Differences in Wait Time in Residential and Non-Residential Specialty and Non-Specialty Substance Abuse Treatment

Background: Wait time to enter substance abuse treatment is one of the most commonly cited barriers to treatment access among those who seek it. The longer treatment seekers must wait to receive treatment, the more likely they will be to dropout before they actually do. Despite the importance of wait time as a component of access, relatively little is known about how wait times may differ across residential and non-residential settings. Moreover, few studies have explored how wait time differs depending on how clients are referred into treatment. In response, the following study will examine differences in wait time across three substance abuse treatment settings—outpatient, detoxification and residential treatment—and calculate average wait times by referral source. Method: The study uses data from the Treatment Episode Data Set. The analytic sample consists of 66,316 treatment episodes, representing all treatment episodes occurring in publicly-funded substance abuse treatment programs in the state of Illinois in 2008. Descriptive comparisons were made using analysis of variance (ANOVA).

Results: Average wait time varied by treatment modality; clients waited 8 days for detoxification, 10 days for residential treatment and 11 days for outpatient treatment (p<.001). Wait times also differed significantly by referral source. Clients referred by substance abuse treatment and health care providers had the shortest average wait times (3 days and 6 days, respectively), while clients referred by the criminal justice system had the longest average wait (14 days) (p<.001). When stratifying by modality, the abovementioned differences in wait time by referral type remained for outpatient treatment and detoxification. However, no differences in wait time by referral type were found in residential treatment.

Conclusion: Over the past two decades, there has been an increasing focus on non-residential services in the field of substance abuse treatment. In light of this, it is essential to understand how access to treatment differs across residential and non-residential settings. Overall, clients entering detoxification had the shortest average wait time, while clients entering outpatient treatment had the longest average wait. Moreover, wait time was more sensitive to referral source in these two settings. In detoxification and outpatient treatment, average wait times differed by more than 10 days depending on how clients were referred treatment. These findings suggest the need for further research to examine specific factors that drive differences in wait time across treatment modality and referral source, with the aim to identify specific points of intervention in the referral and intake processes that can improve access.