 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Donald S. Shepard, PhD, Schneider Institute for Health Policy, Heller School, Brandeis University, 415 South Street, Waltham, MA 02454, 781-736-3975, shepard@brandeis.edu, Marilyn Daley, PhD, Schneider Institute for Health Policy, Heller School, Brandeis University, 415 South Street, Waltham, MA 02454, and Craig T. Love, PhD, Westat Inc., 1650 Research Blvd., Rockville, MD 20850.
Over the past two decades, the criminal justice population in the US has tripled, mostly from more drug involved offenders. Although mounting evidence indicates that prison-based substance abuse treatment programs are effective in reducing re-arrest, few cost-effectiveness studies have been conducted. Using data from the Connecticut Department of Correction and the Connecticut Department of Mental Health and Addiction Services (DMHAS), we compared the cost-effectiveness of four tiers (intensities) of substance abuse treatment programs for a sample of 831 men who were released in 1996-97. We measured effectiveness as the reduction in their recidivism rates (re-arrest within 6, 12, and 18 months of release) compared to those in no tier program, controlling for background characteristics such as security risk and prior arrests. Cost per attender was $189 in tier 1 (general education about substance abuse), $672 in tier 2 (weekly “outpatient” treatment), $2667 (intensive “outpatient” treatment), and $5699 in tier 4 (6-month therapeutic community). Each of the higher tier programs (2, 3 and 4) achieved significant reductions in recidivism at all follow-up intervals. The economic benefits to the State of Connecticut correctional system alone, measured in terms of the costs of avoided re-incarcerations within 12 months of release, were 5.7 times the cost of treatment for tier 2, 3.2 times for tier 3, and 1.8 times the cost for tier 4. Since society receives a favorable return on investment in prison-based treatment programs, it should find ways to ensure that more drug involved inmates receive treatment.
Learning Objectives:
Keywords: Substance Abuse Treatment, Correctional Institutions
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.