OBJECTIVES: Assess behavioral health care utilization and expenditures for patients receiving long acting injectable medications. METHODS: A long acting injectable psychotropic medication is a sustained-action drug formulation administered through intra-muscular injection that allows slow release and gradual absorption. This was a retrospective study using behavioral health and pharmacy claims data. Commercial patients from a large national health plan diagnosed with schizophrenia, substance-related disorders, or mood disorders who received a long acting injectable between January 1, 2012 and July 31, 2015 were identified. A second cohort was comprised of patients with the same conditions during the same timeframe who did not receive a long acting injectable. Patterns of utilization and expenditures were compared between patients with injectables and patients without. Outcomes were measured over a 90 day period starting from either their initial injection (for patients with injectables) or their initial encounter (for patients without). RESULTS: Patients receiving an injectable incurred lower expenditures overall ($3,002 vs. $5,064, p<.05) and had fewer intermediate stays (5.5 vs. 7.9, p<0.05) and outpatient visits (2.8 vs. 5.2, p<0.05) than patients who did not receive an injection. Similar patterns were also observed among patients who had 3 or more injectables ($1,959 vs. $3,223, p<0.05) and patients who were administered Naltrexone specifically ($3,130 vs. $5,474, p<0.05) than patients who did not receive any injections. Patients with a history of injectables incurred lower expenditures ($1,371 vs. $2,471, p<0.05) and had fewer intermediate behavioral health care stays (1.8 vs. 4.9, p<0.05) than patients who were new to the injectable treatment. CONCLUSIONS: Commercial patients incurred lower behavioral health care utilization and expenditures after receiving long acting injectables. Use of long acting injectable psychotropic medications to treat patients with select behavioral health conditions may be a more cost effective alternative to traditional drug therapies.