Costs and benefits of treatment for cocaine addiction in DATOS

FRANÇAIS :
Les coûts des traitements résidentiels et des traitements ambulatoires de la dépendance à la cocaïne sont évalués en terme de bénéfice par rapport au coût de la criminalité. Les données financières proviennent de programmes de 10 villes américaines entre 1991 et 1993 et concernent 502 cocaïnomanes ; elles sont estimées à partir de l'étude NDATUS (National Drug Abuse Treatment Unit Survey). Les coûts des délits sont estimés à partir des rapports d'infractions commis avant, pendant et après les traitements. Les patients en traitement résidentiel long (LTR) sont ceux qui ont commis le plus de délits avant le traitement et donc à qui on peut attribuer l'incidence de coût la plus élevée. Ce sont eux également qui présentent la plus forte diminution de criminalité à un an et pour qui le traitement est un bénéfice.
ENGLISH :
Our objective was to examine the cost of long-term residential (LTR) and outpatient drug-free (ODF) treatments for cocaine-dependent patients participating in the Drug Abuse Treatment Outcome Studies (DATOS), calculate the tangible cost of crime to society, and determine treatment benefits. Subjects were 502 cocaine-dependent patients selected from a national and naturalistic nonexperimental evaluation of community-based treatment. Financial data were available for programs from 10 US cities where the subjects received treatment between 1991 and 1993. Treatment costs were estimated from the 1992 National Drug Abuse Treatment Unit Survey (NDATUS), and tangible costs of crime were estimated from reports of illegal acts committed before, during, and after treatment. Sensitivity analyses examined results for three methods of estimating the costs of crime and cost-benefit ratios. Results showed that cocaine-dependent patients treated in both LTR and ODF programs had reductions in costs of crime from before to after treatment. LTR patients had the highest levels and costs of crime before treatment, had the greatest amount of crime cost reductions in the year after treatment, and yielded the greatest net benefits. Cost-benefit ratios for both treatment modalities provided evidence of significant returns on treatment investments for cocaine addiction. (Author's abstract.)