The results of a NIDA-funded study prepared by RTI International in Research Triangle Park, NC were just released. The study sought to determine the approximate annual cost, per client, of providing a quality methadone treatment program.
The study was completed in close association with Alcohol and Drug Services who operated three methadone clinics in Greensboro, High Point, and Burlington, North Carolina. Estimating the costs to operate an opioid treatment program is a difficult undertaking with many variables which must be accurately factored into a comprehensive analysis.
Some of the variables include: numerous monthly facility-related fees (lease, utilities, cleaning & maintenance), staff salaries, medication, medical equipment, urinalysis testing & lab fees, office equipment (phones, computers, copiers), educational materials and media devices, marketing & promotion, administrative & accounting costs, accreditation fees, medical records, and many other miscellaneous costs. The client census for any opioid treatment program also factors heavily into the clinic’s financial viability as well as does the clinic’s policy on charging for take home medication and other ancillary services.
The RTI study results were based on a clinic census of 170 clients. The largest single cost was labor since all methadone programs require a number of professionals working together as a team in order to deliver quality services. Labor constituted 86.5% of the costs to operate a methadone clinic.
Based on an average daily census of 170 clients, the study defined the annual per client cost to be $7,458. Divided by 365 days per year, this equates to $20.43 per day, per client, to run a quality methadone treatment program. “Quality” mean that clients are receiving regular individual and group counseling services in addition to case management and referral, and some supplemental medical monitoring, referral, and oversight.
Many methadone programs charge their clients far less than $20.43 per day thus promoting the question as to how a clinic can survive financially on an average $13.00 per day client fee. Delivering services at break even or for-a-profit will require that the clinic either cut costs by operating with minimal underpaid staff, offering minimal counseling services, receiving some supplemental State or Federal funding to offset their costs, collecting additional client fees from those whose treatment is partially funded through State/Federal monies, raising their client census to make up losses by serving a larger volume of methadone clients, or acquiring additional funding through grants, donations, or special community funding such as United Way contributions.
Some of these approaches are more problematic than others. “Quality treatment” is always a direct function of having knowledgeable, well-trained staff who are motivated to work with clients and to advocate for their needs and personal growth.
Ultimately, methadone clinics provide life saving treatment and a valuable opportunity for people to reclaim and restart their lives. However, establishing & running a quality methadone program is not cheap. For the addicted individual, opioid treatment is a much more affordable option than buying illicit drugs off the street and living an exhausting, high risk, unhappy existence.
Fortunately, many methadone programs are partially paid for through Medicaid, private insurance, or State dollars earmarked for substance abuse treatment. Even these publicly funded programs struggle … especially when Federal and State budgets are cut year over year.
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