RESIDENTIAL REHAB BRIEFING: Costs

by
THE CONCORDAT OF PROVIDERS OF FULL RECOVERY

Click Residential Rehab Briefing for Contents list of all 6 sections.
Or Download Residential Rehab Core Briefing May 2011
and Download Cross Departmental Financial Benefits Full-Recovery

 

3. COSTS 
Cost of rehab, cost of patients prior to/ not going to rehab,
added value from rehabs’ ex-clients.

It is incorrect to compare methadone prescribing costs of £55/week against rehab costs of £800/week.
First, we cannot look at one week in isolation but must consider the length of time of ‘treatment’: at the opposite ends of the spectrum, a patient might be in rehab four weeks and on methadone 3-4 decades.

Also, NTORS concluded that rehabs deal with far more chaotic complex patients.

Rehabs can cost as little as £416/week (Lancashire) and methadone £116/week (£3,064 per annum)  (Centre for Policy Studies, 2011).

NICE CG51 Psychosocial guidelines worsen costs, as many patients must use inappropriate community services before being referred to rehab – and then only, for example, after suffering strokes, broken bones, vomiting blood etc as the community services maintained their dependency. 
(The Concordat has requested NICE to reverse its decision not to review these guidelines, as it has no grounds for such decision – see Barriers).

Cross-government financial benefits to state economy of rehabs.

(Download Cross Departmental Financial Benefits Full-Recovery) describes a survey showing that 8 random current (May 2011) patients in rehab cost the state £695,451 in the 12 months before they entered rehab excluding all Benefit, Welfare, Housing and Legal Aid payments.
Rehab is far cheaper, especially given its effectiveness; see Evidence base.
3 people in the above cohort had been on methadone, for which their respective costs to the state were £30,000, £60,000 and £100,000 each.

Value:
For its comprehensive care and the significant progress clients can make over a relatively short period of time, the value of first-stage provision if properly run is of great value.  Relatively quickly, clients establish foundations on which their longer term recovery can be built with the right support.

Comparative value:
Despite low drug worker/client contact, harm-reduction treatment services have not and do not come cheap. Annual average client treatment costs for England work out at almost £4,000 per client per year -  more than the basic methadone dispensing and prescribing cost of  £39million a year (£300 per client per year), while annual average 'Tier Three' prescribing and 'Tier Four' client costs have been officially calculated at £6,064.

Two years of £6,064 could pay for for six months of intensive residential rehabilitation or 12 months of more structured abstinence daycare.

An english treatment budget of some three quarters of a billion a year  "bought" 9,392 inpatient detoxifications and only 4,711 residential rehabilitation interventions (spent on 2,476,000 methadone prescriptions).
It is hardly surprising that only 8,112 people were discharged free of drug dependency - 4% of the treatment population - last year. 
www.addictiontoday.org/addictiontoday/2011/03/uk-treatment-war-on-drugs-perverse-outcomes.html