The researcher team used detailed data from 2,567 clients admitted to 43 treatment providers in 13 California counties during 2000 and 2001. The information was gathered via an automated system operated by the California Treatment Outcome Project.
"Even without considering the health and quality-of-life benefits to drug treatment clients themselves, spending taxpayer dollars on substance abuse treatment appears to be a wise investment," said Susan Ettner, lead author and professor of general internal medicine and health services research at UCLA's David Geffen School of Medicine and School of Public Health.
The research team estimated cost of treatment for an individual by multiplying the number of days spent in each treatment setting, such as residential or outpatient, by the average daily cost of each mode of treatment, using cost data collected from treatment providers.
Monetary benefits associated with treatment were estimated using administrative records as well as data provided by each client prior to treatment and nine months after treatment began. The study examined costs of medical care, mental health services, criminal activity, earnings and related costs of government programs such as unemployment and public aid.
Among other findings:
- Treatment costs of clients who began with outpatient care totaled $838 compared to $2,791 for those who began in residential care.
- Reductions were seen in hospital inpatient, emergency room and mental health services costs, but only the $223 reduction in emergency room costs was statistically significant.
- Reduction in the cost of victimization and other criminal activities averaged $5,676.
- No significant changes were seen related to unemployment or disability costs. However, welfare payments increased slightly, perhaps due to increased referrals to public aid programs.
The California Department of Drug and Alcohol Programs, the Center for Substance Abuses Treatment, and the Robert Wood Johnson Foundation provided primary support for the study.
Ettner conducted the study with researchers from the UCLA Integrated Substance Abuse Programs at the Semel Institute for Neuroscience and Human Behavior. Other members of the research team included David Huang, Elizabeth Evans, Danielle Rose Ash, Mary Hardy, Mickel Jourabchi and Yih-Ing Hser.
The California Department of Alcohol and Drug Programs implemented the California Treatment Outcome Project in 1998 at 43 treatment provider sites in the following counties: Alameda, El Dorado, Kern, Lassen, Orange, Riverside, Sacramento, San Benito, San Diego, San Francisco, San Joaquin, San Luis Obispo and San Mateo.
The project is intended to allow regular assessments of drug abuse treatment clients and their outcomes so counties can adjust programs to address changing needs over time. The project is the successor to CalDATA, which gathered similar but less comprehensive data more than a decade ago.
Online resources:
David Geffen School of Medicine at UCLA: http://dgsom.healthsciences.ucla.edu/
UCLA School of Public Health: http://www.ph.ucla.edu
UCLA Integrated Substance Abuse Programs: http://www.uclaisap.org/
Semel Institute for Neuroscience and Human Behavior at UCLA: http://www.npi.ucla.edu/
Journal
Health Services Research