Cited by 164Substance Abuse Treatment and OutcomesHealth Systems, Economic Evaluations, Quality of LifeHomelessness and Social Issues

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Benefit-cost in the California treatment outcome project: Does substance abuse treatment “pay for itself”?

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Ettner, Susan L., Huang, David, Evans, Elizabeth, Rose Ash, Danielle, Hardy, Mary, Jourabchi, Mickel, Hser, Yih‐Ing·2006·Health Services Research

DOI 10.1111/j.1475-6773.2005.00466.xPMC PMC1681530

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Abstract

Objective. To examine costs and monetary benefits associated with substance abuse treatment. Data Sources. Primary and administrative data on client outcomes and agency costs from 43 substance abuse treatment providers in 13 counties in California during 2000–2001. Study Design. Using a social planner perspective, the estimated direct cost of treatment was compared with the associated monetary benefits, including the client's costs of medical care, mental health services, criminal activity, earnings, and (from the government's perspective) transfer program payments. The cost of the client's substance abuse treatment episode was estimated by multiplying the number of days that the client spent in each treatment modality by the estimated average per diem cost of that modality. Monetary benefits associated with treatment were estimated using a pre–posttreatment admission study design, i.e., each client served as his or her own control. Data Collection. Treatment cost data were collected from providers using the Drug Abuse Treatment Cost Analysis Program instrument. For the main sample of 2,567 clients, information on medical hospitalizations, emergency room visits, earnings, and transfer payments was obtained from baseline and 9‐month follow‐up interviews, and linked to information on inpatient and outpatient mental health services use and criminal activity from administrative databases. Sensitivity analyses examined administrative data outcomes for a larger cohort (N=6,545) and longer time period (1 year). Principal Findings. On average, substance abuse treatment costs $1,583 and is associated with a monetary benefit to society of $11,487, representing a greater than 7:1 ratio of benefits to costs. These benefits were primarily because of reduced costs of crime and increased employment earnings. Conclusions. Even without considering the direct value to clients of improved health and quality of life, allocating taxpayer dollars to substance abuse treatment may be a wise investment.

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Authors: Ettner, S. L., Huang, D., Evans, E., Rose Ash, D., Hardy, M., Jourabchi, M., & Hser, Y.
Affiliations: University of California, Los Angeles (US)
Corresponding author: Ettner, Susan L.
ORCID: Ettner, Susan L.
Huang, David
Evans, Elizabeth
Hardy, Mary
Hser, Yih‐Ing
Venue: Health Services Research
Publisher: Wiley
Published: 2005-10-20
Volume: 41
Issue: 1
Pages: 192-213
ISSN: 0017-9124 (ISSN-L)
1475-6773
DOI: 10.1111/j.1475-6773.2005.00466.x
PMC: PMC1681530
OpenAlex: W2156116126
Cited by: 164
References: 45
Citations by year: 2026: 2 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 6 · 2021: 6 · 2020: 10 · 2019: 8 · 2018: 13 · 2017: 10 · 2016: 8 · 2015: 12 · 2014: 7 · 2013: 13 · 2012: 5
FWCI: 5.76
Type: journal article
Language: en
Update notices: erratum (2006-03-09)
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Health Services Research (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Robert Wood Johnson Foundation
California Department of Alcohol and Drug Programs
AcademyHealth
National Institute on Drug Abuse
Center for Substance Abuse Treatment
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Social Sciences › Sociology and Political Science › Homelessness and Social Issues
Keywords: addiction treatment, cost-benefit analysis, treatment costs, monetary rewards, crime costs, employment income, mental health service utilization, health care costs, transfer payments
MeSH terms: California, Cost-Benefit Analysis, Humans, Surveys and Questionnaires, Cohort Studies, Substance Abuse Treatment Centers, Treatment Outcome, Episode of Care, Efficiency, Organizational, Substance-Related Disorders

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Benefit-cost in the California treatment outcome project: Does substance abuse treatment “pay for itself”?

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