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Updated: Aug 20, 2026

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Published on: April 23, 2014
The value of vocational rehabilitation in substance user treatment: a cost-effectiveness framework
Donald S Shepard1, Sharon Reif
1Schneider Institute for Health Policy, Heller School, Brandeis University, Waltham, MA 02454-9110, USA. Shepard@brandeis.edu
Abstract:
Vocational rehabilitation (VR) programs within addiction treatment traditionally consider employment as the desired outcome. This singular focus ignores other benefits, such as.reduced substance use. A framework for evaluating the cost-effectiveness of VR within addiction treatment is presented and illustrated with data from the Alcohol and Drug Services Study (ADSS, 1996--1999). VR was associated with a 2.5% increase in probability of abstinence at an $883 increase in cost per admission. Thus, the estimated cost-effectiveness of VR in promoting abstinence is $35,000 per additional abstinent client ($883/0.025), indicating that VR is a cost-effective contributor to other goals of addiction treatment.
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