The Impact of Substance Abuse on State Budgets 2009 | CASAColumbia

Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets

Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets

Published: May 2009

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Background

Substance use and addiction costs the U.S. billions of dollars each year. This report examines just how much our failure to prevent and treat addiction costs federal, state and local governments and taxpayers, and where those costs fall.

Methods

CASAColumbia’s work for this report involved:

  • A review of more than 900 publications
  • A detailed survey of state budget offices
  • Detailed analysis of federal budget documents
  • Case studies of local budgets

Results

This 3-year study found that substance use and addiction cost federal, state and local governments at least $467.7 billion in 2005. Of every dollar that federal and state governments spent on substance use and addiction in 2005, 95.6 cents went to paying for the wreckage; only 1.9 cents went to prevention and treatment, 0.4 cents to research, 1.4 cents to taxation or regulation and 0.7 cents to interdiction.

The report is an update and expansion of CASAColumbia’s 2001 analysis of the costs of tobacco, alcohol and illegal and prescription drug abuse to state government. Using the most conservative assumptions, the study concluded that in 2005 (the most recent year for which data were available over the course of the study), federal government spending on substance use and addiction was $238 billion, state spending was $136 billion, and local government spending was $94 billion.

The report found that the largest amount of federal and state government spending on the burden of substance abuse and addiction—$207 billion (58%)—was for health care. The second largest amount—$47 billion (13%)—was spent on the justice system, including incarceration, probation, parole, and criminal, juvenile and family courts.

  • Of the $3.3 trillion in total federal and state government spending, 11% was spent on tobacco, alcohol and other drug abuse and addiction and their consequences
  • The federal government spent almost 10% of its budget on substance abuse and addiction. If substance abuse and addiction were its own budget category at the federal level, it would rank 6th, behind social security, national defense, income security, Medicare and other health programs, including the federal share of Medicaid
  • State governments spent almost 16% of their budgets to deal with substance abuse and addiction, up from 13% in 1998. If substance abuse and addiction were its own state budget category, it would rank 2nd behind spending on elementary and secondary education
  • Local governments spent $93.8 billion on substance abuse and addiction, outstripping local spending on transportation and public welfare
  • 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, and New Hampshire spent the least, $0.22
  • For every dollar the federal and state governments spent on prevention and treatment, they spent $59.83 shoveling up the consequences, despite a growing body of scientific evidence confirming the efficacy and cost savings of science-based interventions
  • With respect to children, for every dollar federal and state governments spent on prevention or treatment, they spent $60.25 shoveling up the consequences of substance abuse and addiction
  • For each dollar in alcohol and tobacco taxes and liquor store revenues that federal and state governments collect, they spent $8.95 shoveling up the consequences of substance abuse and addiction

Recommendations

The report details cost-effective methods to reverse these spending patterns and reduce human suffering. Specific recommendations for actions by federal, state and local governments are made in the areas of:

  • Prevention and early intervention
  • Treatment and disease management
  • Tax and regulatory policies
  • Expanded research

A Note on the Language
In 2012, CASAColumbia stopped using words like “drug abuse”/“drug abuser” because the terms are imprecise and have negative connotations. Instead, we now distinguish between “addiction” (clinical criteria for the disease) and “risky use” (use of addictive substances in ways that increase the risk of harm but do not meet criteria for addiction). Some reports and other publications published prior to 2012 still contain this language.

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Further information

Read the press release.

Please contact us at (212) 841.5228 for a copy of the appendix.

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