title: Consequences and costs of shutting off methadone.
abstract: In the face of rising fiscal conservatism, many states and localities with sizable addict populations have reduced or eliminated public funding for methadone maintenance (MM) programs and permitted private-fee-for-service programs to replace them. The social and economic costs of these changed funding policies with reference to the California experience were analyzed. A two-and-a-half year follow-up of a sample of San Diego MM clients (195 men, 129 women) terminated from a public subsidized program compared outcome results to clients from publicly funded MM programs in Orange, Riverside and San Bernardino counties (129 men, 131 women). In a secondary analysis, San Diego clients who transferred into private (fee-for-service) treatment programs were compared with those who did not transfer. Major adverse consequences were found for clients unable or unwilling to transfer to private programs: higher crime and dealing rates, more contact with the criminal justice system, and higher rates of illicit drug use were demonstrated by nontransfer clients. Moreover, the savings resulting from a reduction of MM program costs were nearly offset by increased direct costs for incarceration, legal supervision, and other government-funded drug treatment. Indirect costs were not assessed.
authors: UCLA Drug Abuse Research Group 90024-3511.
authors: M D
authors: MD
authors: Anglin
authors: G R
authors: GR
authors: Speckart
authors: M W
authors: MW
authors: Booth
authors: T M
authors: TM
authors: Ryan
mesh_terms: D000328:Adult; D002140:California; D003156:Community Mental Health Services / Q000191:economics*; D003363:Cost Control / Q000639:trends; D003415:Crime / Q000639:trends; D003430:Cross-Sectional Studies; D005260:Female; D006556:Heroin Dependence / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D010351:Patient Discharge / Q000191:economics
chemical_list: D008691:Methadone