Long-term cost effectiveness of addiction treatment for criminal offenders

This paper extends previous research that performed a cost-effectiveness analysis (CEA) of the Amity in-prison therapeutic community (TC) and Vista aftercare programs for criminal offenders in southern California. To assess the impact of treatment over time for this unique sample of criminal offenders, a 5-year follow-up CEA was performed to compare the cost of an offender's treatment—starting with the in-prison TC program and including any community-based treatment received post-parole—and the effectiveness of treatment in terms of days reincarcerated. The average cost of addiction treatment over the baseline and 5-year follow-up period was 7, 041 for the Amity group and 1, 731 for the control group. The additional investment of 5, 311 in treatment yielded 81 fewer incarceration days (13%) among Amity participants relative to controls—a cost-effectiveness ratio of 65. When considering the average daily cost of incarceration in California (72), these results suggest that offering treatment in prison and then directing offenders into community-based aftercare treatment is cost-effective policy tool. This research was supported by the Robert Wood Johnson Foundation (grant number 041070) and the National Institute on Drug Abuse (grant numbers R01 DA11506, R01 DA11483, and P50 DA07705). We want to acknowledge Dr. Harry K. Wexler of National Development and Research Institutes, Inc. for his important work as the Principal Investigator on the 1-year outcome evaluation of the Amity prison Therapeutic Community. Dr. Wexler's work provided the foundation for the 5-year follow-up on which this study is based. We thank William Russell for his assistance in editing and Venessa de la Portilla for her assistance in preparing the manuscript for submission. This research was supported by the Robert Wood Johnson Foundation (grant number 041070) and the National Institute on Drug Abuse (grant numbers R01 DA11506, R01 DA11483, and P50 DA07705). We want to acknowledge Dr. Harry K. Wexler of National Development and Research Institutes, Inc. for his important work as the Principal Investigator on the 1-year outcome evaluation of the Amity prison Therapeutic Community. Dr. Wexler's work provided the foundation for the 5-year follow-up on which this study is based. We thank William Russell for his assistance in editing and Venessa de la Portilla for her assistance in preparing the manuscript for submission. Notes This research was supported by the Robert Wood Johnson Foundation (grant number 041070) and the National Institute on Drug Abuse (grant numbers R01 DA11506, R01 DA11483, and P50 DA07705). We want to acknowledge Dr. Harry K. Wexler of National Development and Research Institutes, Inc. for his important work as the Principal Investigator on the 1-year outcome evaluation of the Amity prison Therapeutic Community. Dr. Wexler's work provided the foundation for the 5-year follow-up on which this study is based. We thank William Russell for his assistance in editing and Venessa de la Portilla for her assistance in preparing the manuscript for submission.