Shutting off methadone. Costs and benefits.

Area of Science:

• Addiction Medicine
• Public Health Policy
• Criminal Justice Impact

Background:

• A methadone clinic in Bakersfield, California, closed in September 1976, impacting 99 enrolled clients.
• Due to the clinic's remote location, only 11 clients transferred to alternative treatment facilities.

Purpose of the Study:

• To evaluate the long-term consequences of methadone treatment cessation.
• To compare outcomes of clinic-terminated clients with those continuing treatment.

Main Methods:

• A two-year follow-up study was conducted on 99 former methadone clients.
• A comparison group of 88 clients from a continuing program was selected.
• Ninety-five percent of the combined sample (terminated and continuing clients) were interviewed.

Main Results:

• 54% of terminated clients experienced heroin readdiction.
• Arrest and incarceration rates were approximately double for terminated clients compared to the comparison group.
• The closure resulted in a net economic loss when considering the benefits of new admissions.

Conclusions:

• Methadone clinic closure leads to adverse outcomes, including increased readdiction and criminal justice involvement.
• While short-term economic costs might appear lower, clinic closures represent an overall economic and social detriment.
• Policy decisions regarding addiction treatment facility closures require careful consideration of long-term client and societal impacts.