Long-term cost effectiveness of addiction treatment for criminal offenders

This paper extends previous research that performed a cost-effectiveness analysis (CEA) of the Amity in-prison therapeutic community (TC) and Vista aftercare programs for criminal offenders in southern California. To assess the impact of treatment over time for this unique sample of criminal offenders, a 5-year follow-up CEA was performed to compare the cost of an offender's treatment—starting with the in-prison TC program and including any community-based treatment received post-parole—and the effectiveness of treatment in terms of days reincarcerated. The average cost of addiction treatment over the baseline and 5-year follow-up period was $7,041 for the Amity group and $1,731 for the control group. The additional investment of $5,311 in treatment yielded 81 fewer incarceration days (13%) among Amity participants relative to controls—a cost-effectiveness ratio of $65. When considering the average daily cost of incarceration in California ($72), these results suggest that offering treatment in prison and then directing offenders into community-based aftercare treatment is cost-effective policy tool.