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Many persons in substance abuse treatment, especially women, were parents, welfare recipients, or both
Women, parents, and welfare recipients improved after treatment
Measurable treatment benefits exceeded treatment costs for each group of special interest
This report analyzes the outcomes, costs, and benefits of substance abuse treatment that
is, treatment for drug or alcohol problems for two partially overlapping groups that are of special
interest to social welfare agencies: parents of children under 18 years of age and recipients of
public income support such as Aid to Families with Dependent Children (AFDC). The primary
data source is CALDATA, a study of treatment outcomes in a random sample of persons
(N=1,825) representing approximately 150,000 individuals who during 1991-92 received drug
and alcohol treatment and recovery services in California. Key results of this analysis of the drug
and alcohol treatment population were as follows:
Many persons in substance abuse treatment, especially women, were parents, welfare
recipients, or both:
- Slightly more than one-third (36%) of the California treatment population had children living with them prior to treatment.
- About half of those with children were men and half were women. There were substantially more men than women in
treatment, but women were proportionately much more likely to have children or express parenting concerns:
- Nearly half of the women in treatment had children in the household compared with less than one-third of the men
(47% versus 29%).
- More than three times as many women as men cited parenting concerns as a reason for entering treatment
(28% versus 8%).
- Altogether, 56 percent of the women in treatment had children in the household or cited parenting concerns as
reasons for treatment, compared with 33 percent of the
men.
- About 41 percent of all the women in treatment and 64 percent of the women with children in their households
received welfare income in the year before treatment; by comparison, about 18 percent of men and 23 percent of
men with children received welfare.
Women, parents, and welfare recipients improved after treatment:
- The beneficial outcomes of treatment for substance abuse were similar for men, women without children, and
women with children, including those who received welfare income.
- Compared with the year before treatment, the number of substance users after treatment among women with
children who received welfare income dropped by about 39 percent for crack cocaine, 42 percent for cocaine
powder, 48 percent for amphetamines, 14 percent for heroin, and 26 percent for alcohol. (For the purposes of these
analyses "substance user" was defined as someone who had used the substance five or more times in the past year.)
- Among women with children who received welfare income, comparing the year before and the year after treatment:
- The percentage who engaged in one or more illegal activities per annum dropped by about 67 percent, the
percent who sold or helped to sell drugs fell by about 60 percent, and the percent who were arrested, booked,
or taken into custody dropped by about 54 percent.
- The percentage hospitalized during the course of one year dropped by about 58 percent.
- The percentage who were homeless for two days or more dropped by about 61 percent.
Measurable treatment benefits exceeded treatment costs for each
group of special interest:
- The benefits of treatment as measured from the point of view of taxpayers included reductions in crime,
transfer payments, and health care expenditures. These benefits outweighed the costs of treatment for those
who received welfare income, were raising children, or expressed parenting concerns as reasons for seeking treatment.
- An average treatment episode lasted about three months, cost about $1,400, and yielded benefits to
taxpayers during and after treatment worth about $10,000, with the greatest share of benefit deriving from
reductions in the economic burden of crime.
- The measured benefit to taxpayers exceeded the cost of treatment by 6 to 1 for women with children
who did not receive welfare and 2« to 1 for women with children who did receive welfare. The benefits of
treatment were lower among women than men, and especially among women who were parents or received
welfare, principally because these women initially committed less crime than men.
- The role of treatment in moving persons from economic dependency to greater self-support was
difficult to evaluate in CALDATA, because overall unemployment rose steadily in California throughout
the period under study, from about 5.6 percent to 9.2 percent, and the treated population worked largely
in occupations that were disproportionately vulnerable to employment fluctuations.
From the standpoint of social welfare policy, particularly as it bears on families, we believe
these results provide clear encouragement to support treatment options. Our benefit estimates are
conservative, because they do not quantify the improved life chances of the children of treated
parents or measure continuing benefits sustained beyond the first year after treatment. While
treatment does not help everyone, it appears to be a widely useful and cost beneficial instrument
for policy for those concerned with the welfare of families or individuals receiving public income
support.
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