Money Matters: Cost-Effectiveness of Juvenile Drug Court with and without Evidence-Based Treatments

Abstract

The 12-month cost-effectiveness of juvenile drug court and evidence-based treatments within court were compared with traditional Family Court for 128 substance-abusing/dependent juvenile offenders participating in a 4-condition randomized trial. Intervention conditions included Family Court with community services (FC), Drug Court with community services (DC), Drug Court with Multisystemic Therapy (DC/MST), and Drug Court with MST enhanced with a contingency management program (DC/MST/CM). Average cost-effectiveness ratios for substance use and criminal behavior outcomes revealed that economic efficiency in achieving outcomes generally improved from FC to DC, with the addition of evidence-based treatments improving efficiency in obtaining substance use outcomes.

KEYWORDS:

• contingency management
• cost-effectiveness
• juvenile drug court
• multisystemic therapy
• substance abuse

Acknowledgments

This research was supported by grants from the National Institute on Drug Abuse (K23DA015658, r01DA13066), the National Institute on Alcohol Abuse and Alcoholism (r01AA122202), and the Center for Substance Abuse Treatment. Dr. Henggeler is a shareholder in MST Services, the MUSC-licensed purveyor organization that facilitates the transport of MST technology and intellectual property.

Notes

Notes. ^a Indicates the average cost to achieve a one-unit decrease in the outcome compared to pretreatment behavior.

^b A negative ACER indicates that the program was inefficient in obtaining the outcome.