Consequences and costs of shutting off methadone

Addict Behav. 1989;14(3):307-26. doi: 10.1016/0306-4603(89)90062-2.

Abstract

In the face of rising fiscal conservatism, many states and localities with sizable addict populations have reduced or eliminated public funding for methadone maintenance (MM) programs and permitted private-fee-for-service programs to replace them. The social and economic costs of these changed funding policies with reference to the California experience were analyzed. A two-and-a-half year follow-up of a sample of San Diego MM clients (195 men, 129 women) terminated from a public subsidized program compared outcome results to clients from publicly funded MM programs in Orange, Riverside and San Bernardino counties (129 men, 131 women). In a secondary analysis, San Diego clients who transferred into private (fee-for-service) treatment programs were compared with those who did not transfer. Major adverse consequences were found for clients unable or unwilling to transfer to private programs: higher crime and dealing rates, more contact with the criminal justice system, and higher rates of illicit drug use were demonstrated by nontransfer clients. Moreover, the savings resulting from a reduction of MM program costs were nearly offset by increased direct costs for incarceration, legal supervision, and other government-funded drug treatment. Indirect costs were not assessed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • California
  • Community Mental Health Services / economics*
  • Cost Control / trends
  • Crime / trends
  • Cross-Sectional Studies
  • Female
  • Heroin Dependence / rehabilitation
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Opioid-Related Disorders / epidemiology
  • Opioid-Related Disorders / rehabilitation*
  • Patient Discharge / economics

Substances

  • Methadone