Objective: To determine patterns and costs of treatment for heroin dependence over a 12-month period among a cohort of heroin users seeking treatment.
Methods: The design was a longitudinal cohort study of heroin users seeking treatment who participated in the Australian Treatment Outcome Study (ATOS), which was conducted in Sydney, Melbourne and Adelaide, Australia. Treatment for heroin dependence, for those who were followed up at 12 months, was recorded and costed. Unit costs, obtained from secondary sources, were used to estimate the cost of treatment. This study does not include wide societal costs and only includes personal costs as they pertain to treatment.
Results: A follow-up rate of 81% at 12 months was achieved, resulting in data for 596 participants. Participants spent an average of 188 days in treatment over 2.7 episodes. Sixty-nine per cent of the sample reported at least one episode of treatment following their index treatment. There was a noticeable trend for subjects who received maintenance or residential rehabilitation as their index treatment to return to the same form of treatment for subsequent episodes. In contrast, those who received detoxification as index treatment accessed a wider variety of treatment types over the follow-up period. The cost of treatment over the 12-month follow-up totalled dollar 3,901,416, with a mean of dollar 6,517 per person.
Conclusions and implications: This study demonstrates that individuals seeking treatment have multiple treatment episodes throughout a 12-month period, with a tendency to return to the same form of treatment. This study also demonstrates that it is feasible and affordable to provide ongoing treatment for a group of heroin users seeking treatment.