Erowid References Database
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Kleiman MAR.
“Costs and Benefits of Immunotherapies or Depot Medications for the Treatment of Drug Abuse”.
Committee on Immunotherapies and Sustained-Release Formulations for Treating Drug Addiction National Academy of Sciences. 2003 july 14.
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Abstract
Two related but distinct benefit-cost questions could be asked about a proposed imrnunotherapy or depot medication designed to prevent a given drug of abuse from crossing the blood-brain barrier. One is whether the application of such a treatment technique to some particular patient or class of patients would be cost-justified, once it had been developed, approved, and put on the market. For a treatment with high efficacy and acceptable side-effects, answering that question will turn out to be triviaiiy easy as applied to patients with severe, chronic substance abuse disorders, because the benefits per application will be very large multiples of the marginal cost of production and administration.
An efficacious immunotherapy or depot medication, administered to a chronic heavy user of a low-recovery-rate drug (such as tobacco, heroin, alcohol, or cocaine) might easily cut years from the otherwise expected length of that patient's active addiction career. A very rough calculation (given below under the subheading Example: Cigarette Smoking) suggests that the excess of costs over benefits for a month of active heavy cigarette smoking is on the order of $500; the comparable figures for active cocaine or heroin use might exceed that by an order of magnitude. Thus the expected gross benefits of administering an effective anti-smoking treatment to a long-term smoker would be in the range of thousands of dollars per patient. That figure would be substantially higher for a chronic alcoholic, and higher still -- in the tens of thousands of dollars -- for someone addicted to heroin or cocaine.
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