Medications for opioid use disorder, including buprenorphine/naloxone (i.e., Suboxone) and methadone maintenance, are evidence-based treatments for individuals with opioid use disorder. This study examined also whether such treatments produce ultimate cost benefits.
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This research study analyzed 16,000 individuals who received Medication Assisted Treatments (MAT) between 1985 and 2010 in New South Wales, Australia, and had at least one prison stay/release between 2000 and 2012.
Among these individuals, 7,857 received Medication Assisted Treatments (MAT) upon release (at release or within 7 days) and 8,116 did not receive MAT; these groups were compared on demographic, criminal justice, and treatment characteristics. In addition, authors used propensity score matching, a statistical technique that helps create two comparable groups, in order to conduct the cost-benefit analysis. Through this strategy, authors ensured that the group of MAT and non-MAT individuals were as comparable as possible in the absence of a randomized design, on predetermined characteristics, including age at release, gender and indigenous status, juvenile justice system history, number of prior offenses, prior MAT engagement, time in jail, and whether released before 2008 (a time when systematic efforts to make MAT more available in the New South Wales prison system were undertaken).
This yielded two matched groups of 6,734 MAT (taking medication for substance use disorder (SUD)) and 6,734 non-MAT (individuals not taking medications for SUD), released from prison to compare costs (treatment, criminal justice, and social costs) and mortality in the 6 months following release from prison. Finally, authors used a “bootstrapping” procedure with 20,000 repetitions, meaning rather than estimate the effects purely from the two matched samples, they take smaller random samples of the overall sample (6,734 and 6,734) and carry out the analyses 20,000 times. This way they were able to determine how variable and reliable the results were. This is considered to be a rigorous statistical approach, and is contrasted with a conventional inferential approach, where the conclusion is that the group difference observed “is very unlikely due to chance”.
The Medication Assisted Treatments (MAT) group had a greater proportion of individuals that were: female & indigenous, more likely to have prior offenses, a juvenile justice history, & receive medications in prison.
Using the matched groups, the Medication Assisted Treatments (MAT):
Building on prior studies which have shown Medication Assisted Treatment (MAT) is effective in enhancing abstinence and other positive health outcomes, this health economics study indicates that MAT is also a cost-effective approach for recently released prisoners with opioid use disorders.
It is important to examine the cost related to the salutary impact of addiction treatment. Such analyses can enhance the rationale for increased funding and health care coverage dedicated to the treatment and ongoing recovery management of substance use disorders.
Although research using other relevant populations and settings are needed, the implications of this study are potentially large and far-reaching:
Among those released on medication, approximately 95% were on Medication Assisted Treatment (MAT) while in prison. This suggests interventions that help prisoners access medications substantially increases the likelihood they will engage with medications upon release or shortly after leaving prison.
Next steps are to examine the cost effectiveness of Medication Assisted Treatment (MAT) not only with respect to life years gained, but also quality life years gained as is typically done.
Gisev, N., Shanahan, M., Weatherburn, D. J., Mattick, R. P., Larney, S., Burns, L., & Degenhardt, L. (2015). A cost-effectiveness analysis of opioid substitution therapy upon release in reducing mortality among prisoners with a history of opioid dependence. Addiction. doi:10.1111/add.13073
Image Source: http://www.tampabay.com/news/courts/criminal/aging-popluation-takes-toll-on-us-prisons/2228081
l
This research study analyzed 16,000 individuals who received Medication Assisted Treatments (MAT) between 1985 and 2010 in New South Wales, Australia, and had at least one prison stay/release between 2000 and 2012.
Among these individuals, 7,857 received Medication Assisted Treatments (MAT) upon release (at release or within 7 days) and 8,116 did not receive MAT; these groups were compared on demographic, criminal justice, and treatment characteristics. In addition, authors used propensity score matching, a statistical technique that helps create two comparable groups, in order to conduct the cost-benefit analysis. Through this strategy, authors ensured that the group of MAT and non-MAT individuals were as comparable as possible in the absence of a randomized design, on predetermined characteristics, including age at release, gender and indigenous status, juvenile justice system history, number of prior offenses, prior MAT engagement, time in jail, and whether released before 2008 (a time when systematic efforts to make MAT more available in the New South Wales prison system were undertaken).
This yielded two matched groups of 6,734 MAT (taking medication for substance use disorder (SUD)) and 6,734 non-MAT (individuals not taking medications for SUD), released from prison to compare costs (treatment, criminal justice, and social costs) and mortality in the 6 months following release from prison. Finally, authors used a “bootstrapping” procedure with 20,000 repetitions, meaning rather than estimate the effects purely from the two matched samples, they take smaller random samples of the overall sample (6,734 and 6,734) and carry out the analyses 20,000 times. This way they were able to determine how variable and reliable the results were. This is considered to be a rigorous statistical approach, and is contrasted with a conventional inferential approach, where the conclusion is that the group difference observed “is very unlikely due to chance”.
The Medication Assisted Treatments (MAT) group had a greater proportion of individuals that were: female & indigenous, more likely to have prior offenses, a juvenile justice history, & receive medications in prison.
Using the matched groups, the Medication Assisted Treatments (MAT):
Building on prior studies which have shown Medication Assisted Treatment (MAT) is effective in enhancing abstinence and other positive health outcomes, this health economics study indicates that MAT is also a cost-effective approach for recently released prisoners with opioid use disorders.
It is important to examine the cost related to the salutary impact of addiction treatment. Such analyses can enhance the rationale for increased funding and health care coverage dedicated to the treatment and ongoing recovery management of substance use disorders.
Although research using other relevant populations and settings are needed, the implications of this study are potentially large and far-reaching:
Among those released on medication, approximately 95% were on Medication Assisted Treatment (MAT) while in prison. This suggests interventions that help prisoners access medications substantially increases the likelihood they will engage with medications upon release or shortly after leaving prison.
Next steps are to examine the cost effectiveness of Medication Assisted Treatment (MAT) not only with respect to life years gained, but also quality life years gained as is typically done.
Gisev, N., Shanahan, M., Weatherburn, D. J., Mattick, R. P., Larney, S., Burns, L., & Degenhardt, L. (2015). A cost-effectiveness analysis of opioid substitution therapy upon release in reducing mortality among prisoners with a history of opioid dependence. Addiction. doi:10.1111/add.13073
Image Source: http://www.tampabay.com/news/courts/criminal/aging-popluation-takes-toll-on-us-prisons/2228081
l
This research study analyzed 16,000 individuals who received Medication Assisted Treatments (MAT) between 1985 and 2010 in New South Wales, Australia, and had at least one prison stay/release between 2000 and 2012.
Among these individuals, 7,857 received Medication Assisted Treatments (MAT) upon release (at release or within 7 days) and 8,116 did not receive MAT; these groups were compared on demographic, criminal justice, and treatment characteristics. In addition, authors used propensity score matching, a statistical technique that helps create two comparable groups, in order to conduct the cost-benefit analysis. Through this strategy, authors ensured that the group of MAT and non-MAT individuals were as comparable as possible in the absence of a randomized design, on predetermined characteristics, including age at release, gender and indigenous status, juvenile justice system history, number of prior offenses, prior MAT engagement, time in jail, and whether released before 2008 (a time when systematic efforts to make MAT more available in the New South Wales prison system were undertaken).
This yielded two matched groups of 6,734 MAT (taking medication for substance use disorder (SUD)) and 6,734 non-MAT (individuals not taking medications for SUD), released from prison to compare costs (treatment, criminal justice, and social costs) and mortality in the 6 months following release from prison. Finally, authors used a “bootstrapping” procedure with 20,000 repetitions, meaning rather than estimate the effects purely from the two matched samples, they take smaller random samples of the overall sample (6,734 and 6,734) and carry out the analyses 20,000 times. This way they were able to determine how variable and reliable the results were. This is considered to be a rigorous statistical approach, and is contrasted with a conventional inferential approach, where the conclusion is that the group difference observed “is very unlikely due to chance”.
The Medication Assisted Treatments (MAT) group had a greater proportion of individuals that were: female & indigenous, more likely to have prior offenses, a juvenile justice history, & receive medications in prison.
Using the matched groups, the Medication Assisted Treatments (MAT):
Building on prior studies which have shown Medication Assisted Treatment (MAT) is effective in enhancing abstinence and other positive health outcomes, this health economics study indicates that MAT is also a cost-effective approach for recently released prisoners with opioid use disorders.
It is important to examine the cost related to the salutary impact of addiction treatment. Such analyses can enhance the rationale for increased funding and health care coverage dedicated to the treatment and ongoing recovery management of substance use disorders.
Although research using other relevant populations and settings are needed, the implications of this study are potentially large and far-reaching:
Among those released on medication, approximately 95% were on Medication Assisted Treatment (MAT) while in prison. This suggests interventions that help prisoners access medications substantially increases the likelihood they will engage with medications upon release or shortly after leaving prison.
Next steps are to examine the cost effectiveness of Medication Assisted Treatment (MAT) not only with respect to life years gained, but also quality life years gained as is typically done.
Gisev, N., Shanahan, M., Weatherburn, D. J., Mattick, R. P., Larney, S., Burns, L., & Degenhardt, L. (2015). A cost-effectiveness analysis of opioid substitution therapy upon release in reducing mortality among prisoners with a history of opioid dependence. Addiction. doi:10.1111/add.13073
Image Source: http://www.tampabay.com/news/courts/criminal/aging-popluation-takes-toll-on-us-prisons/2228081
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