The Impact of Substance Abuse on Federal, State, and Local Budgets

Posted by Kendall Harmon

As the Administration and the Congress consider health care reform and work to expand access to the 45 million Americans without coverage, it is worth noting that the largest amount of federal and state spending on the burden of substance abuse and addiction--$207.2 billion, or 58 percent—was for health care, and that health care is 74.1 percent of the federal shoveling up burden. With health care costs by far the biggest cost of shoveling up, for the Administration and Congress to attempt health care reform without providing for prevention and treatment of substance abuse and addiction is like trying to make a Reuben sandwich without corned beef and sauerkraut.

Some key 2005 findings of the report are:

* For every dollar federal and state governments spent to prevent and treat substance abuse and addiction, they spent $59.83 in public programs shoveling up its wreckage.
* If substance abuse and addiction were its own state budget category, it would rank second just behind spending on elementary and secondary education.
* If substance abuse and addiction were it own federal budget category, it would rank sixth, behind social security, national defense, income security, Medicare, and other health programs including the federal share of Medicaid.
* Federal and state governments spend more than 60 times as much to clean up the devastation substance abuse and addiction visits on children as they do on prevention and treatment for them.

This report is the second in CASA’s analysis of the impact of tobacco, alcohol and other drug abuse and addiction on government. Our first report, Shoveling Up: The Impact of Substance Abuse on State Budgets, was released in 2001 and was limited to state spending. Such spending has increased since CASA’s 2001 report. In 2005, states spent 15.7 percent of their budgets on substance abuse and addiction compared with 13.3 percent in 1998, up more than 18 percent.

Read it all.



Filed under: * Culture-WatchDrugs/Drug Addiction

10 Comments
Posted May 31, 2009 at 7:06 am [Printer Friendly] [Print w/ comments]



1. Fr. Dale wrote:

So, will legalizing pot reduce the problem of drug abuse treatment expenses?

May 31, 9:04 am | [comment link]
2. Paula Loughlin wrote:

No but it may very well free up the money currently used to prosecute and jail non violent drug users for rehab and medical costs.  And I wonder if one reason that costs are so high is that most courts mandate treatment and rehab as part of probation.  So you might have a reduction from those who seek out treatment to meet court requirements.  Saving those very valuable services for the people who truly need the help.

May 31, 10:47 am | [comment link]
3. Albany+ wrote:

I once heard from someone in the addiction field that the single greatest predictor of recovery success is length of treatment. This is costly, of course, but one reason relapse is so high is that we don’t keep folks in treatment long enough.

In terms of the article, there is an even greater amount of money being spent than the Federal and State Budgets alone reflect because halfway houses, city missions, and so on frequently are not hitting hard or at all on those tax funds.  The whole addiction issue is absolutely enormous in its impact socially and financially.

As to the sad ratio of treatment dollars to “cleaning up the mess” dollars—“For every dollar federal and state governments spent to prevent and treat substance abuse and addiction, they spent $59.83 in public programs shoveling up its wreckage”—we perhaps need to face head-on the financial consequences of not adequately helping addicts themselves. The resistance to helping addicts directly I think has its seat in our aversion to “coddling” and a desire to moralize and punish. But it doesn’t make good dollar or moral sense.

As a side comment, in my pastoral experience almost every craziness in the parish can be traced back to people with heavy alcohol use. It is the “lubricant” of mischief and mischief-makers.

May 31, 1:58 pm | [comment link]
4. AnglicanFirst wrote:

“Substance abuse” is a ‘third rail’ issue that our state and federal level politicians refuse to address ‘head on.’

I have been watching political avoidance of this issue since the later 1980s, when I was responsible, in the Office of the Secretary of Defense, for staffing policy issues related to stopping the production and flow of narcotics from the Amazon Basin that included portions of Ecuador, Peru, Brazil and Bolivia, the Orinoco River Basin that included portions of Colombia and Venezuela and the Madelene River in Colombia.

The lack of progress in counter-narcotics efforts conducted by the federal and state governments over the past 30 years has been both discouraging and mind-boggling.

We are the nation that spanned an undeveloped continent with telegraph wires and rail roads in an incredibly short period of time. 

We mobilized for and won World War Two in another incredibly short period of time.

We put men on the moon within a decade of of President Kennedy’s promise that we would achieve that feat.

And yet, we haven’t made more than a small dent in the flow of narcotics from overseas into the United States during two Republican administrations and now two Democrat administrations.  The current administration seems to have no counter-narcotics plan except for a politically-expedient plan of ‘permissiveness.’

Is this all, over the past 30 years, just due to a lack of political will?  I don’t know. 

But I do know that about a number of things that could have been done and haven’t been done or where done half-heartedly.  I do know of a number of opportunities that have been lost.

But I do know that this citiation from the article says it all.

“If substance abuse and addiction were it own federal budget category, it would rank sixth, behind social security, national defense, income security, Medicare, and other health programs including the federal share of Medicaid.”

May 31, 2:35 pm | [comment link]
5. Sarha7nj wrote:

You can’t change the human heart, AnglicanFirst, simply by interdicting the drugs and trying to stop the flow into this country. Life is hard and many people are going to reach for something to make them feel better, disregarding the future consequences. I’m 33 years old and if there’s anything I’ve learned in our current culture is that every “fix” must be “instant.” Long-term consequences are difficult to comprehend and reinforce, even in my own life. I come from a long line of good Irish Catholic alcoholics and I have long considered it one of the few benefits of my control-freak nature the ability to redirect myself to more socially acceptable addictions, like television or romance novels. But these are all just coping mechanisms, because life is hard. This is a broken world. And many days it is just easier to find a “distraction” than reflect on how difficult my day was with my two special needs children who I do love but who make my life, some days, miserable. So I understand why some people reach for drugs. I am thankful I never have but in many ways, it is the grace of God that has saved me.

May 31, 4:25 pm | [comment link]
6. Fr. Dale wrote:

#4. AnglicanFirst,

As a side comment, in my pastoral experience almost every craziness in the parish can be traced back to people with heavy alcohol use. It is the “lubricant” of mischief and mischief-makers.

Well said!
Don’t forget however that the government has a conflict of interest in drug use. I would guess the tax revenues from alcohol and cigarettes runs into the billions of dollars.

May 31, 4:43 pm | [comment link]
7. JC Olbrych wrote:

“Federal and state governments spend more than 60 times as much to clean up the devastation substance abuse and addiction visits on children as they do on prevention and treatment for them.” 

This bullet point says plainly what so many folks don’t seem to want to hear.  Fetal Alcohol Exposure is the leading cause of mental retardation in this country and the single most preventable.  Because moms drink and drug, their kids are born with permanent irreversible brain damage.  Someone who is addicted to drugs or alcohol presumably can sober up and get some of their life back—for children affected by FAE it’s forever.

May 31, 4:56 pm | [comment link]
8. AnglicanFirst wrote:

Reply to Sarha7nj (#5.).

I appreciate and sympathize and emphathize with you comments. 
Life is hard and many people exhaust their internal resources when trying to cope with hardship.  Unfortunately, many don’t even have a’sense’ of the spiritual resources available to them through Jesus Christ.

But drugs are not alcohol even though both can be addictive.  Some of the narcotics available ‘on the street’ produce an almost immediate addiction in many people that appears to erase any sense of conscience, personal obligation toward others or sense of lawful behavior inthose who become addicted.  Alcohol is an old problem and we don’t need the new problems associated with the wave after wave of new drugs that have become generally popular since the 1960s.

However, one hing that can be done by the government is a concerted effort to restrict the flow of narcotics into our country to a point where their price is driven so high that they become too expensive for long term addiction.

We haven’t done this and our national and state efforts have been poorly planned, poorly supported, poorly implemented and have fallen far short of what shuld have been done and can be done.  Our political leadership, those politicians actually in control, just don’t seem to care.

May 31, 5:00 pm | [comment link]
9. Fr. Dale wrote:

#7. Jennie CO,
As a county intervention worker, it used to bother me that pregnant women would come in and discuss their problems with addictive substances. It’s too bad that they couldn’t be put into treatment programs to protect their unborn children. To me, drug use during pregnancy is child abuse but since unborn children don’t have rights, it is allowed to continue at enormous financial and personal cost. A lot is said about the horrors of abortion but to me drug abuse by pregnant moms is no lesser a horror.
#8. AnglicanFirst,

But drugs are not alcohol even though both can be addictive.

I disagree. I used treatment plans with the letters AODA. Alcohol or other drugs. Alcohol is a drug.
#7.

May 31, 5:20 pm | [comment link]
10. AnglicanFirst wrote:

Deacon Dale, my use of the terms “drugs” and “alcohol” are colloquial usages.

May 31, 6:14 pm | [comment link]
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