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The costs and consequences of three policy options for reducing heroin dependency
Author(s) -
MOORE TIMOTHY J.,
RITTER ALISON,
CAULKINS JONATHAN P.
Publication year - 2007
Publication title -
drug and alcohol review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.018
H-Index - 74
eISSN - 1465-3362
pISSN - 0959-5236
DOI - 10.1080/09595230701373883
Subject(s) - abstinence , prison , psychological intervention , heroin , pharmacotherapy , rehabilitation , intervention (counseling) , medicine , psychiatry , psychology , physical therapy , drug , criminology
and Aims . This study compares the costs and consequences of three interventions for reducing heroin dependency: pharmacotherapy maintenance, residential rehabilitation and prison. Design and Methods . Using Australian data, the interventions' cost‐consequence ratio was estimated, taking into consideration reduction in heroin use during the intervention; the length of intervention; and post‐intervention effects (as measured by abstinence rates). Sensitivity analyses were conducted, including varying the magnitude and duration of treatment effects, and ascribing positive outcomes only to treatment completers. A hybrid model that combined pharmacotherapy maintenance with a prison term was also considered. Results . If the post‐programme abstinence rates are sustained for 2 years, then for an average heroin user the cost of averting a year of heroin use is approximately AUD$5000 for pharmacotherapy maintenance, AUD$11 000 for residential rehabilitation and AUD$52 000 for prison. Varying the parameters does not change the ranking of the programmes. If the completion rate in pharmacotherapy maintenance was raised above 95% (by the threat of prison for non‐completers), the combined model of treatment plus prison may become the most cost‐effective option. Discussion and Conclusions . Relative performance in terms of costs and consequences is an important consideration in the policy decision‐making process, and quantitative data such as those reported herein can provide insights pertinent to evidence‐based policy . [Moore TJ, Ritter A, Caulkins JP. The costs and consequences of three policy options for reducing heroin dependency. Drug Alcohol Rev 2007;26:369–378]