Weighing the Costs - Annual Cost per Drug Addict

This summary presents a perspective on the relative costs of different types of treatment and how they compare with incarceration as a means of dealing with drug dependent individuals. A range of treatment modalities is required to address the varying needs of drug dependent and abusing individuals. Costs for a given treatment modality vary from program to program. The National Treatment Improvement Evaluation Study (NTIES) has estimated unit and average costs for various treatment modalities. The NTIES study provides some uniformity in that these data are derived from CSAT (Center for Substance Abuse Treatment) funded services. Data from the Federal Bureau of Prisons provides a means of considering the costs of incarceration. Regular Outpatient Treatment NTIES estimates the average cost of regular outpatient treatment to be $1,800, based on $15 per day, for 120 days. Outpatient treatment at Level I, as defined by the ASAM (American Society of Addiction Medicine) Patient Placement Criteria, typically involves one or more group or individual sessions with up to 9 hours of service per week. Charges for one group session can be as high as $30 to $50 and typically last from one to several hours. Intensive Outpatient Treatment Intensive outpatient treatment, Level II of the ASAM criteria, ranges from 9 hours of structured services per week as seen in some evening programs to more than 20 hours for day programs. The average cost estimate of $2,500 includes six months of weekly maintenance care group sessions after completion of the intensive phase of the treatment. Methadone Maintenance The NTIES estimates a methadone maintenance cost of $13 per day for an average of 300 days, or $3,900 per person. Costs during the first year of methadone maintenance may be considerably higher due to additional assessments, closer monitoring, and group sessions that are required at the initiation of methadone treatment. Short Term Residential Treatment NTIES estimates the average costs for short term residential care to be $130 per day, for 30 days, yielding a treatment cost of about $4,000. An additional $400 for 25 weekly group sessions is added to the NTIES estimate because research has shown that six months of ongoing care yields better outcomes. Charges for short term residential treatment vary widely depending upon the nature of the clients served and the total package of services provided. Private sector treatment programs include costs of service delivery plus indirect expenses such as capitol debt retirement and typically range from $6,000 to $15,000. These programs usually include up to a year of weekly maintenance care group sessions and/or provision of any other necessary service in the event of relapse. Long Term Residential Treatment The NTIES estimates the average cost for long term residential care to be $49 per day for an average of 140 days or a total of $6,800. Incarceration The incarceration cost estimate of $25,900 is based on one of the more common cost estimation strategies. The total federal corrections budget of approximately $3.2 billion minus construction costs (about 15% of the total budget) is divided by the number of federal inmates (currently about 105,000). Daily operating costs range from just over $53 per day for low security inmates to over $71 per day for high security prisoners. According to the Federal Bureau of Prisons the average weighted operating cost for housing an inmate is $59.83 per day, for an annual cost of approximately $21,800. Capitol investments required for the construction of facilities result in amortized costs that must be added to the operating budget to account for all incarceration costs. Dividing the total budget for fiscal year 1997 by the number of inmates (a cost of over $30,000 per inmate) is inaccurate because construction costs should be spread over the functional life of the facility. The cost estimate of $25,900 which includes non-operational costs but excludes the current year's construction is a reasonable estimate of total incarceration expense.