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Washington State Institute for Public Policy
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Other (non-therapeutic communities) substance use disorder treatment for youth in state institutions

Juvenile Justice
Benefit-cost methods last updated December 2023.  Literature review updated August 2017.
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This analysis is on youth receiving substance use disorder treatment while serving a sentence in a state institution. 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 group- or family-based interventions. The interventions occurred both in detention and the community post-release and ranged in length from three to five months. In the included studies that report demographics, 85% of participants were youth of color and 7% were female.

We exclude evaluations of therapeutic communities and substance use disorder treatments for court-involved youth 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.
 
ALL
BENEFIT-COST
META-ANALYSIS
CITATIONS
For an overview of WSIPP's Benefit-Cost Model, please see this guide. The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2022). 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 $7,153 Benefits minus costs $28,705
Participants $184 Benefit to cost ratio $8.50
Others $22,774 Chance the program will produce
Indirect $2,419 benefits greater than the costs 71%
Total benefits $32,531
Net program cost ($3,826)
Benefits minus cost $28,705

^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. See Estimating Program Effects Using Effect Sizes for additional information.

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
Crime
Any criminal conviction according to court records, sometimes measured through charges, arrests, incarceration, or self-report.
 15 1 110 -0.216 0.142 16 -0.216 0.142 24 -0.216 0.129
Alcohol use disorder
Clinical diagnosis of alcohol use disorder or symptoms measured on a validated scale.  
 15 1 110 -0.175 0.142 15 0.000 0.187 18 -0.175 0.218
Illicit drug use disorder
Clinical diagnosis of illicit drug use disorder or symptoms measured on a validated scale. When possible, we exclude cannabis/marijuana use disorder from this outcome.
 15 1 110 -0.364 0.143 15 0.000 0.187 18 -0.364 0.011
Substance use disorder^
A non-specified alcohol or drug use disorder. Typically, a collection of different types of disorders reported by study authors. 
 15 1 76 -0.143 0.163 15 n/a n/a n/a -0.143 0.381
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
Affected outcome: Resulting benefits:1 Benefits accrue to:
Taxpayers Participants Others2 Indirect3 Total
Crime Criminal justice system $6,702 $0 $22,364 $3,351 $32,417
Alcohol use disorder Labor market earnings associated with alcohol abuse or dependence $0 $1 $0 $0 $1
Property loss associated with alcohol abuse or dependence $0 $0 $0 $0 $0
Illicit drug use disorder Health care associated with illicit drug abuse or dependence $399 $62 $410 $200 $1,072
Mortality associated with illicit drugs $52 $121 $0 $781 $954
Program cost Adjustment for deadweight cost of program $0 $0 $0 ($1,913) ($1,913)
Totals $7,153 $184 $22,774 $2,419 $32,531
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Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $3,114 2012 Present value of net program costs (in 2022 dollars) ($3,826)
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 substance use treatment using a per-youth cost of 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 (3.8 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.
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
Benefits Minus Costs Over Time (Cumulative 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 discounted dollars. 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.

Citations Used in the Meta-Analysis

Friedman, A.S., Terras, A., & Glassman, K. (2002). Multimodal substance use intervention program for male deliquents. Journal of Child and Adolescent Substance Abuse, 11(4), 43-65.

Henderson, C.E., Dakof, G.A., Liddle, H.A., & Greenbaum, P.E. (2010). Effectiveness of multidimensional family therapy with higher severity substance-abusing adolescents: Report from two randomized controlled trials. Journal of Consulting and Clinical Psychology, 78(6), 885-897.