Cost analysis of training and employment services in methadone treatment

Despite the popular belief that vocational training is an important component of methadone treatment, little information is available on the effectiveness and cost of various types of services. This paper presents a cost analysis of developing a training and employment program (TEP) at four methadone treatment programs in a quasi-experimental pilot study. We examine the cost of establishing and operating such programs as well as the marginal cost of a TEP component compared to standard treatment. For both standard and TEP-enhanced treatment, we also estimate the average, fixed, and variable costs of these services and compare differences across programs. Lastly, we examine the financing of standard methadone treatment to provide additional guidance to program directors and treatment administrators. Our main findings can be summarized as follows. The average annual cost of TEP services in the pilot study was between $1,648 and $2,215 per "serviced" TEP client. The average annual cost per client for standard methadone treatment was between $3,546 and $5,104. And the marginal cost of providing TEP services to approximately 36 clients per site in the pilot study was between 3.5% and 7.2% of the total annual cost of standard methadone treatment. The cost methodology presented in this paper can be used in other research projects and by treatment providers to generate consistent and comparable cost estimates of standard and enhanced substance abuse treatment programs.