Costs and benefits of methadone treatment in DATOS - Part 1: discharged versus continuing patients

ENGLISH :
Longer lengths of stay in methadone treatment have been associated with greater treatment benefits such as reductions in heroin use and criminal activity. In this paper, the first of two concentrating on costs of methadone treatment, the positive monetary returns from investments in longer-term methadone treatment for opioid users who participated in NIDA's Drug Abuse Treatment Outcome Studies (DATOS) are demonstrated. Part 1 focuses on crime cost savings for discharged patients (patients who left their index DATOS treatment program before completing 1 year of treatment) and continuing patients (those who continued in treatment for 1 year or longer). It was hypothesized that methadone treatment benefits from tangible crime cost savings during treatment and at follow-up would be greater for the continuing patients. Subjects were 394 methadone patients from 8 medium to large cities and 16 programs; overall 37% were women, 33% African American, with an average age of 37.2. Results supported the hypothesis; longer retention or greater lengths of stay in treatment were associated with greater crime cost savings. It is concluded that methadone treatment provides significant returns on treatment investments for both discharged and continuing patients. However, greater net economic benefits were realized from continuing patients. Cost-containment and ideological practices opposed to methadone maintenance and longer lengths of stay in treatment, if acted upon, may diminish the benefits from averted crime associated with methadone treatment. (Author' s abstract)