Data Show Wide Variation In Addiction Treatment Costs

The cost of treating a person for drug or alcohol abuse varies widely depending on the type of treatment used, according to data from the federal Substance Abuse and Mental Health Services Administration (SAMHSA).

For example, data from the Alcohol and Drug Services Study Cost Study show that the mean cost per course of treatment was highest for people who received outpatient methadone treatment ($7,415) for addiction to heroin or prescription narcotic pain medications.

Treatment for drug abuse or addiction on an outpatient basis without methadone was, in contrast, just $1,433.

The mean cost of a course of residential treatment for substance abuse fell between the two, at $3,840.

To gather the data, researchers from SAMHSA's Office of Applied Studies conducted site visits and talked to administrators at 280 substance abuse treatment facilities in 1997 and 1998.

The researchers collected information on cost, types of patients served, staffing, and services provided to patients. To estimate 2002 health care costs, researchers used the medical care services component of the Consumer Price Index.

Of the facilities participating in the study, 48 offered nonhospital residential treatment, 44 offered outpatient methadone treatment, and 222 offered outpatient treatment without methadone.

In addition to calculating the average cost of an episode of treatment, researchers analyzed the mean cost of a visit to an outpatient methadone setting ($17.78) and an outpatient setting in which methadone was not used ($26.72).

Daily costs, which indicate the mean cost of treatment for each day someone is enrolled in a program, even if they did not have a treatment visit, were found to be the highest for patients receiving substance abuse treatment in a residential setting ($76.13).

In outpatient facilities, the mean cost of enrolled days was lower than in residential facilities because it included days when there were no patient visits.

In outpatient facilities that used methadone, for instance, the mean cost of treatment per enrolled day was $12.65; for those that did not use methadone, the cost was $11.24.

The SAMHSA report noted that although daily costs per patient were lower for outpatient methadone than for nonhospital residential treatment, outpatient methadone treatment had higher costs per treatment episode because patients “stayed in outpatient methadone treatment longer—an average of 520 days compared with 45 days for nonhospital residential treatment.”

The mean duration of treatment for patients who received services in outpatient settings without methadone was 144 days.

Personnel costs accounted for the highest proportion of treatment costs: 79 percent of total costs associated with outpatient treatment without methadone, 65 percent for outpatient methadone treatment, and 63 percent for residential treatment.

Annual treatment costs for each type of facility surveyed were calculated by multiplying the cost of an average treatment episode by the number of admissions per year based on national estimates for the three types of facilities.

For instance, the number of annual admissions to outpatient facilities not offering methadone that participated in the study were 2,151,694—at $1,433 per treatment episode, so annual costs for that type of facility were estimated at $3.1 billion.

The number of annual admissions to nonhospital residential settings for substance abuse treatment was 712,643. The cost of an episode of treatment was about $3,840, so total annual costs were approximately $2.7 billion.

Outpatient methadone clinics surveyed had the lowest number of annual visits (130,472), and annual costs were estimated at just under $1 billion.

While those figures may seem high, they are much lower than the costs incurred by people with untreated addictions, according to SAMHSA Administrator Charles Curie.

“Treatment is a bargain compared with expenditures for jails, foster care for prison, and health complications that often accompany addiction,” he said in a May press release.

The report on the Alcohol and Drug Services Cost Study is posted online at<www.oas.samhsa.gov/2k4/costs/costs.cfm>.▪