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Cost and Benefits of Cocaine Treatment

Flynn, Kristiansen, Porto, and Hubbard have conducted the first DATOS cost-benefit study of the economic impacts of long-term residential (LTR) and outpatient drug-free (ODF) treatments for cocaine dependence. Before, during, and after treatment interviews with a national sample of 502 clients treated for cocaine dependence in 10 U.S. cities showed (again) that significant returns are realized from public investments in treatment. Overall, reductions in costs of crime to society during and after treatment substantially surpass the cost of treatment in both LTR and ODF. These findings demonstrate the value of public investments to treat cocaine addiction. Clients in each modality showed different levels and associated costs of crime before and after treatment. Justification for the public support for both modalities exists in their effectiveness in treating distinctly different clientele.

The average net economic benefit from an episode of LTR treatment was $10,344. Net benefits from an episode of ODF treatment ($795) were of a lesser magnitude. However, the magnitude of return on each dollar of investment in ODF was similar to LTR. Because of the considerably lower crime costs of ODF clients before treatment, and the lower cost associated with ODF treatment due to its lesser intensity than LTR which is appropriate for its client population, ODF returns on treatment investments also provide evidence of the value of public investments in ODF treatment. The sample was selected from programs for which financial data were available and is a subset of the client sample described by Simpson et al. (1999). There were 300 clients from 10 LTR programs and 202 from 9 ODF programs.

  • All subjects met clinical criteria for cocaine dependence or were daily cocaine users in the year before treatment. The majority of subjects were African American (62%), male (66%), and about 32 years of age.

Chart:  Cocaine Dependent Sample

 

Tangible costs of 9 crimes published in the literature (Rajkumar & French, 1997) and reported by clients before, during, and after treatment were used to estimate the cost of crime to society, net benefits, and cost-benefit ratios. These tangible costs included crime victim costs, criminal justice system costs, and crime career costs. Detailed explanations of how these costs were calculated are described by Rajkumar and French.

  • The highest crime group was LTR with per client crime costs of $20,743 before and $4,605 after treatment. These cost reductions from before to after treatment were 78%.
     
  • ODF client crime costs were $3,494 before and $2,503 after treatment representing a reduction of 28%.
     
  • Daily treatment costs were $72 in LTR and $9 in ODF.

Table:  Tangible Costs of Individual Crimes     Chart:  Crime Costs Before vs After Treatment for Cocaine Addiction

 

Total crime cost benefits from treatment for cocaine addiction were $21,000 for LTR and $2,200 for ODF. The ratios of total benefits to cost of treatment were 1.94 for LTR and 1.56 for ODF.

Chart:  Total Crime-Cost Benefits of Cocaine Treatment

 

Different types of clients are treated in LTR and ODF, and this study demonstrates the continuing need and value of offering a mix of treatment modalities. Even though LTR clients had the greatest amount of crime cost reductions in the year after treatment, cost-benefit ratios and net treatment benefits for both ODF and LTR provide evidence of the significant returns on investments in treating cocaine dependence in these modalities.


References

Flynn, P. M., Kristiansen, P. L., Porto, J. V., & Hubbard, R. L. (1999). Costs and benefits of treatment for cocaine addiction in DATOS. Drug and Alcohol Dependence, 57, 167-174.  [Abstract]

Rajkumar, A.S., & French, M.T. (1997). Drug use, crime costs, and the economic benefits of treatment. Journal of Quantitative Criminology, 13, 291-323.

Simpson, D. & Brown, B. (Eds). (1999). Special issue on treatment process and outcome studies from DATOS. Drug and Alcohol Dependence.  [Summary]

Simpson, D., Joe, G., Fletcher, B., Hubbard, R., & Anglin, D. (1999). A national evaluation of treatment outcomes for cocaine dependence. Archives of General Psychiatry, 56, 507-514.  [Abstract]

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