eScholarship provides open access, scholarly publishing services to the University of California and delivers a dynamic research platform to scholars worldwide. University of California Peer Reviewed Title: Linking opioid-dependent hospital patients to drug treatment: Health care use and costs 6 months after randomization. Author: Barnett, Paul G Masson, Carmen L Sorensen, James L Wong, Wynnie Hall, Sharon Publication Date: 12-01-2006 Publication Info: Postprints, Multi-Campus Permalink: http://escholarship.org/uc/item/7gr262wz Additional Info: www.blackwell-synergy.com/doi/abs/10.1111/j.1360-0443.2006.01636.x The definitive version is available at www.blackwell-synergy.com Keywords: Adolescent, Adult, Aged, Case Management, Emergency Medical Services, Female, Health Care Costs, Hospitalization, Humans, Male, Methadone, Middle Aged, Narcotics, Opioid-Related Disorders Abstract: AIMS: To conduct an economic evaluation of the first 6 months' trial of treatment vouchers and case management for opioid-dependent hospital patients. DESIGN: Randomized clinical trial and evaluation of administrative data. SETTING: Emergency department, wound clinic, in-patient units and methadone clinic in a large urban public hospital. PARTICIPANTS: The study randomized 126 opioid-dependent drug users seeking medical care. INTERVENTIONS: Participants were randomized among four groups. These received vouchers for 6 months of methadone treatment, 6 months of case management, both these interventions, or usual care. FINDINGS: During the first 6 months of this study, 90% of those randomized to vouchers alone enrolled in methadone maintenance, significantly more than the 44% enrollment in those randomized to case management without vouchers (P < 0.001). The direct costs of substance abuse treatment, including case management, was 4040 dollars for those who received vouchers, 4177 dollars for those assigned to case management and 5277 dollars for those who received the combination of both interventions. After 3 months, the vouchers alone group used less heroin than the case management alone group. The difference was not significant at 6 months. There were no significant differences in other health care costs in the 6 months following randomization. CONCLUSION: Vouchers were slightly more effective but no more costly than case management during the initial 6 months of the study. Vouchers were as effective and less costly than the