cost of addiction

Substance Abuse Treatment Cost Benefits — The Best Health Deal Around

In these last weeks leading up to the presidential election, health care and surrounding issues will be on everyone's mind. It is an ideal time to revisit the issue of substance abuse treatment cost benefits.

Roughly 9 to 10% of the population meet the definition “substance dependent.” These numbers represent between 31.5 to 35 million people. In any given year, roughly 16% of Americans who are classified as substance dependent or abusers actually get treatment.

Nationwide, between 8.3 and 8.5% of adults suffer from serious mental illness, and substance abuse itself can lead to psychological disorders. Adults who use illicit drugs or alcohol are more than twice as likely to have serious mental illness than non-users. Many victims find that using drugs blunts the effects of their other disorders, and/or makes them more manageable. When those things are combined with the addictive qualities of the drugs, the combination can lead to situations ranging from homelessness to psychotic breaks and violence.

There is no denying that substance addiction is chronic (it does not improve on its own), progressive (always getting worse, never better, over time), and relapsing (users tend to return to alcohol and drugs after abstinence unless their recovery is well-supported).

Untreated addicts devastate families, communities and themselves. The cost to society in dollars includes rising health costs over and above those of our inefficient healthcare system, reduced productivity of workers, absenteeism, theft, destruction of property, higher law enforcement costs, costs related to traffic crashes, and the expense of incarcerating people who could be given preventive treatment at far less overall expense. Intoxication impacts the health of users and the people around them, and often facilitates transmission of infectious diseases such as hepatitis and HIV.

According to government studies, prevention efforts are often successful in lowering rates of substance abuse in some parts of the population — generally the more educated portions — but it remains a pervasive problem among other segments. It has also been shown that treatment is a highly cost-effective way to break the cycle, using programs that combine assessment, matching of treatment to the patient, comprehensive services adapted to the individuals (including social services when needed) and programs of relapse prevention and accountability.

Treatment does work, but it is not a universal answer. Some cases, especially those combined with mental disorders, involve chronic relapsers with whom intervention seems to work less well. It is likely that if detoxification, treatment and follow-up programs are made a priority, along with research into the best procedures, medications and neurobiology associated with addiction, these percentages will improve. Even so, detox and treatment are effective in enough cases to make the pursuit of universal availability a priority, strictly on a monetary and societal basis.

The last comprehensive study of the economic costs of alcohol and other drug abuse in the US, completed in 1999, showed the annual cost of substance abuse to be $510.8 billion.  That amounts to roughly $799 billion annually in 2012 dollars — far more than the cost of effective treatment for every abuser of alcohol and other drugs in the entire country.

Substance abuse treatment cost benefits are the best health care deal around, and for every year an addict stays clean, the benefits increase.

U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Prevention

“Substance Abuse Prevention Dollars and
Cents: A Cost-Benefit Analysis”

The Extent of Drug Addiction and Alcohol Abuse in the United States

According to the latest National Survey on Drug Use and Health (2009), among Americans 12 years of age or older,

  • 18.6 million people abuse alcohol or are addicted to other drugs;
  • Nearly 0ne-quarter (23.7 percent) reported binge drinking at least once in the 30 days prior to the survey (5 or more standard drinks* for males, 4 for females within a 2 to 3 hour period);
  • 6.8 % (17.1 million people) reported heavy drinking (an average of more than two standard drinks a day for men, one for women).

21.8 million individuals 12 or older were current illicit drug users.

  • 16.7 million used marijuana at least 20 times a month.
  • 7 million used prescription drugs to mood alter, rather than for the reason prescribed (not including over-the-counter preparations).
  • 1.6 million used cocaine or crack cocaine.
  • 1.3 million used hallucinogens, such as LSC, PCP, psilocybin and similar drugs.
  • .6 million used inhalants, primarily youths younger than 21.
  • 200,000 used heroin, down about 75% from earlier results due to the increased availability of substitutes such as Oxycontin and similar, easily-obtained, prescription drugs.

The majority will not need treatment.  They may be able to stop on their own, influenced by a drug-intolerant social climate, and/or the threat of social, legal and employment sanctions. However, treatment will be required for those who cannot or will not stop on their own — those who have become physically or psychologically dependent.  Lacking intervention, compulsive users are usually unable to stop for more than a few days at a time, despite the consequences of their alcohol or other drug use. Their need for chemicals forces them to deny the reality of their addiction, in order to protect themselves from accepting the need to stop.

In the case of adolescents, who are still developing physically, emotionally and socially, any use of drugs outside limits prescribed for them by a doctor, is illegal and can be considered abuse — obviously true of alcohol as well. If the use is causing discernible problems, immediate intervention is warranted.  Not only can effective intervention stop the progression of abuse into addiction, but current research has shown that the development of the adolescent brain and nervous system are severely impacted by drugs, especially alcohol.  This may result in chronic cognitive and behavioral issues, beyond those associated with the drugs themselves, that may not be reversible with abstinence.

The annual economic cost of drug and alcohol abuse in the US is immense, estimated at nearly $215 billion ($651.52 a year for every man, woman and child in the country). This refers only to the monetary cost, and does not take into account the costs to individuals, families, friends and society in general of being deprived of the companionship and productivity of these people. Many studies have shown that treatment is not only essential, but is cost-effective** in terms of the price society and individuals pay for addiction that progresses.  Treatment appropriate to the needs of the individual has been shown to work in a significant percentage of cases, although more than one attempt may be necessary.
*Standard drink: One 12-oz. beer, one 5-oz. glass of wine, or one 1.5 oz. shot of 80 proof liquor.