Money Matters: Cost-Effectiveness of Juvenile Drug Court with and without Evidence-Based Treatments

Abstract

The 12-month cost effectiveness of juvenile drug court and evidence-based treatments within Court were compared with traditional Family Court for 128 substance abusing/dependent juvenile offenders participating in a four-condition randomized trial. Intervention conditions included Family Court with community services (FC), Drug Court with community services (DC), Drug Court with Multisystemic Therapy (DC/MST), and Drug Court with MST enhanced with a contingency management program (DC/MST/CM). Average cost effectiveness ratios for substance use and criminal behavior outcomes revealed that economic efficiency in achieving outcomes generally improved from FC to DC, with the addition of evidence-based treatments improving efficiency in obtaining substance use outcomes.

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

“…Several FBT-E models offer prime exemplars of such partnerships . As described earlier, MST has been embedded in juvenile drug courts to facilitate access to untreated substance-using adolescents, and it has been shown to significantly upgrade usual care in this setting (Henggeler et al, 2006; and to be more economically efficient than standard court services (Sheidow, Jayawardhana, Bradford, Henggeler, & Shapiro, 2012). Similarly, MDFT has been housed in juvenile detention centers to build a continuum-of-care bridge between detention and discharge to community supervision, where it significantly increased treatment linkage and retention (Liddle, Dakof, Henderson, & Rowe, 2011).…”

Economic evaluations of contingency management in illicit drug misuse programmes: A systematic review

“…Sheidow et al . [24] took a local community services perspective which included judicial intervention costs in addition to the costs of drug treatment.…”

“…Hartz and colleagues [23] used the number of patients providing continuous negative samples in the last month of methadone treatment prior to dose tapering. Sheidow and colleagues [24] relied on self‐reported days of drug use and number of criminal offenses. Barnett et al .…”

“…Four presented sensitivity analyses to examine parameter and structural uncertainty [17,20,21,25]. Three studies did not consider uncertainty in estimates of cost‐effectiveness [23,24,26], and two studies did not present incremental cost‐effectiveness analyses [22,24]. Sheidow et al .…”

“…Sheidow et al . [24] presented average cost‐effectiveness ratios which cannot be used to inform choices between interventions based on relative cost‐effectiveness and may be misleading [11]. Barnett et al .…”