Research tallies price of addiction

Study finds disparity in money spent on problems, treatment

`It's an upside-down cake'

Critics question assumptions made in nationwide report

January 30, 2001|By Todd Richissin | Todd Richissin,SUN STAFF

Maryland has spent billions of dollars in the past several years on problems stemming from substance abuse while addicts remain on waiting lists for treatment, according to a major national study released yesterday.

The study sought to determine the complete cost of drug abuse to state budgets - not just dollars spent on treatment. It tallied money required for such derived costs as prison beds for addicts and special education programs for children with fetal alcohol syndrome, among other costs.

It found that in 1998, the state spent nearly $1.3 billion on addiction-related problems, while putting up about $35 million for prevention and treatment.

Maryland has nearly doubled the money allocated for treatment since then - setting aside $69 million in fiscal 2001 - but advocates for treatment say significantly more is needed.

The advocates have increasingly been trying to win funding by stressing the fiscal costs of addiction that accompany the human suffering, and yesterday's study was another step in that effort. Various national studies have concluded that for every dollar spent on drug and alcohol treatment, $5 to $7 is saved in medical, criminal justice and related costs.

Next week, a task force led by Lt. Gov. Kathleen Kennedy Townsend is expected to report that thousands of addicts in Maryland want help but cannot get it because of a continuing shortage of treatment programs. In Baltimore, hundreds of heroin addicts are on waiting lists seeking slots in methadone programs.

Yesterday's study said that like other states, Maryland spent far more money addressing problems caused by addiction than it did on prevention and treatment: Out of every dollar the state spent on addiction-related expenses, 97 cents went for prisons, schools programs, welfare and similar programs.

Less than three cents went toward treatment, and less than a penny was spent on prevention.

The study, by the National Center on Addiction and Substance Abuse at Columbia University, is the broadest of its kind, its authors said.

The study was based solely on state budgets and did not include federal dollars or losses to private businesses, which can come in the form of vandalism, increased insurance premiums and lost worker productivity.

Based on three years of research, the study determined that state governments across the country - along with the District of Columbia and Puerto Rico - spent more than $81 billion to deal with substance abuse and $3 billion on prevention, treatment and research.

"It's an upside-down cake of public policy to shovel all the money up into the wreckage and very little at the cause," said Joseph A. Califano Jr., chairman and president of the national center on addiction and a former secretary of health, education and welfare in the Carter administration.

"The numbers are there, and what they show is it's absolutely insane not to have more in the way of treatment and prevention," he added.

"It's worth it in terms of our kids, in terms of improving public health and over the long haul, it's worth it in the financial area."

Totals in the study are based on a number of assumptions, some of which critics questioned.

For example, the study determined that, nationwide, 81 percent of prison and jail inmates had a history of drug or alcohol abuse.

The authors then totaled the amount states spent on incarceration and attributed 81 percent - $487 million in Maryland and $29.8 billion nationally - to addiction.

"Estimating the cost of drug use is so complicated and requires so many difficult assumptions that it's almost useless," said Eric Wish, director of the Center for Substance Abuse Research at the University of Maryland.

"That said, it doesn't matter what the final cost is, because what we do know is that money spent on treatment and prevention, will, in the long run, save money and lives."

The study said that in Maryland in 1998, illegal drug and alcohol abuse cost taxpayers:

$63.6 million for juvenile justice, including incarceration, diversion programs and construction of facilities;

$167.5 million for elementary and secondary education, including special programs for learning disabilities associated with maternal alcohol and drug abuse, special facilities for substance-abusing children and insurance costs for staff who abuse drugs and alcohol;

$292 million in health care, including visits to emergency rooms and coverage of uninsured addicts.

"This study is another strong reason why treatment is worth funding," said Del. Dan K. Morhaim, a Baltimore County Democrat and a physician who was co-chairman of the lieutenant governor's task force on treatment.

"It's not surprising to me that there are a lot of big fiscal implications [to addiction] that we haven't fully defined. Of course, there's a lot of human costs, too, which don't have a price tag."

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