A review of psychological and pharmacological treatment options for methamphetamine dependence

Methamphetamine (MA) is a public health problem both in Australia and internationally and very little is known about the most cost-effective treatment options. This study is a review of recent studies and an assessment of current treatment options for MA dependence. Treatment options for MA dependence can be divided into outpatient and inpatient modality settings according to the level of drug use. Moderate improvements through higher rates of retention in treatment (especially residential rehabilitation) have been found in individuals who completed either cognitive-behavioural therapy or counselling as a form of outpatient treatment and in those users who completed a residential rehabilitation treatment programme at an inpatient treatment modality. There remains a need for further research to investigate the efficacy of existing treatment options in individuals with MA use problems and to address the economic impact of those interventions in terms of cost-effectiveness/cost utility. © 2012 Informa UK Ltd

Cost-effectiveness of counselling as a treatment option for methamphetamine dependence

© 2015 Informa UK Ltd. Introduction and aims: Illicit methamphetamine (MA) use is an important public health concern. There is a dearth of knowledge about effective and cost-effective treatments for methamphetamine (MA) dependence in Australia. This article evaluates the cost-effectiveness of counselling as a treatment option for illicit MA use compared with no treatment option. Design and methods: Data are from 501 individuals recruited into Methamphetamine Treatment Evaluation Study (MATES). The population of MA users from MATES is extrapolated to a total number of 1000 MA users in the intervention group (counselling treatment) and control group (non-treatment group). A decision analytic model is developed that examines the costs and health outcomes [measures as quality adjusted life years (QALYs) gained] for the treatment and comparison group over a 3-year period. A societal perspective is adopted and model inputs are subject to sensitivity and uncertainty analysis to test the robustness of results to parameter variability. Results are discounted by using 3% discount rate and expressed in 2011 Australian dollars. Results: The incremental cost-effectiveness analysis suggests that counselling is a dominant health care intervention, i.e. saves money and is more effective than a do nothing intervention. The incremental difference in costs is -AU$18.36 million (95$22.80 million to -AU$14.31 million) and the incremental difference in QALY is 107 (95$63832 per QALY in the Australian society. The results of the sensitivity analysis show that the ICER is most sensitive to change in five major inputs: baseline utility, utility at 3 months, dealing crime costs, property crime costs and fraud crime costs. Discussion and Conclusions: The economic evaluation of the cost-effectiveness of counselling for MA dependence, as a first cost-effectiveness study to assess psychosocial treatment options for MA dependence, shows that greater investment in this cost-effective strategy will produce significant cost-savings and improve health outcomes as well as improve a lot of externality issues associated with drug use

Health-related quality of life (HRQL) among methamphetamine users in treatment

Little is known about the effectiveness of available treatment options for methamphetamine (MA) abuse and dependence. This study aimed to measure improvements in health-related quality of life (HRQL) among MA users associated with different treatment options. Data are from 501 individuals (366 males and 135 females) recruited into the Methamphetamine Treatment Evaluation Study (MATES) who were aged 16 years and over. Participants completed the SF-12 Short Form questionnaire on entry to treatment (or to the study), and again 3 months (n = 404) and 12 months after starting treatment (n = 375). The SF-6D scoring algorithm was used to elicit single preference-based measures of HRQL from participants in the non-treated group (n = 101) and three treatment modalities: counselling (n = 40), residential rehabilitation (n = 248) and detoxification (n = 112), at baseline, 3 and 12 months post-treatment entry. There was complete data available at the three time points for 349 participants. The results indicate that both the treatment and non-treatment groups were found to have an improved HRQL at the 3 and 12-month follow-ups, though the improvement experienced by the group receiving residential rehabilitation was of a greater magnitude than the other groups. Methamphetamine users have a lower HRQL when compared to the general population. The HRQL of MA users had improved 3 months after they started treatment, and had improved again 12 months after starting treatment. © 2013 Copyright Taylor and Francis Group, LLC