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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.
CASAColumbia’s work for this report involved:
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.
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:
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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