Effect of substance abuse treatment on employment and crime outcomes

Crime and employment are important, but understudied, outcomes of substance abuse (SA) treatment. In 2005, Washington State expanded access to SA treatment for Medicaid patients and other welfare patients on the assumption that treatment would be associated with improved outcomes in the form of reduced crime, increased employment and reduced medical care utilization. The effect of SA treatment on medical utilization has been previously reported (Wickizer et al., 2012). Here I report the effects of SA treatment on crime and employment outcomes. The study population included working age disabled clients on Medicaid and clients on general assistance (n > 23,000). Multivariable regression analyses were conducted to examine crime and employment outcomes. SA treatment was associated with reductions in arrests from 18% to 33$ (p < .01); arrests avoided per 100 persons ranged from 13.8 to 46.2. SA treatment was also associated with positive employment outcomes. The adjusted odds ratios for any employment during the two-year follow-up period ranged from 1.5 to 1.6 depending on the welfare cohort. The incidence rate ratios generated by the analysis were approximately 1.35, implying that welfare clients having SA treatment would, on average, have been employed for 1.35 more quarters during the 2-year follow-up period compared to clients not having SA treatment. These analyses suggest that SA treatment is associated with positive outcomes in the form of enhanced employment and reduced crime. In making resource allocation decisions, policy makers should consider the effects of SA treatment on crime and employment outcomes.