ArticleSubstance abuse treatment, prevention, and policy2014
Examining attrition rates at one specialty addiction treatment provider in the United States: a case study using a retrospective chart review.
Article in Substance abuse treatment, prevention, and policy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- How effective are remote and/or digital interventions as part of alcohol and drug treatment and recovery support? A systematic review and meta-analysis.Addiction (Abingdon, England) · 2025Pooled it
- Effects of a brief pre-admission telephone reminder on no-show and dropout rates in substance use disorder treatment: a quasi-experimental study.Substance abuse treatment, prevention, and policy · 2022Trial
- Pretreatment social network characteristics relate to increased risk of dropout and unfavorable outcomes among women in a residential treatment setting for substance use.Journal of substance abuse treatment · 2020Trial
- Concurrent Treatment with Prolonged Exposure for Co-Occurring Full or Subthreshold Posttraumatic Stress Disorder and Substance Use Disorders: A Randomized Clinical Trial.Psychotherapy and psychosomatics · 2017Trial
- A Pilot Randomized Controlled Trial Evaluating Peer Recovery Coaches for Addiction Recovery Among Indigenous Americans.Journal of the American Psychiatric Nurses AssociationTrial
- Identifying Patients at Risk for Psychotherapy Dropout in Community Settings.JAMA network open · 2026Article
- It takes a village: Feedback from personnel in addiction treatment programs indicates support for changing the intake process.Journal of substance use and addiction treatment · 2025Article
- Identifying components of recovery capital that support substance use disorder treatment completion.Addictive behaviors reports · 2024Article
- Effectiveness and feasibility of a motivational interviewing intake (MII) intervention for increasing client engagement in outpatient addiction treatment: an effectiveness-implementation hybrid design protocol.Addiction science & clinical practice · 2023Article
- A Transdiagnostic group therapy for sleep and anxiety among adults with substance use disorders: Protocol and pilot investigation.Frontiers in psychiatry · 2023Article
- Does Treatment Readiness Shape Service-Design Preferences of Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Methamphetamine? A Cross Sectional Study.International journal of environmental research and public health · 2022Article
- Identification of Quantifiable Predictors of Relapse in Patients with Alcohol-Associated Liver Disease.Hepatology communications · 2021Article
- Examination of referral source and discharge outcomes among women in residential substance use disorder treatment.Journal of substance abuse treatment · 2021Article
- Perception of Substance Use Disorder Training: a Survey of General Psychiatry Residents in Nigeria.Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry · 2021Article
- Targeting the Barriers in the Substance Use Disorder Continuum of Care With Peer Recovery Support.Substance abuse : research and treatment · 2021Review
- The Impact of Matching to Psychotherapy Preference on Engagement in a Randomized Controlled Trial for Patients With Advanced Cancer.Frontiers in psychology · 2021Article
- A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health.Frontiers in public health · 2019Article
- Initial treatment dropout in patients with substance use disorders attending a tertiary care de-addiction centre in north India.The Indian journal of medical research · 2017Article
- Behavioral interventions for Cambodian female entertainment and sex workers who use amphetamine-type stimulants.Journal of behavioral medicine · 2016Article
- Validation of the alcohol use item banks from the Patient-Reported Outcomes Measurement Information System (PROMIS).Drug and alcohol dependence · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEngaging individuals who have a substance use disorder (SUD) in treatment continues to be a challenge for the specialty addiction treatment field. Research has consistently revealed high rates of missed appointments at each step of the enrollment process: 1. between calling for services and assessment, 2. between assessment and enrollment, and 3. between enrollment and completion of treatment. Extensive research has examined each step of the process; however, there is limited research examining the overall attrition rate across all steps.
methodsA single case study of a specialty addiction treatment agency was used to examine the attrition rates across the first three steps of the enrollment process. Attrition rates were tracked between August 1, 2011 and July 31, 2012. The cohort included 1822 unique individuals who made an initial request for addiction treatment services. Monthly retrospective reviews of medical records, phone logs, and billing data were used to calculate attrition rates. Attrition rates reported in the literature were collected and compared to the rates found at the target agency.
resultsMedian time between request for treatment and assessment was 6 days (mean 7.5) and between assessment and treatment enrollment was 8 days (mean 12.5). An overall attrition rate of 80% was observed, including 45% between call and assessment, 32% between assessment and treatment enrollment (another 17% could not be determined), and 37% left or were removed from treatment before 30 days. Women were less likely to complete 30 days of treatment compared to men. No other demographics were related to attrition rates. DISCUSSION: One out of every five people who requested treatment completed a minimum of 30 days of a treatment. The attrition rate was high, yet similar to rates noted in the literature. Limitations of the single case study are noted.
conclusionAttrition rates in the U.S. are high with approximately 75% to 80% of treatment seekers disengaging at one of the multiple stages of the enrollment and treatment process. Significant changes in the system are needed to improve engagement rates.
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Registered trials
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