Cost of Methadone Maintenance in Canadian Prisons

Before considering the various benefits of providing MMT in federal prisons in Canada, this article will first concentrate on the costs associated with such an intervention. Recently, NIDA (1999) reported that the annual cost of providing MMT is approximately $1,700 per client. To properly determine the cost effectiveness of providing MMT programs in federal prisons in this country, it is useful to compare this figure to the annual health care costs that would otherwise be required for one IDU living with HIV/AIDS.

According to the Harm Reduction Action Society (2000) in Vancouver, the required health care for one IDU may extend beyond twenty years. The subsequent cost of such a long-term commitment becomes significant given that, in 1998, the average age of newly diagnosed cases of HIV was 23 (Bognar, Legare and Ross 1998). Projected treatment costs for IDU’s living with HIV/AIDS in British Columbia alone were $72.3 million in 1999/2000 (Hanvelt, Copley, Schneider and Meagher 1999). In the long-term, those researchers projected that the lifetime expense of medical treatment for one IDU living with HIV/AIDS in British Columbia would be approximately $134,559.

For calculation purposes and notwithstanding the Vancouver Harm Reduction Society’s prediction that the required health care for one IDU may extend beyond twenty years, let us assume that one IDU living in British Columbia will live for exactly twenty years following his/her commencement of intravenous drug use. Let us also assume the accuracy of Hanvelt et al.’s (1999) projected lifetime expense of medical treatment for one IDU living with HIV/AIDS in British Columbia to be approximately $134,559. In turn, the annual health care cost of one IDU living with HIV/AIDS in that province would be approximately $6,728 ($134,559 divided by 20 years). This figure is almost four (4) times the estimated annual cost of providing MMT to one IDU.

Long-term savings calculations indicate that approximately $3 million for treatment could be saved in one year alone, if only five to seven of every 100 HIV infections were prevented each year (Hanvelt et al. 1999). Such a financial incentive is a substantial reason to adopt a policy to expand existing MMT in federal prisons in Canada.

Not only are health care costs important to this discussion, however, but so too is the cost of incarcerating one heroin-addicted IDU. To be sure, studies (which will be explored later in this article) indicate that the provision of MMT in prison is associated with a reduction in both future criminal behaviour and heroin use. It is therefore suggested that the expansion of MMT in federal prisons in Canada will render it possible to reduce the “recycling” of IDU’s through the criminal justice system and, in turn, reduce the costs of incarcerating those IDU’s in the future.

The annual cost of incarcerating one IDU in Canada is approximately $68,300. Consider the potential expenditures for incarcerating one heroin-addicted IDU repeatedly over the course of twenty years, and then consider the potential long-term savings by providing MMT in Canadian prisons instead.

To summarize:

• The estimated annual cost of MMT is $1,700 per IDU.
• The estimated annual cost of health care required for one IDU living with HIV/AIDS in British Columbia is approximately $6,728; almost four times the estimated annual cost of MMT.
• The estimated annual cost of incarcerating one heroin-addicted IDU is approximately $68,300.