Studies considering costs and effects of substance abuse | ||||||
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Dennis (2004) [29] |  | Costs intervention and comparators (per episode of care per patient) (MET/CBT 5, MET/CBT 12, FSN, ACRA, MDFT)  In trial 1 MET/CBT 5,MET/CBT 12 and FSN were compared. In trial 2 MET/CBT 5, ACRA and MDFT were compared. Costs were collected with a program (DATCAP) which yields estimates such as the total annual opportunity cost of treatment and the labor cost per client. | Difference cost | |||
 The difference in costs were not showed in this study. However, it was showed that the differences were significant. | ||||||
 MET/CBT 5 (trial 1):  € 1,226  MET/CBT 12 (trial 1):  € 1,305  FSN (trial 1):  € 3,576 | MET/CBT 5 (trial 2): €1,716 ACRA (trial 2): € 1,551 MDFT (trial 2): € 2,205 | |||||
 | Effects intervention and comparators (per patient) (MET/CBT 5, MET/CBT 12, FSN, ACRA, MDFT) | Difference effects | ||||
 |  Met CBT 5 (trial 1)  Days of abstinence: 269  Recovery*: 28 %  Met CBT 12 (trial 1)  Days of abstinence: 256  Recovery: 17 %  MET FSN (trial 1)  Days of abstinence: 260  Recovery: 22 %  *Recovery is defined as having no use or abuse dependence problems and living in the community | Met CBT 5 (trial 2) Days of abstinence: 251 Recovery: 23 % ACRA (trial 2) Days of abstinence: 265 Recovery: 34 % MDFT (trial 2) Days of abstinence: 257 Recovery: 19 % |  The difference in effects were not showed in this study However it was showed that the difference was not significant. | |||
Results | Cost per day of abstinence:  Met CBT5 (trial 1): € 541  Met CBT 12: € 677  Met FSN: € 1,667 Costs per person in recovery  Met CBT5 (trial 1): € 4,360  Met CBT 12: € 41,172  Met FSN: € 16,651 | Cost per days of abstinence:  MET/CBT5 (trial 2): € 991  ACRA: € 729  MDFT: € 1,143 Costs per person in recovery  MET/CBT5 (trial 2): € 7,337  ACRA: € 4,913  MDFT: € 12,970 | ||||
French (2008) [25] |  | Costs intervention per patient (FFT, Joint and CBT)  FFT:  Treatment costs: € 1,817  Joint:  treatment costs: € 2,847  CBT:  Treatment costs: € 1.439 | Costs comparator per patient (Group)  Group:  Treatment costs: € 990 | Difference costs | ||
 The difference in costs were not showed in this study | ||||||
Effects intervention per patient (FFT, Joint and CBT)  FFT:  % days marijuana use 4 months: 25.3  %of days marijuana use 7 months:39.8  YSR delinquency score 4 months: 8.2  YSR delinquency score 7 months:9.2  Joint  % of days of marijuana use 4 months: 38.1  marijuana use 7 months:35.4  YSR delinquency score 4 months: 9.1  YSR delinquency score 7 months:8.5  CBT % of days marijuana use 4 months: 50.6  % of days marijuana use 7 months:51.8 YSR delinquency score 4 months: 10.2  YSR delinquency score 7 months:10.4 | Effects comparator per patient (Group)  Group  % of days of marijuana use 4 months: 54.8  marijuana use 7 months: 40.7  YSR delinquency score 4 months: 9.5  lYSR delinuency score 7 months: 9.4 | Difference effects with regression model: | ||||
 FFT versus group:  % days marijuana use after 4 months: −20.11*  % days marijuana use after 7 months: 4.87  YSR delinquency score 4 months: −0.60  YSR delinquency score 7 months: 0.15  CBT versus group  % days marijuana use after 4 months: 4.76  % days marijuana use after 7 months: 18.27  YSR delinquency score 4 months: 0.38  YSR delinquency score 7 months: 0.42  Joint versus group  % days marijuana use after 4 months: −14.86  % days marijuana use after 7 months “-2.00  YSR delinquency score 4 months: −0.50  YSR delinquency score 7 months: −1.50 | Joint versus group Delinquency score after 4 months: −0.50 Delinquency score after 7 months: −1.50 | |||||
Results | Group therapy was most cost-effective, none of the other therapies were significantly different in effect compared to group therapy. So the intervention with the lowest costs was considered to be most cost-effective. | |||||
Sheidow (2012) [27] |  | Costs Intervention (DC, DC + MST, DC + MST + CM)  Treatment costs DC: € 9,083  Treatment costs DC + MST: € 12,369  Treatment costs DC + MST + CM: € 12,859 | Costs comparator (FC)  Treatment costs FC:  € 3,679 | Difference costs: | ||
 The difference in costs were not shown in this study | ||||||
Effects intervention (DC, DC + MST, DC + MST + CM)  DC  Marijuana use (days): −16.65  Polydrug use (days): 1.41  Alcohol use (days): 0.49  Heavy alcohol use (days): 0.86  SRD status offenses (incidents): −7.24  SRD Theft (incidents): −3.28  SRD crimes against persons (incidents): −2.69  DC ± MST  Marijuana use (days): −30,17  Polydrug use (days): :-1.11  Alcohol use (days): 0.27  Heavy alcohol use (days): −0.45  SRD status offenses (incidents): −11.11  SRD Theft (incidents): −2.79  SRD crimes against persons (incidents): −3.90  DC ± MST ± CM  Marijuana use (days): −27.86  Polydrug use (days): −6.76  Alcohol use (days): −7.56  Heavy alcohol use (days): −4.13  SRD status offenses (incidents): −10.38  SRD Theft (incidents): −3.19  SRD crimes against persons (incidents): −2.4 | Effects comparator (FC)  Marijuana use (days): −15,43  Polydrug use (days): 2.27  Alcohol use (days): 2.97  Heavy alcohol use (days): 0.76  SRD status offenses (incidents): 9.22  SRD Theft (incidents): −5.54  SRD crimes against persons (incidents): 0.49 | Difference effects:  The difference in effects were not showed in this study | ||||
Results | ACERS were calculated; average costs/ difference between mean incidents before and after treatment (negative means inefficient) | |||||
 | FC | DC | DC + MST | DC + MST + CM | ||
Marijuana use: Polydrug use: Alcohol use: Heavy alcohol use: SRD status offenses: SRD theft: SRD crimes against persons: | € 238 (215–262) € −1,619 (−8,8839–5,601) € −,1,239 (−6,546–5,601) € −4,857 (−10,632–918) € −400 (−1,206–398) € 663 (428–899) € −7,588 (−10,667–4,510) | € 545 (474–617) € −6,425 (−27,541–14,692) € −18,814 (−42,034–4,405) € −10,535 (−28,804–7,733) € 1,254 (1,132–1,376) € 2,773 (−2.441–7,987) € 3,377 (2,976–3,777) | € 410 (377–442) € 11,209 (−3,757–26,175) € −44,838 (−61,014–28,662) € 27,592 (−14,636–69,821) € 1,114 (907–1,321) € 4,428 (−1,224–10,081) € 3,175 (236–6,123) | € 461 (434–488) € 1,912 (1,624–2,182) € 1,699 (1,486–1,912) € 3,109 (1,708–4,511) € 1,239 (1,009–1,496) € 4,032 (1,204–6,859) € 5,346 (4,723–5,968) | ||
Studies considering costs and benefits of substance abuse | ||||||
Schoenwald (1996) [32] | Costs interventions (MST)  Mental health outpatient (total): €4,242  Mental health day treatment (total): € 5,423  Mental health residential treatment (total): €6,899  Psychiatric inpatient (total): €15,752  Psychiatric emergency room (total): €1,150  Substance abuse outpatient (total): € 2,001  Substance abuse residential treatment (total): €3,450  Substance abuse inpatient (total): € 16,098  Marine Institute day treatment (total): € 18,926  Marine Institute residential treatment (total): € 3,036  Treatment costs: € 266,516 | Costs comparator (CAU)  Mental health outpatient (total): € 19,075  Mental health day treatment (total): € 1,118  Mental health residential treatment (total): €0  Psychiatric inpatient (total): €18,513  Psychiatric emergency room (total): €3,450  Substance abuse outpatient (total): € 20,272  Substance abuse residential treatment (total): €43,695  Substance abuse inpatient (total): €93,771  Marine Institute day treatment (total): €28,618  Marine Institute residential treatment (total): €0 | Benefits interventions Incarceration days: €65,427 | Benefits CAU Incarceration days: €120,851 | ||
 | Results | MST: Total costs (costs + benefit) with incarceration = €408,919 and the total costs (costs + benefit) with incarceration per youth = €6,930 CAU: Total costs (costs + benefit) with incarceration = € 335,845 and the costs (costs + benefit) per youth = €5,693. Difference in total between groups = €1,019 | ||||
French (2003) [22] | Costs interventions (MET/CBT 5, MET/CBT 12, FSN, ACRA, MDFT) | Benefits interventions (MET/CBT 5, MET/CBT 12, FSN, ACRA, MDFT) | ||||
 Treatment costs were measured |  Health service utilization; Outpatient clinic/doctor’s office visit  Days bothered by health/medical problem  Substance-absue treatment utilization; Days in detoxification program; Day in inpatient treatment program; Day in long-term residential program; Intensive outpatient program visits; Regular outpatient program visits  Education and employment; Days missed at school or training; Personal income; Days stressful for parents  Day missed of work or school by parent  Criminal activity; Arrests; Day on probation; Days on parole; Days in prison/jail; Days in juvenile detention | |||||
 Incremental arm:  MET/CBT5:€ 1,226  MET/CBT12: € 1,305  FSN: € 3,576 |  Alternative arm:  MET/CBT5: € 1,716  ACRA: € 1,551  MDFT: € 2,216 |  Incremental arm:  MET/CBT5  Baseline € 2,553  3 months: € 2,133  6 months: € 1,671  9 months: € 945  12 months: € 1,217  MET/CBT12  Baseline: € 2,179  3 months: € 2,433  6 months: € 828  9 months: € 1,431  12 months: € 687  FSN:  Baseline: € 2,552  3 months: € 4,525  6 months: € 1,783  9 months: € 1,205  12 months: € 1,726 | Alternative arm: MET/CBT5 Baseline € 2,694 3 months: € 3,587 6 months: € 2,213 9 months: € 2,275 12 months: € 1,907 ACRA Baseline: € 2,506 3 months: € 3,691 6 months: € 1,748 9 months: € 3,113 12 months: € 3,237 MDFT: Baseline: € 2,019 3 months: € 3,938 6 months: € 1,467 9 months: € 2,573 12 months: € 2,098 | |||
 | Results | Net economic benefits (benefits + costs) relative to baseline: 3 different models were administred; Model 1: only time dummies for each of the follow-up periods (as treatment conditions were not included, we did not show the results. Model 2: time dummies and indicator variables for treatment condition. Model 3: time and treatment variables withan indicator variable for site. The last specification added numerous demographic and environmental controls. | ||||
MET/CBT12: Model 2: € −198 (349) Model 3: € −171 (346) Model 4: € −340 (334) FSN: Model 2: € 607* (343) Model 3: € 653 (340) Model 4: € 250 (333) *p < 0.1 | Acra: Model 2: € 369 (436) Model 3: € 530 (430) Model 4: € 554 (405) MDFT Model 2: −€ 61 (441) Model 3: € 128 (436) Model 4: € 100 (530) | |||||
McCollister (2009) [24] | Â | Costs interventions (DC, DC/MST, DC) | Costs comparators (FC) | Benefits interventions (DC, DC/MST, DC) | Benefits comparators (FC) | |
Treatment costs | Treatment costs |  Criminal activity costs according to Self-reported criminal activity (SRD):  DC:  € 28.601 (94.314)  DC/MST:  €65.640 (240.559)  DC/MST/CM:  €80.222 (336.461) |  Self-reported criminal activity (SRD):  FC: € 206.045 (545.581) | |||
 DC:  €8,156  DC/MST:  €11,547  DC/MST/CM:  € 11,547 |  FC:  €3,304 | |||||
Results | After 12 months, total costs relative to FC with multivariate model (intervention costs not incorporated): DC: € -124,877 (−84,107) DC/MST: €-117,918 (−82,570) DC/MST/CM: €140,274 (/79.066)* All DC conditions generated reduction in crime costs, greater than average costs of treatment. |