The investment and regenerative value of addiction treatment

Abstract

Purpose – The purpose of this paper is to show that despite welfare retrenchment and political rhetoric towards welfare, spending on residential addiction treatment should be protected. Design/methodology/approach – Examining benefits in context of costs, the research used social return on investment to monetise benefits and compare with costs. Based at a residential addiction centre, the research used questionnaires and focus groups with residents and former residents. Findings – The centre created almost £4 of benefit for every £1 of cost. Whilst the bulk of savings came from health, housing and criminal justice, there was also a regenerative impact for the local economy. Research limitations/implications – Sampling in sensitive themes is always problematic, however, the research had contact with many respondents, achieved data saturation and used the centre's success rate as a guide to weight the findings. Practical implications – The benefits of addiction treatment go beyond health outcomes and raise questions about how this should be reflected in cost distribution. Consequently, this has implications for the ways in which addiction services should be measuring their successes beyond solely health outcomes. Social implications – Existing research has largely overlooked the benefit of addiction treatment to the local economy and the fact that, as an investment, this benefit will continue to grow as more people enter the labour market over time. Originality/value – The research recognises the political context of funding and measures success beyond solely health outcomes. Furthermore, the research recognises the regenerative impact of addiction treatment, which is often overlooked in similar research.

The social return on investment model: a systematic literature review

“…The health sector is particularly prone to highlight the relevance of this SROI function (Bhaumik et al , 2013; Laing and Moules, 2017; Millar and Hall, 2013). Regarding the 91 papers demonstrating the legitimation function of SROI, 60 studies were published in Anglo Saxon countries, of which 22 were published in the UK (Iafrati, 2015; Parks and Brownlee, 2014), 16 in Canada (Akingbola et al , 2015; Shi et al , 2019) and 13 in the USA (Kousky et al , 2019; Ramon et al , 2018). Interestingly, the sector legitimized by the SROI is mainly the welfare sector, particularly health, with 31 studies (Aguilar-Agudo et al , 2019; Goudet et al , 2018; Searles et al , 2016), social inclusion counting 13 studies (Hoffmann et al , 2014; Mihalopoulos et al , 2020) and other sectors such as well-being, education and justice (Akingbola et al , 2015; Lund, 2015; Ravulo et al , 2020).…”

Valuing the impact of health and social care programs using social return on investment analysis: how have academics advanced the methodology? A systematic review

“…Of the eight SROI studies, the majority were undertaken in developed nations with half conducted in the UK, two in Canada and one each in the USA and Kenya. One intervention was aimed at children,25 two at pregnant or post-partum women,26 27 two at adults overcoming addiction,28 29 one at adults and families transitioning from homelessness30 and two at older people 31 32. In conducting their analysis, all but one study31 referred extensively to the Guide to SROI 12…”

“…For studies that included previous beneficiaries of an intervention,25–29 31 32 there was the potential for positive sample bias, as those for whom the intervention was a success may be more willing to participate in an evaluation or may be more likely to be put forward for inclusion by the organisation offering the intervention. Most studies25–28 30 32 collected data at only one time point (retrospectively), which limits our understanding of the impact of the intervention, as opposed to pre–post data collection, for example, and also increases the likelihood of memory bias.…”

“…However, some relatively minor adaptations or additions were made (Online supplementary appendix II). For example, Iafrati attempted to overcome positive sampling bias by weighting outcome values at 65%; this estimate equating to the centre’s overall reported success rate at helping people overcome addiction during the relevant time period 29. Furthermore, the analysis for this study adopted a sociopolitical approach which focused on monetary savings at the societal level rather than personal outcomes.…”