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Therefore, we undertook a cost\u2010effectiveness analysis of OST treatment upon prison release and the prevention of death in the first 6\u2009months post\u2010release.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population\u2010based, retrospective data linkage study using records of OST entrants (1985\u20132010), charges and court appearances (1993\u20132011), prison episodes (2000\u201311) and death notifications (1985\u20132011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>New South Wales, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A cohort of 16\u2009073 people with a history of opioid dependence released from prison for the first time between 1\u2009January 2000 and 30\u2009June 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>OST treatment compared to no OST treatment at prison release.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Mortality and costs (treatment, criminal justice system\u2014court, penalties, prison\u2014and the social costs of crime) were evaluated at 6\u2009months post\u2010release. Analyses included propensity score matching, bootstrapping and regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>A total of 13\u2009468 individuals were matched (6734 in each group). Twenty (0.3%) people released onto OST died, compared with 46 people (0.7%) not released onto OST. The final average costs were lower for the group that received OST post\u2010release ($7206 versus $14\u2009356). The incremental cost\u2010effectiveness ratio showed that OST post\u2010release was dominant, incurring lower costs and saving more lives. The probability that OST post\u2010release is cost\u2010effective per life\u2010year saved is 96.7% at a willingness to pay of $500.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Opioid substitution treatment (compared with no such treatment), given on release from prison to people with a history of opioid dependence, is cost\u2010effective in reducing mortality in the first 6\u2009months of release.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.13073","type":"journal-article","created":{"date-parts":[[2015,7,25]],"date-time":"2015-07-25T11:12:56Z","timestamp":1437822776000},"page":"1975-1984","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["A cost\u2010effectiveness analysis of opioid substitution therapy upon prison release in reducing mortality among people with a history of opioid dependence"],"prefix":"10.1111","volume":"110","author":[{"given":"Natasa","family":"Gisev","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Australia  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian","family":"Shanahan","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Australia  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Don J.","family":"Weatherburn","sequence":"additional","affiliation":[{"name":"New South Wales Bureau of Crime Statistics and Research (BOCSAR)  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard P.","family":"Mattick","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Australia  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Larney","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Australia  Sydney New South Wales Australia"},{"name":"Alpert Medical School, Brown University  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Burns","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Australia  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8513-2218","authenticated-orcid":false,"given":"Louisa","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Australia  Sydney New South Wales Australia"},{"name":"School of Population and Global Health The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,23]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"The Health of Australia's Prisoners 2012","author":"Australian Institute of Health and Welfare (AIHW)","year":"2013"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-7-17"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.02990.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa064115"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002207.pub4"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002209.pub2"},{"key":"e_1_2_9_8_1","first-page":"1","article-title":"Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation","volume":"119","author":"Connock M.","year":"2007","journal-title":"Health Technol Assess"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03676.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004666"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12536"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200826050-00003"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.01.010"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2012.694598"},{"key":"e_1_2_9_15_1","series-title":"Drug Treatment Series no. 20","volume-title":"National Opioid Pharmacotherapy Statistics Annual Data Collection 2012","author":"Australian Institute of Health and Welfare (AIHW)","year":"2013"},{"key":"e_1_2_9_16_1","unstructured":"Australian Institute of Health and Welfare (AIHW).2013[cited 1 October 2014]. 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