The costs of crime during and after publicly funded treatment for opioid use disorders: a population-level study for the state of California.
The costs of crime during and after publicly funded treatment for opioid use disorders: a population-level study for the state of California.
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DOI：
10.1111/add.13729
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发表时间：
2017-05
期刊：
影响因子：
--
通讯作者：
Nosyk B
中科院分区：
文献类型：
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作者：
Krebs E;Urada D;Evans E;Huang D;Hser YI;Nosyk B
阿片类药物使用障碍的治疗降低了死亡率和传染病传播的风险；然而，量化相关毒品犯罪减少的潜在经济利益的机会很少。这篇论文的目的是估计在参与公费治疗期间和之后的犯罪成本，以比较阿片类激动剂治疗(OAT)和戒毒后假想的6个月期间的犯罪总成本。以行政数据为基础的回溯性队列研究，提供有关戒毒治疗和刑事司法系统互动的全面信息。美国加利福尼亚州公共资助的戒毒设施(2006-2010年)。在中位数2.3年的时间里，对31659名首次接受OUD治疗并与刑事司法和死亡数据有关的人进行了跟踪调查。首次治疗入院的中位年龄为32岁，其中35.8%为女性，37.1%主要使用处方阿片类药物。每天的犯罪成本(2014美元)是从社会角度计算的，由治安、法庭、惩戒和刑事受害的成本组成。我们估计了参与燕麦片治疗或戒毒治疗的平均边际效应，对潜在的固定和时变的混杂因素进行了调整，包括在治疗开始之前参与药物使用和刑事司法系统。与治疗后相比，燕麦片治疗期间每天的犯罪成本降低了126美元(95%可信区间：116美元，136美元)，戒毒治疗降低了144美元(135美元，154美元)。使用观察到的燕麦片(161天)和戒毒(19天)的中位数，在假设的6个月期间总结治疗期间和治疗后的犯罪成本，我们估计让一个人参加燕麦片而不是戒毒将节省17,550美元(16,840美元，18,383美元)。在美国加利福尼亚州的公共资助的药物治疗设施中，参与阿片类药物使用障碍的治疗与开始治疗后六个月的犯罪成本较低有关，而且接受无时间限制治疗的个人的经济效益要大得多。
Treatment for opioid use disorders (OUD) reduces the risk of mortality and infectious disease transmission; however, opportunities to quantify the potential economic benefits of associated decreases in drug-related crime are scarce. This paper aimed to estimate the costs of crime during and after periods of engagement in publicly-funded treatment for OUD to compare total costs of crime over a hypothetical 6-month period following initiation of opioid agonist treatment (OAT) versus detoxification. Retrospective, administrative data-based cohort study with comprehensive information on drug treatment and criminal justice systems interactions. Publicly-funded drug treatment facilities in California, USA (2006–2010). 31,659 individuals admitted for the first time to treatment for OUD, and who were linked with criminal justice and mortality data, were followed during a median 2.3 years. Median age at first treatment admission was 32, 35.8% were women, and 37.1% primarily used prescription opioids. Daily costs of crime (2014$US) were calculated from a societal perspective and were composed of the costs of policing, court, corrections, and criminal victimization. We estimated the average marginal effect of treatment engagement in OAT or detoxification adjusting for potential fixed and time-varying confounders, including drug use and criminal justice system involvement prior to treatment initiation. Daily costs of crime during treatment compared with after treatment were $126 lower for OAT (95% CI: $116, $136) and $144 lower for detoxification ($135, $154). Summing the costs of crime during and after treatment over a hypothetical 6-month period using the observed median durations of OAT (161 days) and detoxification (19 days), we estimated that enrolling an individual in OAT as opposed to detoxification would save $17,550 ($16,840, $18,383). In publicly-funded drug treatment facilities in California USA, engagement in treatment for opioid use disorders is associated with lower costs of crime in the six months following initiation of treatment, and the economic benefits were far greater for individuals receiving time-unlimited treatment.