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Washington State Institute for Public Policy
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Other (non-therapeutic communities) substance use disorder treatment for court-involved youth

Juvenile Justice
Benefit-cost methods last updated December 2019.  Literature review updated August 2017.
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This analysis is on court-involved youth receiving substance use disorder treatment as a condition of their probation. Other substance use disorder treatment is a broadly defined category that includes a variety of substance use disorder treatment modalities targeted and delivered to youth who are involved in the juvenile justice system. Substance use disorder treatments seek to reduce substance use issues (e.g., general use and frequency) and its related effects (e.g., recidivism). These interventions can be delivered in individual, group, or family modalities.

In the included studies, youth participated in a variety of community-based treatment types, which could include individual-, group-, or family-based interventions. Most youth were classified as high-risk per scores on a validated recidivism risk instrument. In the included study that reported treatment duration, youth were in treatment for 3.5 months. In the included studies that report demographics, 64% of participants were youth of color and 6% were female.

We exclude evaluations of therapeutic communities and substance use disorder treatments for youth in state institutions from this meta-analysis and analyze them separately.

Key Terms

Court-involved youth: Youth who are processed through the juvenile justice system but who are not ordered to a period of confinement in a residential or correctional facility. This includes populations of arrested youth, diverted youth, charged youth, adjudicated youth, and youth on probation or formal supervision.

Youth in state institutions: Youth who are confined in a residential or correctional facility when they participate in the program.

Youth post-release: Youth who are returning to the community following a period of confinement in a residential or correctional facility and who participate in the program after release to the community.

BENEFIT-COST
META-ANALYSIS
CITATIONS
The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2018). The chance the benefits exceed the costs are derived from a Monte Carlo risk analysis. The details on this, as well as the economic discount rates and other relevant parameters are described in our Technical Documentation.
Benefit-Cost Summary Statistics Per Participant
Benefits to:
Taxpayers $734 Benefits minus costs ($2,562)
Participants $1,981 Benefit to cost ratio $0.17
Others ($736) Chance the program will produce
Indirect ($1,453) benefits greater than the costs 42 %
Total benefits $526
Net program cost ($3,087)
Benefits minus cost ($2,562)
1In addition to the outcomes measured in the meta-analysis table, WSIPP measures benefits and costs estimated from other outcomes associated with those reported in the evaluation literature. For example, empirical research demonstrates that high school graduation leads to reduced crime. These associated measures provide a more complete picture of the detailed costs and benefits of the program.

2“Others” includes benefits to people other than taxpayers and participants. Depending on the program, it could include reductions in crime victimization, the economic benefits from a more educated workforce, and the benefits from employer-paid health insurance.

3“Indirect benefits” includes estimates of the net changes in the value of a statistical life and net changes in the deadweight costs of taxation.
Detailed Monetary Benefit Estimates Per Participant
Benefits from changes to:1 Benefits to:
Taxpayers Participants Others2 Indirect3 Total
Crime ($431) $0 ($1,114) ($215) ($1,760)
Labor market earnings associated with smoking $796 $1,870 $0 $0 $2,667
Health care associated with smoking $366 $103 $378 $183 $1,030
Property loss associated with alcohol abuse or dependence $0 $0 $1 $0 $1
Mortality associated with smoking $3 $6 $0 $123 $132
Adjustment for deadweight cost of program $0 $0 $0 ($1,544) ($1,544)
Totals $734 $1,981 ($736) ($1,453) $526
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $2,855 2012 Present value of net program costs (in 2018 dollars) ($3,087)
Comparison costs $0 2012 Cost range (+ or -) 20 %
The per-participant cost estimate is based on the average monthly cost of treatment in Washington applied to the average length of treatment in the included studies. We estimate the monthly cost of treatment using a per-youth cost of substance use treatment provided by Washington State Juvenile Rehabilitation, divided by the average length of treatment in Washington. We multiply this monthly cost by the weighted average length of treatment for the included studies (3.5 months).
The figures shown are estimates of the costs to implement programs in Washington. The comparison group costs reflect either no treatment or treatment as usual, depending on how effect sizes were calculated in the meta-analysis. The cost range reported above reflects potential variation or uncertainty in the cost estimate; more detail can be found in our Technical Documentation.
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.

^WSIPP’s benefit-cost model does not monetize this outcome.

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic in order to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the types of program impacts that were measured in the research literature (for example, crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases.

Adjusted effect sizes are used to calculate the benefits from our benefit cost model. WSIPP may adjust effect sizes based on methodological characteristics of the study. For example, we may adjust effect sizes when a study has a weak research design or when the program developer is involved in the research. The magnitude of these adjustments varies depending on the topic area.

WSIPP may also adjust the second ES measurement. Research shows the magnitude of some effect sizes decrease over time. For those effect sizes, we estimate outcome-based adjustments which we apply between the first time ES is estimated and the second time ES is estimated. We also report the unadjusted effect size to show the effect sizes before any adjustments have been made. More details about these adjustments can be found in our Technical Documentation.

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
ES SE Age ES SE Age ES p-value
Alcohol use disorder 16 1 146 -0.231 0.102 16 0.000 0.187 19 -0.231 0.024
Cannabis use disorder 16 1 146 -0.007 0.102 16 0.000 0.187 19 -0.007 0.944
Crime 16 1 146 0.020 0.102 17 0.020 0.102 25 0.020 0.842
Regular smoking 16 1 146 -0.092 0.102 16 -0.092 0.102 26 -0.092 0.369
Substance use disorder^ 16 1 58 -0.017 0.228 16 n/a n/a n/a -0.017 0.939

Citations Used in the Meta-Analysis

Chassin, L., Knight, G., Vargas-Chanes, D., Losoya, S.H., & Naranjo, D. (2009). Substance use treatment outcomes in a sample of male serious juvenile offenders. Journal of Substance Abuse Treatment, 36 (2), 183-194.

Henderson, C.E., Wevodau, A.L., Henderson, S.E., Colbourn, S.L., Gharagozloo, L., North, L.W., & Lotts, V.A. (2016). An independent replication of the adolescent-community reinforcement approach with justice-involved youth. The American Journal on Addictions, 25 (3), 233-240.