Yale scientists have put a price on incentive-based treatments for drugs abusers, helping to clarify the programs’ costs and benefits.
Researchers from the Yale Department of Epidemiology and Public Health and the University of Connecticut Health Center found that it costs an additional $258 per patient to use prize-based incentives, which past research has shown can encourage patients to remain drug-free. The study, conducted by Yale research scientist Todd Olmstead and professor Jody Sindelar, along with University of Connecticut researcher Nancy Petry, was recently published in the September issue of Drug and Alcohol Dependence.
“Nobody knew how much more money this type of treatment cost in terms of the prizes themselves and the administrative costs,” Olmstead said. “We wanted to shed light on the costs and cost effectiveness and to break down the barriers for wider implementations.”
The researchers gathered data from eight clinics serving a variety of patients across the country, focusing on treatment for addiction to cocaine, amphetamine and methamphetamine. The incentive method they explored was a supplemental program used alongside traditional treatment.
If the patients submitted drug-free urine samples, they earned chances to draw from a fishbowl with 500 chips, representing different levels of prizes. Out of 500 chips, 250 said “Good job,” 209 were for small items worth about $1, 40 were for larger prizes worth $20, and one was for the jumbo prize worth $100. The longer the patients remained drug-free, the more draws they earned.
“The incentive is to have continuous days of abstinence, which encourages long periods of abstinence,” Sindelar said. “This escalates the number of consecutive days and weeks patients stay clean, which mimics getting out of the habit.”
Petry, who designed the prize-based incentive technique, compared it to traditional behavior modification methods such as giving children allowances to encourage them to do a particular task more often.
Previous studies have proven that these types of treatment supplements are effective in helping substance abuse patients stay abstinent for longer periods of time, Olmstead said.
Although he said he wasn’t surprised by the effectiveness of the method, he was surprised by the amount of money required for the administration. Including inventory, restocking and shopping for the items, the cost of the administration totaled almost as much as that of the prizes themselves.
“The next question is how to improve cost-effectiveness, streamline administration and improve efficiency,” Olmstead said.
While the researchers said it remains to be proven whether or not this strategy makes financial sense, they said they believe spending the extra $258 will cut back on some of the negative consequences of drug use, including crime and lost work days. The hope, they said, is that the results of their study will encourage more people to implement prize-based incentives in conjunction with traditional substance abuse treatment.
“Substance abuse treatment is becoming less punitive,” Petry said. “It’s becoming more of a positive experience, so the patients now like going to treatment because they get prizes and get stay clean longer. It changes the atmosphere of the whole treatment.”