|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$820||Benefits minus costs||($17,613)|
|Participants||$1,176||Benefit to cost ratio||($0.05)|
|Others||$339||Chance the program will produce|
|Indirect||($3,121)||benefits greater than the costs||0 %|
|Net program cost||($16,826)|
|Benefits minus cost||($17,613)|
|Detailed Monetary Benefit Estimates Per Participant|
|Benefits from changes to:1||Benefits to:|
|Property loss associated with problem alcohol use||$0||$0||$0||$0||$0|
|Labor market earnings associated with opioid drug abuse or dependence||$280||$616||$0||$0||$896|
|Health care associated with opioid drug abuse or dependence||$314||$61||$339||$156||$869|
|Mortality associated with opioids||$227||$499||$0||$5,129||$5,855|
|Adjustment for deadweight cost of program||$0||$0||$0||($8,407)||($8,407)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$16,356||2015||Present value of net program costs (in 2017 dollars)||($16,826)|
|Comparison costs||$0||2015||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|
|Opioid use disorder||38||5||337||-0.566||0.152||38||0.000||0.000||39||-0.566||0.001|
|Problem alcohol use||38||1||153||-0.049||0.364||38||0.000||0.000||39||-0.049||0.893|
Comer, S.D., Sullivan, M.A., Yu, E., Rothenberg, J.L., Kleber, H.D., Kampman, K., . . . O'Brien, C.P. (2006). Injectable, sustained-release naltrexone for the treatment of opioid use disorder: A randomized, placebo-controlled trial. Archives of General Psychiatry, 63(2), 210-218.
Krupitsky, E., Nunes, E.V., Ling, W., Illeperuma, A., Gastfriend, D.R., & Silverman, B.L. (2011). Injectable extended-release naltrexone for opioid use disorder: A double-blind, placebo-controlled, multicentre randomised trial. Lancet, 377(9776), 1506-1513.
Lee, J.D., McDonald, R., Grossman, E., McNeely, J., Laska, E., Rotrosen, J., & Gourevitch, M.N. (2015). Opioid treatment at release from jail using extended-release naltrexone: A pilot proof-of-concept randomized effectiveness trial. Addiction, 110(6), 1008-1014.
Lee, J.D., Friedmann, P.D., Kinlock, T.W., Nunes, E.V., Boney, T.Y., Hoskinson, R.A., . . . O’Brien, C.P. (2016). Extended-release naltrexone to prevent opioid relapse in criminal justice offenders. New England Journal of Medicine, 374(13), 1232-1242.