by C. Peter Rydell and Susan S. Everingham
RAND Corporation, 1994

The 1994 RAND study on controlling cocaine provides a powerful argument for increasing U.S. drug treatment programs.It is often cited in the debate on the effectiveness of the "drug war." This study depicts both past and future trends in cocaine consumption. It also provides the first systematic method of comparing the cost effectiveness of cocaine control programs. The RAND study is a "modeling study": it analyzes the data of other organizations. The study revolves around the central question of how the government can effectively allocate the drug budget. It presents a model that estimates the relative cost-effectiveness of four cocaine-control programs: "source control," "interdiction," "domestic law enforcement," and "treatment."

Three of these approaches are clearly "supply control" programs aimed at stopping the influx of drugs into the country, and commonly associated with law enforcement. The "source-control" program refers to the strategy of attacking the drug supply from abroad (primarily Peru, Bolivia, and Colombia). The "interdiction" approach is aimed at stopping drugs at the U.S. border. The "domestic law enforcement" approach is geared towards the arrest and imprisonment of drug buyers and sellers within the United States. These law enforcement approaches were analyzed and compared to the treatment approach, and the question is asked: "How much would the government have to spend on each approach to decrease cocaine consumption in the U.S. by 1%?" The results show that treatment is overwhelmingly the most cost-effective way of reducing cocaine consumption and its resulting social costs. In brief, the RAND study shows that treatment is 7 times more cost effective than domestic law enforcement method, 10 times more effective than interdiction, and 23 times more effective than the "source control" method.

The RAND report is not available online. To order "Controlling Cocaine: Supply Versus Demand Programs" by C. Peter Rydell and Susan S. Everingham, contact:

RAND
1700 Main Street
P.O. Box 2138
Santa Monica, CA, 90407-2138
Phone: (310) 451-6988

This five-year study assesses the impact of treatment on 5,388 clients in publicly funded substance abuse programs across the United States. It was funded by the U.S. Department of Health & Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). The study found that treatment led to significantly reduced substance use; lasting benefits a full year after treatment; increased employment and income; improved mental and physical health; decreased criminal activity; decreased homeless rates; and decreased at-risk behaviors for HIV/AIDS infections.

This site provides a list of federally sponsored treatment studies, most of which conclude that treatment is, in fact, effective. While the resources on this site overlap somewhat with the NIDA and NTIES sites, it contains several reports that are not listed elsewhere.

This 1998 General Accounting Office report resulted from the review and synthesis of the largest and most comprehensive studies of drug treatment effectiveness. While the report did not extensively analyze the methodologies of these studies, it did find that general trend towards reliance on self-reported data may overstate treatment effectiveness. It found objective tests, such as urinalysis, to be more consistent in identifying continued drug use.

This watershed study came out of California in 1994. It showed that drug treatment should be viewed as a public investment rather than cost, and that for every dollar that goes into treatment, the public saves $7 in health care and crime costs. The CALDATA study determined that drug abuse costs the state of California $3.1 billion each year, 70% of which is due to costs associated with crime. A total of $1.3 billion is spent on crime victim's medical costs, property damage and lost work time, and $442 million is spent on medical care for drug abusers.

This manual, sponsored by NIDA, is a tool kit designed to assist treatment programs in determining their own cost-effectiveness and benefit. It contains strategies for collecting data and shows how to use the findings to improve your program.