The value of vocational rehabilitation in substance user treatment: A cost-effectiveness framework

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.