of the greatest utility possible, micro-aggregation of certain variables was performed. This involved identifying the problematic variables, sorting records by the first problematic variable, organizing records into groups of three based on their value for this variable, averaging the values for each grouping, and applying the average to the records in each group. This was repeated for each of the problematic variables, which included client count and financial data. Geographic identifiers were also removed. The overall impact of these protection procedures was small and should not affect most analytic uses of the data.

The Phase I facility public use file includes 2,394 of the original 2,395 records. One facility’s record was deleted due to the presence of outlying data.

Client records can be matched between corresponding Phase II and Phase III abstract and follow-up data files using the CASEID variable. Facility data can be matched across the Phase I, II, and III data files and cost study data files using the FACID variable.

The unit of analysis for the Phase I facility (Part 1) and Phase II administrator (Part 2) data is the facility. Data from the Phase II and Phase III abstract and follow-up files (Parts 3–8) are analyzed at the client level. Analyses for the cost study (Part 12) are conducted at the modality or "type of care" level within facilities.

Please note that the unit of time for some variables in the facility file is specified in a separate variable, and these units are distinct from each other. For example, to analyze length of treatment, the researcher needs to examine two variables: QUANTITY VAR NAME and UNIT VAR NAME. QUANTITY specifies the "quantity" of treatment length, while UNIT specifies the unit of QUANTITY, such as days, weeks, months, years, or sessions.

The Finite Population Correction Factor and the two Stratified Jackknife Factor data files are provided for use with the WesVar and SUDAAN statistical software and are not intended for use with other statistical packages. WesVar was developed by Westat, Inc., and SUDAAN is a product of the Research Triangle Institute. These three files are being distributed as received from the principal investigator and have not been tested by SAMHDA.

The data from the follow-up Incentive Study in Phase III are not released as part of this public use collection.

ADSS was implemented in three phases.

In Phase I, a nationally representative sample of treatment facilities was surveyed to assess characteristics of treatment services and clients, including treatment type, costs, program capacity, the number of clients served, waiting lists, and services provided to special populations.
In Phase II, records were abstracted from a sample of clients in a subsample of Phase I facilities. This phase included four sub-components:
- The main study, an analysis of abstracted records to assess the treatment process and characteristics of discharged clients
- The incentive study, which assessed the impact of varying financial payments on follow-up interview participation among nonmethadone outpatient clients
- The in-treatment methadone client study, which assessed the treatment process of methadone maintenance
- The comparison study of early dropout clients, which provided a proxy comparison group of records from substance users that went untreated
Phase III involved follow-up personal interviews with Phase II clients who could be located. The interviews sought to determine post-treatment status in terms of substance use, economic condition, criminal justice involvement, and further substance use treatment episodes. Urine testing was conducted to validate self-reported drug use.

For specific methodological information, please check the codebook for a specific data set from the sidebar to the right.

Choose Year

Time period: 1996/1999

Dataset ID: DS0007

Versions: 2009-04-01: Question text was added into the codebooks for parts 1 through 8. The SAS transport (XPORT) and SPSS portable files were replaced with a SAS CPORT and SPSS system file. Additionally, a tab-delimited excel data file was included for download for each dataset.