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The European Journal of Health Economics

, Volume 6, Issue 1, pp 53–64 | Cite as

Substance abuse treatment, what do we know?

An economist’s perspective
  • Matilde P. MachadoEmail author
Original Papers

Abstract

The literature on treating substance abuse has dealt basically with four important questions: (a) Is treatment effective? (b) Are all programs equally effective? (c) Why do programs differ in their effectiveness? (d) Which treatments are more cost-effective? This paper reviews the substance abuse treatment literature around these four questions and discusses methodological issues that hinder the interpretation and generalization of results to date. The answer to the first question is a sounding “yes,” treatment is effective but not all programs are equally effective. Researchers have moved beyond the “black box” literature that concentrated on patient and program characteristics as explanations for differences in effectiveness and search for the “active” ingredients of treatment. These include, for example, the treatment philosophy of the program’s director and staff attitudes towards patients. Cost-effectiveness studies are less common, and their conclusions are mixed. In general, it is probably safe to say that for the majority of patients, outpatient or shorter programs are more cost-effective.

Keywords

Substance abuse Alcohol misuse Survey Treatment evaluation Effectiveness 

Notes

Acknowledgements

This research was carried out in part while I was at the IAE, Barcelona, as a Marie Curie postdoctoral fellow (European Community grant #ERBFMBICT972472). I also thank the research support from the Merck Foundation. Useful comments came from Daniel A. Ackerberg, Michael H. Riordan, and two anonymous referees. Mercedes Cabañas provided invaluable assistance as a documentalist. This article was supported by an unrestricted educational grant awarded jointly to the Universities Carlos III de Madrid and Pompeu Fabra de Barcelona by The Merk Foundation, the philanthropic arm of Merck Co. Inc., White House Station, New Jersey, USA. The responsibility for all errors and omissions is mine.

Conflict of interest:

No information supplied

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Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  1. 1.Universidad Carlos III de MadridSpain
  2. 2.Universidad Carlos III de MadridGetafeSpain

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