04 Dec Injectable Opiate Treatment Most Cost Effective for Heroin Addiction
Injected opiate treatments are a more cost effective method for treating chronic heroin addiction than oral treatments, according to a new study from King’s College London.
published in the British Journal of Psychiatry.
The study, which was published in the British Journal of Psychiatry, consisted of an economic evaluation of the Randomized Injectable Opiate Treatment Trial (RIOTT) that was conducted by the National Addictions Centre at King’s College. The lead author for the economic evaluation study was Professor Sarah Byford of the Centre for the Economics of Mental and Physical Health at King’s Institute of Psychiatry.
Between 5 percent and 10 percent of heroin addicts do not respond to standard treatment tools, which usually include oral methadone. The RIOTT study was designed to examine the relative effectiveness of three alternate treatment methods: optimized oral methadone, supervised injectable heroin and supervised injectable methadone.
The RIOTT study has found that the two forms of injectable opiate treatment—supervised injectable methadone or supervised injectable heroin—are more effective than the optimized oral methadone treatment. However, the two forms of injectable treatment are also more expensive than the oral methadone.
Effective, and Cost-Effective
The RIOTT study took 127 individuals who did not respond to standard treatment for heroin addiction. These patients were given one of the three alternate forms of treatment. The results of the trial showed that optimized oral methadone was effective for 27 percent of the patients, supervised injectable methadone was effective for 39 percent of the patients, and supervised injectable heroin was effective for 72 percent of the patients.
That shows a very significant improvement for the injectable treatment options. However, these injectable treatments are also quite expensive, costing about$6,500 per year for injectable methadone, and $16,000 per year for injectable heroin.
Using the RIOTT study information on the relative effectiveness of the treatment alternatives, Professor Byford and her research team examined a wide variety of economic factors to find out which method was the most affordable for the overall community.
The team found that the effectiveness of the supervised injection treatments made up for the initial expense. They estimated that the higher costs were recovered through reduced costs for the criminal justice system. Successful treatment meant that heroin addicts were not re-entering the criminal justice system through arrests for drug possession, or other criminal activity resulting from drug seeking behavior. That meant potential savings for law enforcement, eliminating the cost of a trial and other criminal processing, and eliminating the cost of incarcerating an offender. There is also potential savings for the heath care system, which would avoid the cost of repeat treatment for an addict who undergoes a relapse.
Overall, Professor Byford and her colleagues found an estimated savings of just under $10,000 per year. Given the number of heroin addicts in the UK, they estimate between $47 million (29 million British pounds) and $95 million (59 million British pounds) in annual savings.
Sharing the Costs
In the United Kingdom, health care services are provided by a nationalized health system called the National Health Service (NHS.) Since both the health care system and the criminal justice system are government services, cost sharing is relatively simple. Higher costs for the NHS can be countering by savings for the criminal justice system, and the overall cost to the community is less.
In the United States, where heath care services are still largely privatized, cost sharing is more of a challenge. While the overall cost to the economy of the injectable treatments would be less, the health care system would still be absorbing a large part of the cost of the higher-priced treatments, while seeing little to none of the cost benefits of recovering addicts avoiding the criminal justice system.
Of course, the larger community benefits from a reduction in crime in more than just economic ways. Lower crime rates result in a better quality of life in a variety of ways. Less crime means that there are fewer victims of criminal activity and more addicts in recovery also mean families of addicts that are under less stress, not to mention the greatly improved quality of life for the addicts themselves who are able to stay clean and sober.
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