Headline
A jail-based methadone treatment program is shown to reduce reincarnation and lead to overall cost savings.
Context
Individuals with criminal legal system involvement experience high rates of substance use disorder (SUD) and are more likely to experience an opioid overdose than the general population. Medications for addiction treatment (MAT) are the gold standard of treatment for opioid use disorder (OUD) and have been proven to be cost-effective in community-based settings, though less is known about the cost impact of MAT in correctional settings. This study assessed the cost-effectiveness of a jail-based methadone maintenance treatment (MMT) continuation program, implemented in a large urban jail in New Mexico.
Findings
The jail-based MMT continuation program served individuals with OUD who were previously enrolled in a community-based MMT program prior to incarceration. Among a sample of 228 program participants, the group experienced 25 fewer subsequent days of incarceration due to recidivism in the three years following release from jail compared with a sample of individuals with OUD who did not receive MMT. Based on the average per-individual cost of providing MMT (estimated at $689 for an average of six weeks of treatment) and its impact on reincarnation, the authors determined that it cost $28 to reduce an incarcerated day through this program. This is significantly less than the average per-day cost of incarceration at this facility ($116).
Takeaways
This study significantly contributes to the evidence base for MAT provided in correctional settings, demonstrating its potential to reduce recidivism and offer overall cost savings. Since program eligibility was limited to individuals who had received MMT in community-based settings prior to incarceration, the study also highlights the importance of partnerships and data-sharing between correctional agencies and community-based health care providers. As resources for providing MAT in jail settings become increasingly available through the Centers for Medicare & Medicaid Services reentry 1115 demonstration waiver opportunity and other state policy mechanisms, correctional stakeholders can use this evidence to make the case for implementation of MAT in their facilities.