Economic Analysis of Methamphetamine Prevention Effects and Employer Costs

Abstract

ABSTRACT. Objective: The goal of this research was to evaluate economically three interventions designed to prevent substance use in general populations of adolescents, specifi cally focusing on the prevention of methamphetamine use and its subsequent benefi ts to employers. Method: In a randomized, controlled trial, three preventive interventions were delivered to 6th-or 7th-grade youth in 58 Iowa school districts, with 905 of these youth (449 girls) providing follow-up assessments as 12th graders. Intervention conditions included the family-focused Iowa Strengthening Families Program (ISFP), the school-based Life Skills Training (LST) program, and a combined condition of both the Strengthening Families Program: For Parents and Youth 10-14 (SFP10-14; an ISFP revision) plus LST (LST + SFP10-14). Analyses based on intervention costs, 12th-grade methamphetamine use rates, and methamphetamine-related employer costs yielded estimates of intervention cost, cost-effectiveness, benefi t-cost ratio, and net benefi t. Results: The ISFP lowered methamphetamine use by 3.9%, cost $25,385 to prevent each case, and had a benefi t-cost ratio of 3.84, yielding a net benefi t of $2,813 per youth. The LST program reduced methamphetamine use by 2.5%, required $5,122 per prevented case, and had a benefi t-cost ratio of 19.04, netting $2,273 per youth. The combined LST + SFP10-14 prevention condition lowered methamphetamine use rates by 1.8%, cost $62,697 to prevent each case, had a benefi t-cost ratio of 1.56, and netted $620 per youth. Findings were robust after varying a number of key parameters across a range of plausible values. Conclusions: Substance use prevention programming is economically feasible, particularly for effective interventions that have lower per person treatment delivery costs. (J. Stud. Alcohol Drugs, 72, 577-585, 2011)

Addressing Core Challenges for the Next Generation of Type 2 Translation Research and Systems: The Translation Science to Population Impact (TSci Impact) Framework

“…It has demonstrated significant effects in reducing the initiation and prevalence of adolescent conduct problems and substance misuse, including marijuana, methamphetamine, and prescription drug misuse 6.5 years past baseline (e.g., Spoth et al 2011; Spoth et al 2012a, b). PROSPER also has been shown to be cost-efficient (Crowley et al 2012) and cost-effective (Guyll et al 2011), sustaining implementation quality over time (Spoth et al 2011). …”

Can we build an efficient response to the prescription drug abuse epidemic? Assessing the cost effectiveness of universal prevention in the PROSPER trial

“…This is likely a dramatic underestimate of the total societal value from universal programs that are known to not only prevent other forms of substance abuse (e.g., alcohol, tobacco, methamphetamines; Guyll et al, 2011; Spoth et al, 2008b) but a variety of delinquent behaviors linked to long-term criminality and increased use of social service systems (Aos et al, 2011). Nevertheless, compared to approaches that aim to reduce nonmedical use that is already occurring (e.g., treatment), a prevention-oriented approach to nonmedical use may be especially well-suited for society’s current needs.…”

“…Universal EBPIs are increasingly delivered within the context of formal prevention delivery and support systems that facilitate implementation and sustainability of prevention efforts (e.g., PROSPER, Weed & Seed, Communities-that-Care, SPF-SIG, Getting-to-Outcomes ; (Crowley et al, 2012; Hawkins, 1992, 2009; Spoth et al, 2004; Wandersman, 2000). Large demonstration trials, including the PROSPER study, have illustrated that EBPIs, delivered within these systems, represent a promising strategy for reducing nonmedical prescription opioid use (Aos et al, 2011, 2004; Guyll et al, 2011; Spoth et al, 2007a, Under Review; Spoth, 2006), but relatively little work has sought to evaluate these programs’ capacity to efficiently reduce nonmedical prescription opioid use in everyday contexts (Spoth et al, 2008). This lack of evaluation has contributed to universal EBPIs being largely overlooked and underutilized in recent federal and state responses.…”

A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research

“…If trial participants can be linked to administrative records within each system, it may be feasible to conduct high-quality cross-system analyses (Crowley, 2015; Garnier & Poertner, 2000). In many cases administrative data will not be available and researchers will need to employ survey methods to assess impact on systems (Guyll, Spoth, & Crowley, 2011; Kuklinski et al, 2012). While guidance exists on approaches to measuring service utilization in many systems, for the most part they are siloed within disciplinary journals and traditions (French, Dunlap, Zarkin, McGeary, & McLellan, 1997; Horwitz, 2001).…”