|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$769||Benefits minus costs||$1,660|
|Participants||$1,233||Benefit to cost ratio||$4.62|
|Others||$418||Chance the program will produce|
|Indirect||($302)||benefits greater than the costs||52 %|
|Net program cost||($458)|
|Benefits minus cost||$1,660|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||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|
Problem alcohol use
Alcohol use reflecting problem behaviors (e.g., high frequency drinking, binge drinking, or drinking that has a high impact on daily life) for individuals who do not have an alcohol use disorder.
Adult use of cannabis that does not rise to the level of “disordered.”
Illicit drug use^
Adult use of illicit drugs that does not rise to the level of “disordered.” When possible, we exclude cannabis/marijuana use from this outcome.
Emergency department visits
Whether someone visited the emergency department, or the number of times they visited the emergency department.
Drinking and driving^
Official or self-reported drinking and driving—arrests, citations, or behavior.
Injuries due to substance use.
Opioid drug use^
Adult use of opioids that does not rise to the level of “disordered.”
|Detailed Monetary Benefit Estimates Per Participant|
|Affected outcome:||Resulting benefits:1||Benefits accrue to:|
|Problem alcohol use||Criminal justice system||$0||$0||$4||$0||$4|
|Labor market earnings associated with problem alcohol use||$490||$1,152||$0||($245)||$1,397|
|Property loss associated with problem alcohol use||$0||$3||$6||$0||$9|
|Mortality associated with problem alcohol||$1||$3||$0||$33||$37|
|Emergency department visits||Health care associated with emergency department visits||$277||$75||$408||$139||$900|
|Program cost||Adjustment for deadweight cost of program||$0||$0||$0||($229)||($229)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$362||2005||Present value of net program costs (in 2018 dollars)||($458)|
|Comparison costs||$0||2005||Cost range (+ or -)||20 %|
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
|Benefits Minus Costs Over Time (Cumulative 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 discounted dollars. 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.|
Academic ED SBIRT Research Collaborative. (2007). The impact of screening, brief intervention, and referral for treatment on emergency department patients' alcohol use. Annals of Emergency Medicine, 50(6), 699-710.
Blow, F.C., Barry, K.L., Walton, M.A., Maio, R.F., Chermack, S.T., Bingham, C.R., Ignacio, R.V., . . . Strecher, V.J. (2006). The efficacy of two brief intervention strategies among injured, at-risk drinkers in the emergency department: impact of tailored messaging and brief advice. Journal of Studies on Alcohol,67 (4), 568-78.
Bogenschutz, M.P., Donovan, D.M., Mandler, R.N., Perl, H.I., Forcehimes, A.A., Crandall, C., Lindblad, R., . . . Douaihy, A. (2014). Brief intervention for patients with problematic drug use presenting in emergency departments: A randomized clinical trial. JAMA Internal Medicine, 174(11), 1736-1745.
Cherpitel, C.J., Korcha, R.A., Moskalewicz, J., Swiatkiewicz, G., Ye, Y., & Bond, J. (2010). Screening, brief intervention, and referral to treatment (SBIRT): 12-month outcomes of a randomized controlled clinical trial in a Polish emergency department. Alcoholism: Clinical and Experimental Research, 34(11), 1922-1928.
Crawford, M.J., Patton, R., Touquet, R., Drummond, C., Byford, S., Barrett, B., Reece, B., . . . Henry, J.A. (2004). Screening and referral for brief intervention of alcohol-misusing patients in an emergency department: a pragmatic randomised controlled trial. Lancet, 364(9442), 9-15.
Crawford, M.J., Csipke, E., Brown, A., Reid, S., Nilsen, K., Redhead, J., & Touquet, R. (2010). The effect of referral for brief intervention for alcohol misuse on repetition of deliberate self-harm: an exploratory randomized controlled trial. Psychological Medicine, 40(11), 1821-1828.
Daeppen, J.-B., Gaume, J., Bady, P., Yersin, B., Calmes, J.-M., Givel, J.-C., & Gmel, G. (2007). Brief alcohol intervention and alcohol assessment do not influence alcohol use in injured patients treated in the emergency department: a randomized controlled clinical trial. Addiction, 102(8), 1224-1233.
Dauer, A. R., Rubio, E. S., Coris, M. E., & Valls, J. M. (2006). Brief intervention in alcohol-positive traffic casualties: is it worth the effort?. Alcohol and Alcoholism , 41(1), 76-83.
D'Onofrio, G., Pantalon, M.V., Degutis, L.C., Fiellin, D.A., Busch, S.H., Chawarski, M.C., Owens, P.H., . . . O'Connor, P.G. (2008). Brief intervention for hazardous and harmful drinkers in the emergency department. Annals of Emergency Medicine, 51(6), 742.
D'Onofrio, G., Fiellin, D.A., Pantalon, M.V., Chawarski, M.C., Owens, P.H., Degutis, L.C., Busch, S.H., . . . O'Connor, P.G. (2012). A brief intervention reduces hazardous and harmful drinking in emergency department patients. Annals of Emergency Medicine, 60(2), 181-92.
Drummond, C., Deluca, P., Coulton, S., Bland, M., Cassidy, P., Crawford, M., Dale, V., . . . Kaner, E. (2014). The effectiveness of alcohol screening and brief intervention in emergency departments: A multicentre pragmatic cluster randomized controlled trial. Plos One, 9(6), e99463.
Field, C.A., Cochran, G., & Caetano, R. (2012). Ethnic differences in the effect of drug use and drug dependence on brief motivational interventions targeting alcohol use. Drug and Alcohol Dependence, 126, 21-26.
Goodall, C. A., Ayoub, A. F., Crawford, A., Smith, I., Bowman, A., Koppel, D., & Gilchrist, G. (2008). Nurse-delivered brief interventions for hazardous drinkers with alcohol-related facial trauma: A prospective randomised controlled trial. British Journal of Oral and Maxillofacial Surgery, 46(2), 96-101.
Havard, A., Shakeshaft, A.P., Conigrave, K.M., & Doran, C.M. (2012). Randomized controlled trial of mailed personalized feedback for problem drinkers in the emergency department: the short-term impact. Alcoholism, Clinical and Experimental Research, 36(3), 523-31.
Kunz, F.M.J., French, M.T., & Bazargan-Hejazi, S. (2004). Cost-effectiveness analysis of a brief intervention delivered to problem drinkers presenting at an inner-city hospital emergency department. Journal of Studies on Alcohol, 65(3), 363-70.
Longabaugh, R., Woolard, R.E., Nirenberg, T.D., Minugh, A.P., Becker, B., Clifford, P.R., . . . Gogineni, A. (2001). Evaluating the effects of a brief motivational intervention for injured drinkers in the emergency department. Journal of Studies on Alcohol, 62(6), 806-816.
Mello, M.J., Baird, J., Lee, C., Strezsak, V., French, M.T., & Longabaugh, R. (2016). A randomized controlled trial of a telephone intervention for alcohol misuse with injured emergency department patients. Annals of Emergency Medicine, 67(2), 263–275.
Mello, M.J., Longabaugh, R., Baird, J., Nirenberg, T., & Woolard, R. (2008). DIAL: A telephone brief intervention for high-risk alcohol use with injured emergency department patients. Annals of Emergency Medicine, 51(6), 755-764.
Mello, M. J., Baird, J., Nirenberg, T.D., Lee, C., Woolard, R., & Longabaugh, R. (2013). DIAL: a randomised trial of a telephone brief intervention for alcohol. Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention, 19(1), 44-48.
Monti, P.M., Colby, S.M., Barnett, N.P., Spirito, A., Rohsenow, D.J., Myers, M., . . . Lewander, W. (1999). Brief intervention for harm reduction with alcohol-positive older adolescents in a hospital emergency department. Journal of Consulting and Clinical Psychology, 67(6), 989-994.
Monti, P.M., Barnett, N.P., Colby, S.M., Gwaltney, C.J., Spirito, A., Rohsenow, D.J., & Woolard, R. (2007). Motivational interviewing versus feedback only in emergency care for young adult problem drinking. Addiction, 102(8), 1234-1243.
Segatto, M. L., Andreoni, S., de, S. S. R., Diehl, A., & Pinsky, I. (2011). Brief motivational interview and educational brochure in emergency room settings for adolescents and young adults with alcohol-related problems: a randomized single-blind clinical trial. Revista Brasileira De Psiquiatria, 33(3), 225-33.
Sommers, M.S., Lyons, M.S., Fargo, J.D., Sommers, B.D., McDonald, C.C., Shope, J.T., & Fleming, M.F. (2013). Emergency department-based brief intervention to reduce risky driving and hazardous/harmful drinking in young adults: A randomized controlled trial. Alcoholism, Clinical and Experimental Research, 37(10), 1753-1762.
Woodruff, S.I., Clapp, J.D., Eisenberg, K., McCabe, C., Hohman, M., Shillington, A.M., Sise, C.B., . . . Gareri, J. (2014). Randomized clinical trial of the effects of screening and brief intervention for illicit drug use: The Life Shift/Shift Gears study. Addiction Science & Clinical Practice, 9(8).
Woolard, R., Baird, J., Longabaugh, R., Nirenberg, T., Lee, C.S., Mello, M.J., & Becker, B. (2013). Project Reduce: Reducing alcohol and marijuana misuse: Effects of a brief intervention in the emergency department. Addictive Behaviors, 38(3), 1732-1739.