{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:12:38Z","timestamp":1780078358257,"version":"3.54.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2004,4,23]],"date-time":"2004-04-23T00:00:00Z","timestamp":1082678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2004,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:bold>Aims\u2003<\/jats:bold>To compare the cost and cost\u2010effectiveness of methadone maintenance treatment and 180\u2010day methadone detoxification enriched with psychosocial services.<\/jats:p><jats:p><jats:bold>Design\u2003<\/jats:bold>Randomized controlled study conducted from May 1995 to April 1999.<\/jats:p><jats:p><jats:bold>Setting\u2003<\/jats:bold>Research clinic in an established drug treatment program.<\/jats:p><jats:p><jats:bold>Participants\u2003<\/jats:bold>One hundred and seventy\u2010nine adults with diagnosed opioid dependence.<\/jats:p><jats:p><jats:bold>Intervention\u2003<\/jats:bold>Patients were randomized to methadone maintenance (<jats:italic>n<\/jats:italic>\u2003=\u200391), which required monthly 1\u2003hour\/week of psychosocial therapy during the first 6\u2003months or 180\u2010day detoxification (<jats:italic>n<\/jats:italic>\u2003=\u200388), which required 3\u2003hours\/week of psychosocial therapy and 14 education sessions during the first 6\u2003months.<\/jats:p><jats:p><jats:bold>Measurements\u2003<\/jats:bold>Total health\u2010care costs and self\u2010reported injection drug use. A two\u2010state Markov model was used to estimate quality\u2010adjusted years of survival.<\/jats:p><jats:p><jats:bold>Findings\u2003<\/jats:bold>Methadone maintenance produced significantly greater reductions in illicit opioid use than 180\u2010day detoxification during the last 6\u2003months of treatment. Total health\u2010care costs were greater for maintenance than detoxification treatment ($7564 versus $6687;<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001). Although study costs were significantly higher for methadone maintenance than detoxification patients ($4739 versus $2855,<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001), detoxification patients incurred significantly higher costs for substance abuse and mental health care received outside the study. Methadone maintenance may provide a modest survival advantage compared with detoxification. The cost per life\u2010year gained is $16\u2003967. Sensitivity analysis revealed a cost\u2010effectiveness ratio of less than $20\u2003000 per quality\u2010adjusted life\u2010year over a wide range of modeling assumptions.<\/jats:p><jats:p><jats:bold>Conclusions\u2003<\/jats:bold>Compared with enriched detoxification services, methadone maintenance is more effective than enriched detoxification services with a cost\u2010effectiveness ratio within the range of many accepted medical interventions and may provide a survival advantage. Results provide additional support for the use of sustained methadone therapy as opposed to detoxification for treating opioid addiction.<\/jats:p>","DOI":"10.1111\/j.1360-0443.2004.00728.x","type":"journal-article","created":{"date-parts":[[2004,5,10]],"date-time":"2004-05-10T07:58:17Z","timestamp":1084175897000},"page":"718-726","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Cost and cost\u2010effectiveness of standard methadone maintenance treatment compared to enriched 180\u2010day methadone detoxification"],"prefix":"10.1111","volume":"99","author":[{"given":"Carmen L.","family":"Masson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul G.","family":"Barnett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen L.","family":"Sees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin L.","family":"Delucchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Rosen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wynnie","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M.","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,4,23]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1999.9444793.x"},{"key":"e_1_2_5_3_1","first-page":"365","article-title":"The cost\u2010effectiveness of methadone maintenance","volume":"67","author":"Barnett P. 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