|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$1,083||Benefits minus costs||($20,376)|
|Participants||$280||Benefit to cost ratio||($0.17)|
|Others||$1,743||Chance the program will produce|
|Indirect||($6,046)||benefits greater than the costs||0 %|
|Net program cost||($17,437)|
|Benefits minus cost||($20,376)|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||No. of effect sizes||Treatment N||Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
Opioid use disorder
Clinical diagnosis of opioid use disorder or symptoms on a validated scale.
STD risky behavior^
For youth, this outcome includes unprotected sex and other behaviors. For high-risk drug users, this also includes intravenous drug use.
“All-cause mortality,” or the proportion of all deaths in a given population during a specified period of time, regardless of the cause.
Alcohol use disorder
Clinical diagnosis of alcohol use disorder or symptoms measured on a validated scale.
Any criminal conviction according to court records, sometimes measured through charges, arrests, incarceration, or self-report.
|Detailed Monetary Benefit Estimates Per Participant|
|Affected outcome:||Resulting benefits:1||Benefits accrue to:|
|Crime||Criminal justice system||$685||$0||$1,445||$342||$2,472|
|Alcohol use disorder||Property loss associated with alcohol abuse or dependence||$0||$0||$0||$0||$0|
|Opioid use disorder||Labor market earnings associated with opioid drug abuse or dependence||$76||$178||$0||$0||$254|
|Health care associated with opioid drug abuse or dependence||$297||$42||$298||$148||$785|
|Mortality associated with opioids||$25||$60||$0||$2,182||$2,267|
|Program cost||Adjustment for deadweight cost of program||$0||$0||$0||($8,718)||($8,718)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$16,356||2015||Present value of net program costs (in 2018 dollars)||($17,437)|
|Comparison costs||$0||2015||Cost range (+ or -)||20 %|
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
|Benefits Minus Costs Over Time (Cumulative Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in discounted dollars. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
Lee, J.D., McDonald, R., Grossman, E., McNeely, J., Laska, E., Rotrosen, J., & Gourevitch, M.N. (2015). Opioid treatment at release from jail using extended-release naltrexone: A pilot proof-of-concept randomized effectiveness trial. Addiction, 110(6), 1008-1014.
Lee, J.D., Friedmann, P.D., Kinlock, T.W., Nunes, E.V., Boney, T.Y., Hoskinson, R.A., . . . O’Brien, C.P. (2016). Extended-release naltrexone to prevent opioid relapse in criminal justice offenders. New England Journal of Medicine, 374(13), 1232-1242.
Springer, S.A., Di Paola, A., Azar, M.M., Barbour, R., Biondi, B.E., Desabrais, M., . . . Lincoln, T., (2018). Extended-release Naltrexone improves viral suppression among incarcerated persons living with HIV with opioid use disorders transitioning to the community: Results of a double-blind, placebo-controlled randomized trial. Journal of Acquired Immune Deficiency Syndromes, 78(1), 43-53.