|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$1,744||Benefits minus costs||$9,427|
|Participants||$3,039||Benefit to cost ratio||n/a|
|Others||$504||Chance the program will produce|
|Indirect||$3,806||benefits greater than the costs||60 %|
|Net program cost||$333|
|Benefits minus cost||$9,427|
|Detailed Monetary Benefit Estimates Per Participant|
|Benefits from changes to:1||Benefits to:|
|Labor market earnings associated with alcohol abuse or dependence||$1,122||$2,637||$0||$0||$3,759|
|Property loss associated with alcohol abuse or dependence||$0||$3||$6||$0||$10|
|Health care associated with illicit drug abuse or dependence||$483||$75||$497||$242||$1,296|
|Mortality associated with illicit drugs||$138||$324||$0||$3,398||$3,860|
|Adjustment for deadweight cost of program||$0||$0||$0||$167||$167|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$407||1993||Present value of net program costs (in 2018 dollars)||$333|
|Comparison costs||$924||2014||Cost range (+ or -)||10 %|
|Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||No. of effect sizes||Treatment N||Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
|Alcohol use disorder||39||6||627||-0.331||0.132||39||0.000||0.187||42||-0.317||0.016|
|Illicit drug use disorder||39||5||545||-0.360||0.118||39||0.000||0.187||42||-0.374||0.002|
Carroll, K., Nich, C., Ball, S., Mccance, E., & Rounsavile, B. (1998). Treatment of cocaine and alcohol dependence with psychotherapy and disulfiram. Addiction, 93(5), 713-727.
Carroll, K.M., Nich, C., Shi, J.M., Eagan, D., Ball, S.A. (2012) Efficacy of disulfiram and Twelve Step Facilitation in cocaine-dependent individuals maintained on methadone: A randomized placebo-controlled trial. Drug and Alcohol Dependence, 126, 224-231.
Donovan, D.M., Daley, D.C., Brigham, G.S., Hodgkins, C.C., Perl, H. I., Garrett, S.B., Doyle, S.R., . . . Zammarelli, L. (2013). Stimulant abuser groups to engage in 12-Step: A multisite trial in the National Institute on Drug Abuse Clinical Trials Network. Journal of Substance Abuse Treatment, 44(1), 103-114
Kahler, C.W., Read, J.P., Ramsey, S.E., Stuart, G. L., McCrady, B.S., & Brown, R.A. (2004). Motivational enhancement for 12-step involvement among patients undergoing alcohol detoxification. Journal of Consulting and Clinical Psychology, 72(4), 736-741.
Kaskutas, L.A., Subbaraman, M., Witbrodt, J., Zemore, S.E. (2009) Effectiveness of Making Alcoholics Anonymous Easier (MAAEZ), a group format 12-step facilitation program. Journal of Substance Abuse Treatment, 37(3), 228-239.
Timko, C., DeBenedetti, A., & Billow, R. (2006). Intensive referral to 12-Step self-help groups and 6-month substance use disorder outcomes. Addiction, 101(5), 678-688.
Walitzer, K.S., Dermen, K.H., & Barrick, C. (2009). Facilitating involvement in Alcoholics Anonymous during out-patient treatment: a randomized clinical trial. Addiction, 104(3), 391-401.