|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$1,543||Benefits minus costs||$4,559|
|Participants||$3,153||Benefit to cost ratio||$17.70|
|Others||$154||Chance the program will produce|
|Indirect||($17)||benefits greater than the costs||86 %|
|Net program cost||($273)|
|Benefits minus cost||$4,559|
|Detailed Monetary Benefit Estimates Per Participant|
|Benefits from changes to:1||Benefits to:|
|Labor market earnings associated with problem alcohol use||$1,419||$3,125||$0||$57||$4,601|
|Property loss associated with problem alcohol use||$0||$4||$8||$0||$13|
|Health care associated with emergency department visits||$123||$23||$143||$61||$351|
|Adjustment for deadweight cost of program||$0||$0||$0||($136)||($136)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$205||2000||Present value of net program costs (in 2016 dollars)||($273)|
|Comparison costs||$0||2000||Cost range (+ or -)||20 %|
|Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
|Meta-Analysis of Program Effects|
|Outcomes measured||No. of effect sizes||Treatment N||Adjusted effect sizes (ES) and standard errors (SE) used in the benefit-cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
|Drinking and driving^||2||543||-0.307||0.284||39||-0.042||0.426||41||-0.307||0.279|
|Emergency department visits||2||784||-0.125||0.071||39||-0.017||0.107||41||-0.125||0.078|
|Illicit drug use^||9||1773||-0.155||0.073||39||-0.021||0.109||41||-0.155||0.033|
|Opioid drug use^||4||249||-0.396||0.184||39||-0.054||0.276||41||-0.396||0.031|
|Problem alcohol use||48||7318||-0.195||0.024||39||-0.027||0.037||41||-0.195||0.001|
Aalto, M., Saksanen, R., Laine, P., Forsstrom, R., Raikaa, M., Kiviluoto, M., et al. (2000) Brief intervention for female heavy drinkers in routine general practice: A 3-year randomized controlled study. Alcoholism: Clinical and Experimental Research, 24(11), 1680-1686.
Aalto, M., Seppa, K., Mattila, P., Mustonen, H., Ruuth, K., , . . . Sillanaukee, P. (2001). Brief intervention for male heavy drinkers in routine general practice: a three-year randomized controlled study. Alcohol and Alcoholism, 36(3), 224-230.
Anderson, P. & Scott, E. (1992). The effect of general practitioners' advice to heavy drinking men. British Journal of Addiction, 87, 891-900.
Assanangkornchai, S., McNeil, E.B., Edwards, J.G., Nima, P., & Edwards, J.G. (2015). Comparative trial of the WHO ASSIST-linked brief intervention and simple advice for substance abuse in primary care. Asian Journal of Psychiatry, 18, 75-80.
Babor, T. F., & Grant, M. (1992). Project on identification and management of alcohol-related problems: Report on Phase II: A randomized clinical trial of brief interventions in primary health care. Geneva, Switzerland: World Health Organization.
Babor, T.F., Higgins-Biddle, J.C., Dauser, D., Burleson, J.A., Zarkin, G.A., & Bray, J. (2006). Brief interventions for at-risk drinking: patient outcomes and cost-effectiveness in managed care organizations. Alcohol and Alcoholism (oxford, Oxfordshire), 41, 6.
Bernstein, J., Bernstein, E., Tassiopoulos, K., Heeren, T., Levenson, S., & Hingson, R. (2005). Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug and Alcohol Dependence, 77(1), 49-59.
Chang, G., McNamara, T. K., Orav, E. J., Koby, D., Lavigne, A., Ludman, B., Vincitorio, N. A., . . . Wilkins-Haug, L. (2005). Brief intervention for prenatal alcohol use: a randomized trial. Obstetrics and Gynecology, 105(5), 991-8.
Chang, G., Fisher, N.D.L., Hornstein, M.D., Jones, J.A., Hauke, S.H., Niamkey, N., Briegleb, C., . . . Orav, E.J. (2011). Brief intervention for women with risky drinking and medical diagnoses: A randomized controlled trial. Journal of Substance Abuse Treatment, 41(2), 105-114.
Crawford, M.J., Sanatinia, R., Barrett, B., Byford, S., Dean, M., Green, J., Jones, R., . . . Ward, H. (2014). The clinical effectiveness and cost-effectiveness of brief intervention for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial (SHEAR). Health Technology Assessment, 18(30), 1-48.
Curry, S.J., Ludman, E.J., Grothaus, L.C., Donovan, D., & Kim, E. (2003). A randomized trial of a brief primary-care-based intervention for reducing at-risk drinking practices. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 22(2), 156-65.
Emmen, M.J., Schippers, G.M., Wollersheim, H., & Bleijenberg, G. (2005). Adding psychologist's intervention to physicians' advice to problem drinkers in the outpatient clinic. Alcohol and Alcoholism, 40(3), 219-226.
Fleming, M.F., Manwell, L.B., Barry, K.L., Adams, W. & Stauffacher, E.A. (1999). Brief physician advice for alcohol problems in older adults: A randomized community-based trial. Journal of Family Practice, 48, 378-384.
Fleming, M.F., Barry, K.L., Manwell, L.B., Johnson, K. & London, R. (1997). Brief physician advice for problem alcohol drinkers: A randomized controlled trial in community-based primary care practices. Journal of the American Medical Association, 277, 1039-1045.
Fleming, M.F., Mundt, M.P., French, M.T., Manwell, L.B., Stauffacher, E.A. & Barry, K.L. (2002). Brief physician advice for problem drinkers: Long-term efficacy and benefit-cost analysis. Alcoholism: Clinical and Experimental Research, 26(1), 36-43.
Fleming, M., Brown, R., & Brown, D. (2004). The efficacy of a brief alcohol intervention combined with CDT feedback in patients being treated for type 2 diabetes and/or hypertension. Journal of Studies on Alcohol, 65(5), 631-7.
Fleming, M.F., Lund, M.R., Wilton, G., Landry, M., & Scheets, D. (2008). The healthy moms study: The efficacy of brief alcohol intervention in postpartum women. Alcoholism, Clinical and Experimental Research, 32(9), 1600-6.
Fleming, M. F., Balousek, S. L., Grossberg, P. M., Mundt, M. P., Brown, D., Wiegel, J. R., Zakletskaia, L. I., . . . Saewyc, E. M. (2010). Brief physician advice for heavy drinking college students: a randomized controlled trial in college health clinics. Journal of Studies on Alcohol and Drugs, 71(1), 23-31.
Freeborn, D. K., Polen, M. R., Hollis, J. F., & Senft, R. A. (2000). Screening and brief intervention for hazardous drinking in an HMO: effects on medical care utilization. The Journal of Behavioral Health Services & Research, 27(4), 446-53.
Gelberg, L., Andersen, R. M., Afifi, A.A., Leake, B.D., Arangua, L., Vahidi, M., Singleton, K., . . . Baumeister, S.E. (2015). Project QUIT (Quit Using Drugs Intervention Trial): a randomized controlled trial of a primary care-based multi-component brief intervention to reduce risky drug use. Addiction, 110(11), 1777-1790.
Grossberg, P.M., Brown, D.D. & Fleming, M.F. (2004). Brief Physician Advice for High-Risk Drinking Among Young Adults. Annals of Family Medicine, 2(5), 474-480.
Heather, N., Campion, P.D., Neville, R.G., & Maccabe, D. (1987). Evaluation of a controlled drinking minimal intervention for problem drinkers in general practice (The DRAMS scheme). Journal of the Royal College of General Practitioners, 37(301), 358-363.
Humeniuk, R., Ali, R., Babor, T., Souza-Formigoni, M.L.O., de, L.R.B., Ling, W., McRee, B., . . . Vendetti, J. (2012). A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries. Addiction, 107(5), 957-966.
Israel, Y., Hollander, O., Sanchez-Craig, M., Booker, S., Miller, V., Gingrich, R., & Rankin, J. G. (1996). Screening for problem drinking and counseling by the primary care physician-nurse team. Alcoholism, Clinical and Experimental Research, 20(8), 1443-50.
Kaner, E., Newbury-Birch, D., Bland, M., Coulton, S., Godfrey, C., Parrott, S., Cassidy, P., . . . Shepherd, J. (2013). Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): Pragmatic cluster randomised controlled trial. Bmj, 346, 7892.
Kristenson, H., Ohlin, H., Hulten-Nosslin, M.B., Trell, E., & Hood, B. (1983). Identification and intervention of heavy drinking in middle-aged men: Results and follow-up of 24-60 months of long-term study with randomized controls. Alcoholism: Clinical and Experimental Research, 7, 203-209.
Kypri, K., Saunders, J.B., Williams, S.M., McGee, R.O., Langley, J.D., Cashell-Smith, M.L., & Gallagher, S.J. (2004). Web-based screening and brief intervention for hazardous drinking: A double-blind randomized controlled trial. Addiction, 99, 11.
Kypri, K., Langley, J. D., Saunders, J. B., Cashell-Smith, M. L., & Herbison, P. (2008). Randomized controlled trial of web-based alcohol screening and brief intervention in primary care. Archives of Internal Medicine, 168(5), 530-536.
Lock, C. A., Kaner, E., Heather, N., Doughty, J., Crawshaw, A., McNamee, P., Purdy, S., . . . Pearson, P. (2006). Effectiveness of nurse-led brief alcohol intervention: a cluster randomized controlled trial. Journal of Advanced Nursing, 54(4), 426-439.
Maheswaran, R., Beevers, M., & Beevers, D.G. (1992). Effectiveness of advice to reduce alcohol consumption in hypertensive patients. Hypertension, 19, 79-84.
Maisto, S.A., Conigliaro, J., McNeil, M., Kraemer, K., Conigliaro, R. L., & Kelley, M. E. (2001). Effects of two types of brief intervention and readiness to change on alcohol use in hazardous drinkers. Journal of Studies on Alcohol, 62(5), 605-614.
Manwell, L.B., Fleming, M.F., Mundt, M.P., Staffacher, E.A., & Barry, K.L., (2000). Treatment of problem alcohol use in women of childbearing age: Results of a brief intervention trial. Alcoholism: Clinical and Experimental Research, 24(10), 1517-1524.
Mertens, J.R., Ward, C.L., Bresick, G.F., Broder, T., & Weisner, C.M. (2014). Effectiveness of nurse-practitioner-delivered brief motivational intervention for young adult alcohol and drug use in primary care in South Africa: A randomized clinical trial. Alcohol and Alcoholism, 49(4), 430-438.
Nilssen, O. (1991). The Tromso Study: Identification of and a controlled intervention on a population of early-stage risk drinkers. Preventive Medicine,20, 518-528.
Noknoy, S., Rangsin, R., Saengcharnchai, P., Tantibhaedhyangkul, U., & McCambridge, J. (2010). RCT of effectiveness of motivational enhancement therapy delivered by nurses for hazardous drinkers in primary care units in Thailand. Alcohol and Alcoholism, 45(3), 263-270.
Ockene, J.K., Adams, A., Hurley, T., Wheeler, E. & Hebert, J.R. (1999). Brief physician- and nurse practitioner-delivered counseling for high-risk drinkers: Does it work? Archives of Internal Medicine, 159(18), 2198-2205.
Richmond, R., Heather, N. Wodak, A. Kehoe, L., & Webster, I. (1995). Controlled evaluation of a general practice-based brief intervention for excessive drinking. Addiction 90(1), 119-132.
Romelsjö, A., Andersson, L, Barrner, H., Borg, S., Granstrand, C., Hultman, O., . . . Wikblad, O. (1989). A randomized study of secondary prevention of early stage problem drinkers in primary health care. British Journal of Addiction, 84(11), 1319-1327.
Roy-Byrne, P., Bumgardner, K., Krupski, A., Dunn, C., Ries, R., Donovan, D., West, I. I., . . . Zarkin, G.A. (2014). Brief intervention for problem drug use in safety-net primary care settings. Jama, 312(5), 492.
Saitz, R., Palfai, T.P., Cheng, D., Alford, D.P., Bernstein, J.A., Lloyd, T.C.A., Meli, S.M., . . . Samet, J.H. (2014). Screening and brief intervention for drug use in primary care: The ASPIRE randomized trial. Drug and Alcohol Dependence, 140.
Schaus, J. F., Sole, M. L., McCoy, T. P., Mullett, N., & O'Brien, M. C. (2009). Alcohol screening and brief intervention in a college student health center: A randomized controlled trial. Journal of Studies on Alcohol and Drugs, Suppl. 16, 131-141.
Scott, E. & Anderson, P. (1990). Randomized controlled trial of general practitioner intervention in women with excessive alcohol consumption. Drug and Alcohol Review, 10(4), 313-321.
Senft, R.A., Polen, M.R., Freeborn, D.K. & Hollis, J.F. (1997). Brief intervention in a primary care setting for hazardous drinkers. American Journal of Preventive Medicine, 13(6), 464-470.
Wallace, P., Cutler, S., & Haines , A. (1988). Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption. British Medical Journal, 297(6649), 663-668.