NDARC Technical Report No. 203
Heroin use results in a significant social burden. In addition to the wider social impact, heroin use represents a serious public health concern creating many challenges for policy makers and treatment providers alike. This health burden comes at some cost; heroin dependence accounts for a significant proportion of the total burden of disease and injury related to illicit drugs in Australia. Despite this, there is little information on either the use of health care services generally, or more specifically the use of drug treatment services over extended periods of time, by heroin users in Australia.
This report documents economic costs of treatment for heroin and other health services using data from the Australian Treatment Outcome Study. The aims of this report are to:
This current report presents 12 month cost data from New South Wales, South Australia and Victoria.
Seven hundred and forty five individuals entering treatment and 80 heroin users not seeking treatment were recruited into the study and interviewed by trained research staff using a structured questionnaire. A total of 649 individuals, who were followed up at 12 months and for whom there was complete resource use information are included in the report. Data was collected on all treatment experiences (type, and number of days of treatment) over the 12-month follow-up, use of other health care services, as well as their heroin and other drug use, mental health and criminal activity. Treatment and other health services use were costed using a set of standard prices.
Total treatment (combining index and non-index treatment)
Other health system utilisation and costs
It is beneficial to consider what the $6,187 of drug treatment purchased. There was, on average, 15.3 more heroin free days per month at twelve months, a 76% improvement. There was a 55% improvement in rates of abstinence and a 52% decrease in the numbers who committed a crime in the previous month. In this study, the cost savings related to decrease in crime were not estimated, however results from NTORS in the UK determined that the cost of crime decreased by 50% in two in two years post treatment compared to the year prior to treatment. This suggests that the purchase of the drug treatment provides substantial benefit to society in terms of decrease in heroin use, both in terms of abstinence and harm reduction and a decrease in crime.
Citation: Shanahan, M., Havard, A., Mills, K., Williamson, A., Ross, J., Teesson, M., Darke, S., Ali, R., Cooke, R. and Lynskey, M. (2004) Health services use and treatment costs over 12 months among heroin users: Findings from the Australian Treatment Outcomes Study (ATOS), Sydney: National Drug and Alcohol Research Centre.