The economic costs of jail-based methadone maintenance treatment

Background: The US has the highest incarceration rate in the world and spends $40–$80 billion to house inmates per year. It is well-known that a significant correlation is present between substance use and crime, especially over recent years as opioid use disorder (OUD) has grown exponentially. To mitigate OUD, methadone maintenance treatment (MMT) has demonstrated effectiveness in numerous randomized and quasi-experimental studies. A potentially fruitful environment for MMT is correctional facilities, particularly short-term facilities, such as city and county jails. However, little is known about the economic implications of MMT within correctional facilities. Objective: The aim of the present study was to estimate the economic costs of jail-based MMT using data from a novel, established MMT program located within a large urban jail in New Mexico. Methods: Data were collected using administrative records and by interviewing program administrators using a modified version of the Drug Abuse Treatment Cost Analysis Program (DATCAP). Both sensitivity analysis and cost-structure analysis were conducted to gauge the robustness of the findings. Results: The average (per patient) weekly cost of MMT is $115 and the total treatment cost for an average treatment episode is $689. These costs are generally in-line with non-jail-based MMT programs of similar size. Weekly cost estimates range from $86 to $185 depending on the size of the treatment facility, with larger programs exhibiting lower per-patient costs. Conclusion: Results provide a valuable economic benchmark to policy makers, criminal justice officials, and program administrators considering establishing and/or expanding MMT in jail settings.