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July 14, 1993

Addiction Medicine

Author Affiliations

Northwestern University Medical School, Chicago, Ill

JAMA. 1993;270(2):184-185. doi:10.1001/jama.1993.03510020048011

The health care debates of 1993 highlight the need for better knowledge of service utilization patterns, treatment effectiveness, and cost-effectiveness of health care. Addiction medicine will be increasingly challenged to provide highquality, cost-effective treatments to maximize the effectiveness of health care expenditures in this area. Updated 1-year prevalence data from the Epidemiologic Catchment Area Program report that specialists in mental and addictive disorders provide treatment for 5.9% of the US population, and only 28.5% of people with mental or addictive disorders seek treatment.1 Over 30 million persons are uninsured in this country. A significant percentage of alcohol and drug abusers fall into this category. The extent to which addiction treatment services would be available in a climate of managed competition is unclear and concerning.

Few studies specifically address cost-effectiveness of treatment. Goodman et al,2 in an analysis of short-term treatment costs, highlighted the complexity of cost analysis research