|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$668||Benefits minus costs||$3,837|
|Participants||$820||Benefit to cost ratio||$11.39|
|Others||$341||Chance the program will produce|
|Indirect||$2,378||benefits greater than the costs||60 %|
|Net program cost||($369)|
|Benefits minus cost||$3,837|
|Detailed Monetary Benefit Estimates Per Participant|
|Benefits from changes to:1||Benefits to:|
|Labor market earnings associated with opioid drug abuse or dependence||$227||$534||$0||$0||$762|
|Health care associated with opioid drug abuse or dependence||$340||$49||$341||$170||$898|
|Mortality associated with opioids||$101||$237||$0||$2,393||$2,731|
|Adjustment for deadweight cost of program||$0||$0||$0||($185)||($185)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$1,007||2016||Present value of net program costs (in 2018 dollars)||($369)|
|Comparison costs||$651||2016||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||9||520||-0.291||0.068||38||0.000||0.075||39||-0.291||0.001|
Brooner, R.K., Kidorf, M.S., King, V.L., Stoller, K.B., Neufeld, K.J., & Kolodner, K. (2007). Comparing adaptive stepped care and monetary-based voucher interventions for opioid dependence. Drug and Alcohol Dependence, 88, S14-S23.
Carroll, K.M., Ball, S.A., Nich, C., O'Connor, P.G., Eagan, D.A., Frankforter, . . . Rounsaville, B.J. (2001). Targeting behavioral therapies to enhance naltrexone treatment of opioid dependence: efficacy of contingency management and significant other involvement. Archives of General Psychiatry, 58(8), 755-761.
Chen, W., Hong, Y., Zou, X., McLaughlin, M.M., Xia, Y., & Ling, L. (2013). Effectiveness of prize-based contingency management in a methadone maintenance program in China. Drug and Alcohol Dependence, 133(1), 270-274.
Hser, Y.I., Li, J., Jiang, H., Zhang, R., Du, J., Zhang, C., Zhang, B., . . . Zhao, M. (2011). Effects of a randomized contingency management intervention on opiate abstinence and retention in methadone maintenance treatment in China. Addiction, 106(10), 1801-1809.
Kidorf, M., Brooner, R.K., Gandotra, N., Antoine, D., King, V.L., Peirce, J., & Ghazarian, S. (2013). Reinforcing integrated psychiatric service attendance in an opioid-agonist program: A randomized and controlled trial. Drug and Alcohol Dependence, 133(1), 30-36.
Ling, W., Hillhouse, M., Ang, A., Jenkins, J., & Fahey, J. (2013). Comparison of behavioral treatment conditions in buprenorphine maintenance. Addiction, 108(10), 1788-1798.
Preston, K.L., Umbricht, A., & Epstein, D.H. (2000). Methadone dose increase and abstinence reinforcement for treatment of continued heroin use during methadone maintenance. Archives of General Psychiatry, 57(4), 395-404.
Preston, K.L., Umbricht, A., & Epstein, D.H. (2002). Abstinence reinforcement maintenance contingency and one-year follow-up. Drug and Alcohol Dependence, 67(2), 125-137.
Rowan-Szal, G.APD., Joe, GWED., Hiller, MLPD., & Simpson, DDPD. (1997). Increasing early engagement in methadone treatment. Journal of Maintenance in the Addictions, 1(1), 49-61.