A variety of approaches to substance abuse treatment have been shown to lower healthcare costs, particularly for expensive services such as emergency room visits and inpatient care.

A number of studies show that treated individuals have lower rates of emergency room use and hospitalization, which usually results in lower overall healthcare costs (Ettner, et al., 2006; Holder, 1998; McGeary & French, 2000; Parthasarathy, Weisner, Hu, & Moore, 2001; Turner, Laine, Yang, & Hauck, 2003; Wickizer, Krupski, Stark, Mancuso, & Campbell, 2006). Lower use of expensive health care is found consistently across individuals using different substance abuse treatment modalities, such as outpatient drug free, residential and medication assisted treatment, and for both alcohol and drug addiction (Ettner, et al., 2006; Wickizer, et al., 2006). Of course, cost and effectiveness vary by site and type of treatment (Cisler, Holder, Longabaugh, Stout, & Zweben, 1998; Ettner, et al., 2006; Finney & Monahan, 1996).

Some treatment interventions , such as Screening Brief Intervention Referral and Treatment (SBIRT), based in primary, emergency or other medical care settings or brief physician advice for problem drinkers, also show promising results for healthcare savings (Washington State Screening, Brief Intervention, Referral and Treatment Project, 2008). However, treatment does not always completely eliminate cost differences between those whose substance abuse is treated and others without a substance use disorder (Goodman, Tilford, Hankin, Holder, & Nishiura, 2000; Harwood, 2008; Parthasarathy, et al., 2001). In the short term, the cost of substance abuse treatment can be higher than healthcare savings (Ettner, et al., 2006). Actual healthcare savings from treatment, also called healthcare cost offsets, may vary widely depending on age, gender and the presence of co-occurring psychiatric conditions (Zywiak, et al., 1999).

Placing these results in context, it is important to understand that healthcare cost savings are only one type of economic benefit from treatment. Substance abuse treatment often increases employment and reduces criminal activity (Holloway, Bennett, & Farrington, 2006; Hser & Evans, 2008; Hubbard, Craddock, & Anderson, 2003; Metsch, Pereyra, Miles, & McCoy, 2003; Wickizer, Campbell, Krupski, & Stark, 2000). Many effective substance abuse treatments produce net savings when lower criminal justice costs and increased earnings from employment are included in calculations (Doran, 2008; McCollister & French, 2003). Even when only healthcare costs are considered, the cost effectiveness of substance abuse treatment compares very favorably with other effective healthcare interventions, most of which improve health outcomes but do not produce cost savings (Cohen, Neumann, & Weinstein, 2008). Substance abuse treatment is among the most cost-effective healthcare interventions available.