Research Brief
The Benefits and Costs of Drug Use Prevention: Clarifying a Cloudy Issue
Jan 1, 1999
An Ounce of Prevention, a Pound of Uncertainty
The Cost-Effectiveness of School-Based Drug Prevention Programs
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Focuses on school-based drug prevention programs that have proven effective in formal evaluations. Effectiveness at reducing cocaine consumption is inferred from effectiveness at reducing marijuana initiation, and spillover effects on those not participating in the program are accounted for. Given substantial uncertainties in all pertinent factors, the cost-effectiveness estimation framework is constructed to permit easy substitution of alternate values at reader preference or as more information becomes available. The authors conclude that prevention can reduce lifetime cocaine consumption by 2 to 11 percent. Although these effects are small, prevention programs are inexpensive, so that the associated cost-effectiveness values bracket those of a range of enforcement strategies. Treatment, however, appears more cost-effective than prevention. A nationwide drug prevention program would cost only a tiny fraction of what the United States now spends on drug control, but its effect on the cocaine-using population would be modest and slow to accumulate.
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Table of Contents
Chapter One
Introduction
Chapter Two
Effectiveness at Reducing Cocaine Consumption
Chapter Three
Cost-Effectiveness at Reducing Cocaine Consumption
Chapter Four
Other Benefits
Chapter Five
Nationwide Implementation
Chapter Six
Conclusions and Policy Implications
Appendix A
Estimating Average Lifetime Cocaine Consumption
Appendix B
Prevention's Effectiveness at Reducing Marijuana Initiation
Appendix C
Relationship Between Age of Marijuana Initiation and Lifetme Consumption of Cocaine and Marijuana
Appendix D
Estimating the Magnitude of the Social Multiplier
Appendix E
How Prevention's Cost-Effectiveness Varies Over Time
Appendix F
Estimating the Magnitude of the Market Multiplier
Appendix G
Estimating the Magnitude of the Causation/Correlation Qualifier
Appendix H
Estimating the Magnitude of the Scale-Up Degradation Qualifier
Appendix I
Prevention's Effect on Heavy Alcohol Use and Cigarette Smoking
Appendix J
Accumulation of Prevention's Effect Nationwide
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