Guidelines and challenges for estimating the economic costs and benefits of adolescent substance abuse treatments

Journal of Substance Abuse Treatment

Popovici

Tapsell

2008

Self Cite

Federal, State, and local government agencies require current and accurate cost information for publicly funded substance abuse treatment programs to guide program assessments and reimbursement decisions. The Center for Substance Abuse Treatment (CSAT) published a list of modality-specific cost bands for this purpose in 2002. However, the upper and lower values in these ranges are so wide that they offer little practical guidance for funding agencies. Thus, the dual purpose of this investigation was to assemble the most current and comprehensive set of economic cost estimates from the readily-available literature and then use these estimates to develop updated modality-specific cost bands for more reasonable reimbursement policies. Although cost estimates were scant for some modalities, the recommended cost bands are based on the best available economic research, and we believe these new ranges will be more useful and pertinent for all stakeholders of publicly-funded substance abuse treatment.

Section: Discussionmentioning

confidence: 99%

The economic costs of substance abuse treatment: Updated estimates and cost bands for program assessment and reimbursement

Journal of Substance Abuse Treatment

Popovici

Tapsell

2008

Self Cite

“…As chemical dependency (CD) treatment for adolescents has become more specialized, the focus of interventions has been widened in an attempt to address some of these other problem areas. 2,4,5 The American Academy of Child and Adolescent Psychiatry has recommended that interventions target problems in family, vocational, and legal domains in addition to providing treatment for substance use problems. 6 Treatment success depends not only on the attainment of abstinence by the adolescent but also on spillover effects that benefit the adolescent, his/her family, and society as a whole.…”

Section: Introductionmentioning

confidence: 99%

“…9,10 While some of the expected social benefits of adolescent treatment programs overlap with those of adult programs (i.e., reductions in criminal activity and healthcare utilization), improvement in other domains may be more relevant for adolescents than adults and vice versa. 5 For instance, it is desirable that treatment programs for adolescents reinforce school engagement and educational attainment. Investment in education during adolescence carries potential benefits such as improved lifetime earnings, cognitive functioning, and health.…”

Section: Introductionmentioning

confidence: 99%

Substance Use, Education, Employment, and Criminal Activity Outcomes of Adolescents in Outpatient Chemical Dependency Programs

Balsa

Homer

J Behav Health Serv Res

et al. 2007

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Although the primary outcome of interest in clinical evaluations of addiction treatment programs is usually abstinence, participation in these programs can have a wide range of consequences. This study evaluated the effects of treatment initiation on substance use, school attendance, employment, and involvement in criminal activity at 12 months post-admission for 419 adolescents (aged 12 to 18) enrolled in chemical dependency recovery programs in a large managed care health plan. Instrumental variables estimation methods were used to account for unobserved selection into treatment by jointly modeling the likelihood of participation in treatment and the odds of attaining a certain outcome or level of an outcome. Treatment initiation significantly increased the likelihood of attending school, promoted abstinence, and decreased the probability of adolescent employment, but it did not significantly affect participation in criminal activity at the 12-month follow-up. These findings highlight the need to address selection in a non-experimental study and demonstrate the importance of considering multiple outcomes when assessing the effectiveness of adolescent treatment.

“…These challenges coincide with other recent studies of adolescent substance use and suggest that economic evaluations of adolescent interventions can be more complicated than those of adult treatment. 32 The four main limitations in the present study were sample size, missing data, collecting reliable criminal activity data from adolescents, and the distribution of the criminal activity cost measure.…”

Section: Discussionmentioning

confidence: 88%

Estimating the Differential Costs of Criminal Activity for Juvenile Drug Court Participants: Challenges and Recommendations

McCollister

J Behav Health Serv Res

Sheidow

et al. 2008

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Juvenile drug court (JDC) programs have expanded rapidly over the past 20 years and are an increasingly popular option for rehabilitating juvenile offenders with substance use problems. Given the high cost of crime to society, an important economic question is whether and to what extent JDC programs reduce criminal activity among juvenile offenders. To address this question, the present study added an economic cost analysis to an ongoing randomized trial of JDC conducted in Charleston, South Carolina. Four treatment conditions were included in the parent study: Family Court with usual community-based treatment (FC, the comparison group), Drug Court with usual community-based treatment (DC), DC with Multisystemic Therapy (DC/MST), and DC/MST enhanced with Contingency Management (DC/MST/CM). The economic study estimated the cost of criminal activity for nine specific crimes at baseline (pretreatment) and 4 and 12 months thereafter. A number of methodological challenges were encountered, suggesting that it may be more difficult to economically quantify frequency and type of criminal activity for adolescents than for adults. The present paper addresses methodological approaches and challenges, and proposes guidelines for future economic evaluations of adolescent substance abuse and crime prevention programs.