Cost-effectiveness analysis of four interventions for adolescents with a substance use disorder

Abstract

Alcohol, tobacco, and illicit drug use among adolescents in the U.S. continues to be a serious public health challenge. A variety of outpatient treatments for adolescent substance use disorders have been developed and evaluated. Although no specific treatment modality is effective in all settings, a number of promising adolescent interventions have emerged. As policy makers try to prioritize which programs to fund with limited public resources, the need for systematic economic evaluations of these programs is critical. The present study attempted a cost-effectiveness analysis (CEA) of four interventions, including family-based, individual, and group cognitive behavioral approaches, for adolescents with a substance use disorder. The results indicated that treatment costs varied substantially across the four interventions. Moreover, family therapy showed significantly better substance use outcome compared to group treatment at the 4-month assessment, but group treatment was similar to the other interventions for substance use outcome at the 7-month assessment and for delinquency outcome at both the 4-month and 7-month assessments. These findings over a relatively short follow-up period suggest that the least expensive intervention (group) was the most cost effective. However, this study encountered numerous data and methodological challenges in trying to supplement a completed clinical trial with an economic evaluation. These challenges are explained and recommendations are proposed to guide future economic evaluations in this area. KeywordsCost-effectiveness analysis; adolescent substance use interventions; substance use disorders; adolescent treatment outcomes; behavioral and family-based interventions

Adolescents' Perspectives on Strengths-Based Group Work and Group Cohesion in Residential Treatment for Substance Abuse

“…Treatment for adolescents suffering from substance abuse is most commonly conducted within group formats often following 12-step models, psychoeducational models, or cognitive behavioral therapy (CBT) models (Kaminer, 2005). Group approaches have been found to be both cost-effective and beneficial with several youth populations, including youths suffering from substance abuse (e.g., French et al, 2008;Kaminer;. Among the various forms of interventions, group CBT has generally been found to be one of the most effective treatments for youths with substance use issues (French et al;Vaughn & Howard, 2004;.…”

A entrevista motivacional em adolescentes usuários de droga que cometeram ato infracional

“…Em um estudo realizado por Armstrong e Costello (2002), há o relato de que 60% dos adolescentes com diagnóstico de abuso ou dependência de substâncias têm algum diagnóstico de comorbidades, e a associação mais comum é com TDAH e com TOD, seguida por depressão. Neste mesmo estudo, está descrita a relação de uso de álcool com depressão e o uso de tabaco com transtornos de ansiedade, e de maconha com TDAH, resultado corroborado por outros estudos (French et al, 2008). Souza e Oliveira (2005), encontraram uma prevalência de TDAH 36,7% no grupo de usuários de drogas e 10% no grupo de adolescentes que não usavam drogas.…”

“…Há um crescimento nos índices de usuários de drogas nesta faixa etária, e a idade de experimentação está sendo cada vez mais precoce (Carlini, Galduroz, Notto, & Napo, 2002). Os abusadores adolescentes experienciam uma variedade de problemas, incluindo rapidez na evolução do diagnóstico de abusadores para dependentes, e uma ocorrência maior de comorbidades relacionadas ao uso, bem como envolvimento com atos infracio-nais (Becker & Curry, 2008;Martin & Copeland, 2008), sendo esses os fatores que fazem com que os profissionais da área da saúde, tentem buscar alternativas eficientes para intervenções que auxiliem na prevenção e resolução desta problemática (French et al, 2008).…”

An economic analysis of the in-prison therapeutic community model on prison management costs

“…The cost of providing the SATF TC program was estimated using the Drug Abuse Treatment Cost Analysis Program (DATCAP). 2 This cost evaluation guide, developed by French and colleagues (French, 2001a(French, , 2001bFrench, Dunlap, Zarkin, McGeary, & McLellan, 1997), has been widely adopted by researchers to estimate program costs of drug abuse treatment in various modalities, including prison-based and postrelease programs for criminal offenders (French et al, 2008;Knealing, Roebuck, Wong, & Silverman, 2008;Kunz, French, & Bazargan-Hejazi, 2004;McCollister, French, Inciardi, et al, 2003;McCollister, French, Prendergast, et al, 2003;Mundt, French, Roebuck, Manwell, & Barry, 2005;Zavala et al, 2005). The DATCAP estimates the total economic costs (or opportunity costs) of treatment, including personnel, program supplies and materials, contracted services, buildings and facilities, and any resources either free of charge or partially subsidized by private or public entities.…”