Are Non-Pharmacological Interventions Effective in Reducing Drug Use and Criminality? A Systematic and Meta-Analytical Review with an Economic Appraisal of These Interventions

Amanda E. Perry, Rebecca Woodhouse, Matthew Neilson, Marrissa Martyn St James, Julie Glanville, Catherine Hewitt and Dominic Trépel
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Amanda E. Perry: Department of Health Sciences, Mental Health and Addictions Research Group, ARRC Building, 2nd Floor, University of York, Heslington, York YO10 5DD, UK
Rebecca Woodhouse: Department of Health Sciences, Mental Health and Addictions Research Group, ARRC Building, 2nd Floor, University of York, Heslington, York YO10 5DD, UK
Matthew Neilson: Department of Health Sciences, Mental Health and Addictions Research Group, ARRC Building, 2nd Floor, University of York, Heslington, York YO10 5DD, UK
Marrissa Martyn St James: Health Economics and Decision Science, School for Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
Julie Glanville: York Health Economics Consortium Ltd., Enterprise House, Innovation Way, University of York, York YO10 5NQ, UK
Catherine Hewitt: York Trials Unit and NIHR RDS YH, Department of Health Sciences, Faculty of Science, ARRC Building, University of York, Heslington, York YO10 5DD, UK
Dominic Trépel: Department of Health Sciences, Mental Health and Addictions Research Group, ARRC Building, 2nd Floor, University of York, Heslington, York YO10 5DD, UK

IJERPH, 2016, vol. 13, issue 10, 1-20

Abstract: Background: The numbers of incarcerated people suffering from drug dependence has steadily risen since the 1980s and only a small proportion of these receive appropriate treatment. A systematic review to evaluate the effectiveness and economic evidence of non-pharmacological interventions for drug using offenders was conducted. Methods: Cochrane Collaboration criteria were used to identify trials across 14 databases between 2004 and 2014. A series of meta-analyses and an economic appraisal were conducted. Results : 43 trials were identified showing to have limited effect in reducing re-arrests RR 0.97 (95% CI 0.89–1.07) and drug use RR 0.90 (95% CI 0.80–1.00) but were found to significantly reduce re-incarceration RR 0.70 (95% CI 0.57–0.85). Therapeutic community programs were found to significantly reduce the number of re-arrests RR 0.70 (95% CI 0.56–0.87). 10 papers contained economic information. One paper presented a cost-benefit analysis and two reported on the cost and cost effectiveness of the intervention. Conclusions: We suggest that therapeutic community interventions have some benefit in reducing subsequent re-arrest. We recommend that economic evaluations should form part of standard trial protocols.

Keywords: systematic review; drug treatment; economic appraisal; offenders (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
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