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Friday, May 29, 2009

Editorial: Cut the toll of addictions

An extensive study of the true costs of substance abuse argues for a shift to more prevention, treatment efforts.

RoundTable blog

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America spends an astonishing amount of money paying for its failures in preventing and treating addictions: by one measure, $374 billion in 2005 alone in federal and state government expenditures.

Most of the money ($207 billion) was spent on health care related to smoking and substance abuse, including overdrinking, and on criminal justice ($47 billion), driven largely by the country's perpetual war on drugs. Just a sliver -- about 2 percent -- went to prevention and treatment of the addictions themselves.

If the country can turn that strategy around, it can save lives and money.

Together with spending by localities, a newly released study indicates, taxpayers in 2005 shelled out at least $468 billion in addiction-related spending -- a figure that includes consequences beyond addicts' broken health and, frequently, their criminal involvement.

The three-year study by the National Center on Addiction and Substance Abuse at Columbia University also added in the impact of addictions on children's welfare, domestic violence, homelessness, mental illness and developmental disabilities -- social ills often related to alcohol and drug abuse.

Among the study's findings:

"If substance abuse and addiction were its own state budget category, it would rank second behind spending on elementary and secondary education. ...

"For every $100 spent by state governments on substance abuse and addiction, the average spent on prevention, treatment and research was $2.38; Connecticut spent the most, $10.39; New Hampshire spent the least, $0.22." The analysis showed Virginia spent 1 cent for prevention and 2 cents for treatment out of every substance abuse dollar.

Yet, the center's chairman and former U.S. Secretary of Health, Education and Welfare Joseph Califano Jr. points out, research shows "every dollar spent on quality treatment can deliver a return of $12 or more in reduced substance abuse-related criminal justice and health care costs."

As for prevention, "17 years of research at CASA have shown that a child who reaches age 21 without smoking, using illegal drugs or abusing alcohol is virtually certain never to do so."

CASA's groundbreaking study argues strongly for society to cut its losses by focusing on prevention and treatment of what has come to be understood more and more as a chronic disease.

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