Treatment Works: The Washington State Experience
Prepared by: Division of Alcohol and Substance Abuse
Kenneth D. Stark, Director P.O. Box 45330 Olympia, Washington 98504-5330 (206) 438-8200 or
SCAN 595-8200
Treatment Associated with Positive Employment
Among persons found eligible for the ADATSA Program, those who participated in treatment were more likely to be substantively employed over an 18-month follow-up period than those who did not participate in treatment (Longhi, et al, 1993).
(Note: Substantive employment is defined as having continuous work for at least 12 months of the 18-month follow-up period at wages above the welfare grant level.)
This same study reported a high continuity for substantive employment. Of ADATSA clients substantively employed in the first 6 months after treatment, 85% were still substantively employed 18 months after treatment Longhi, et al, 1993).
Among persons substantively employed, earnings were higher for clients completing all treatment. For example, among most ADATSA clients who were substantively employed:
Those who completed all treatment earned an average of $1,049 per month,
Those who completed only some treatment earned an average of $954 per month, whereas
Those who completed no treatment earned an average of $593 per month (Longi, et al, 1993).
A subset of ADATSA clients, AFDC recipients, was found to be significantly more likely to be substantively employed in the post-treatment period if they had participated in treatment (17% employed in the treated group vs. 4% in the non treated group) Longhi, et al, 1993).
Treatment Plus Extra Vocational Training Related to
Higher Employment Outcomes
ADATSA clients who completed both chemical dependency treatment and special vocational training were more likely to have at least some employment compared to those who completed treatment but had no extra vocational training, 72 % vs. 50 % (Longhi, et al, 1993).
They also earned more than double the average income of those who completed treatment but had no extra vocational training (Longhi, et al, 1993).
Treatment Associated with Lower
Medical Cost
Treated clients were less likely to have high
inpatient medical costs after treatment if pretreatment inpatient medical costs were high.
Overall. ADATSA clients who received treatment incurred half the in-hospital costs than
non-treated clients during a 12 month follow-up period. This is a positive finding as
in-hospital costs are usually due to more severe medical problems (Lm&, et al, 1993).
Average Medicaid payments for the infant's medical care in the first year of life were lower for women who received DASA-funded chemical dependency treatment in the prenatal period ($2,986) than for those whose substance abuse problem was identified but not treated in the prenatal period ($3,343) (Schrager, Kenny, & Cawthon, 1993).
(Note: Medicaid payments for medical care of infants of identified substance abusers were somewhat higher (see above) than those infants of Medicaid women who were not identified as substance abusers, $2,190).
Treatment Associated with Improved Birth OutcomesSubstance abusing women who received DASA-funded chemical dependency treatment in the prenatal period were less likely to have a low birth weight infant (8.7%) than were substance abusing pregnant women who did not receive treatment (12.9%) (Schrager, et al, 1993).
(Note: Non-substance abusing pregnant won-on who received Medicaid funding had lower rates of low birthweight babies, 5.3%, an did non-Medicaid women, 3.3%).)
The Washington State MOM's Project is a study of the effects of two types of chemical dependency treatment among pregnant substance abusing women. Preliminary analysis of data from this project showed that, compared to women who receive no treatment during pregnancy women who used in treatment continuously for three months or more had a 70% reduction in pre-term deliveries. (Krohn, 1993).
Treated ADATSA Clients Had Lower Impatient Treatment and Detox Reentry CostOverall, ADATSA clients who participated in treatment had lower inpatient treatment and detox re-entry costs during a 12-month follow-up period than clients who did not receive treatment. This is a positive outcome as re-entry into inpatient and detox programs usually indicate relapse in the recovery process (Longhi, et al, 1993)
Treatment Associated with Lower Death RatesAmong most ADATSA clients, those who participated in treatment had lower death rates than those who did not participate in treatment (4.5 times more likely to die than persons in the general population vs. 7.5 times more likely) Longhi, et al 1993).
(Note: Given the short follow-up period, these estimates should be regarded as preliminary.)
Treatment Associated with Cost SavingsFor most clients, treatment pays for itself in reduced medical assistance. income assistance, and inpatient treatment re-entry costs within two to three-years. For example:
Among treated ADATSA clients without mental health
problems who were already on public assistance (48% of all ADATSA clients), it was
estimated that $803 was saved per client in the 12 months following treatment. This is 36%
of treatment costs (where treatment cost were estimated to be $2,253 per client).
If these trends continued. public service agencies would "recover" the amount
expended for these clients' treatment in less than three years through cost avoidance in
other health or social services (Longhi, et al, 1993).
Men and women less than 30 years old who received ADATSA
treatment (36% of all clients) were estimated to have first year cost avoidance rates of
50% and 44% respectively. (For men, the estimated savings was $908 with treatment costs
being $1,632; for women, the estimated savings was $804 with treatment costs being $1.8.)
This suggests that public service agencies would "recover" the amount
expended for these clients' treatment in about two years through cost avoidance in other
health or social services, assuming the same cost avoidance rates continued (Longhi,
et ai, 1993).
Among non-pregnant, AFDC recipients with no reported mental health problems (70% of the AFDC sample), those who participated in ADATSA treatment had lower income assistance and lower medical assistance costs compared to those who did not participate in treatment. This finding suggests that treatment may shorten these clients continued reliance on AFDC assistance and may decrease their medical expenses by improving their health and the health of their children(Longhi, et al, 1993).
Treatment Related to Fewer Alcohol Traffic ViolationsAccording to an ongoing study conducted by the University of Washington and the Traffic Safety Commission, drivers given deferred prosecution had significantly fewer alcohol related traffic violations during the first, second, and fourth years after disposition when compared with convicted drivers diagnosed as alcoholic (Baxter, Salzberg, & Kleyn, 1993).
Treatment Related to Lowered Prison CostsFelony offenders who received ADATSA treatment had lower confinement costs than those who had not received treatment during a 12-month follow-up period: $3,015 compared to $4,185 per client, resulting in a cost avoidance of $1,170 (Longhi, et al, 1993).
ReferencesBaxter, B., Salzberg, P. M., & Kleyn, J. E. (May, 1993). Research on Deferred Prosecution . Paper presented at the Division of Alcohol and Substance Abuse Public Policy Forum, Tumwater, Washington.
Krohn, M. (1993). Preliminary findings for MOMS project. FOCUS, Winter/Fall. Olympia, Washington: Department of Social and Health Services, Division of Alcohol and Substance Abuse.
Longhi, D., Brown, M., & Comtois, D. (1993). ADATSA Treatment Outcomes: Employment and Cost Avoidance, Olympia, Washington: Department of Social and Health Services, Office of Research and Data Analysis.
Schrager, L., Kenny, F., Cawthon, L. (1993). Substance Abuse Treatment for Female DASA Clients, Treatments, Birth Outcomes, and Demographic Profiles, Olympia, Washington: Department of Social and Health Services, Office of Research and Data Analysis.