Substance Abuse definitions

The Elephant in the Living room of America-
Educate yourself, Lawmakers, and community leaders on the real problems facing your state and our nation.


The choice for governors and state legislators is this; either continue to tax their constituents for funds to shovel up the wreckage of alcohol, drug and nicotine abuse and addiction or recast their priorities to focus on preventing and treating such abuse and addiction.
Joseph Califano, CASA
Facts on Addiction in the U.S. The costs of addiction are many. Substance Abuse, Alcohol and Other Drug abuse, addictions create havoc on our physical and mental states, our families, our work environments, communities, and criminal justice and social service systems.
Understanding how pervasive these problems are helps us understand how pervasive the solutions must be too!
Every dollar spent on treatment leads to a $7.46 reduction in crime-related spending and lost productivity. Source: RAND Corporation Study, prepared for the Office of National Drug Control Policy and the U.S. Army, 1994.

In a study examining alcohol and interpersonal violence, results showed approximatelyone-half of all violent episodes are drug related.
Alcohol is the drug most often associated with violence. Source: Cychosz, CM. Alcohol and interpersonal violence: Implications for educators. Journal of Health Education, 27(2): 73-77, 1996

The economic cost of addiction is staggering --
it is estimated that every man, woman and child in the U.S. pays nearly $1,000 a year for unnecessary health care, extra law enforcement, auto crashes, crime and lost
 productivity that results Source: "Cost of Untreated Substance Abuse to Society," Constance M. Horgan, Sc.D., The Comminique, Spring, 1995, Center for Substance Abuse Treatment.

Two-thirds of partner abuse victims (those abused by a current
or former spouse, boyfriend or girlfriend) reported that alcohol had
been a factor; for spouse abuse victims, the offender was drinking in three
 out of four cases. Source: Greenfeld, L. Alcohol and Crime: An Analysis of National Data on the Prevalence of Alcohol Involvement in Crime. Bureau of Justice Statistics, 1998. Report # NCJ-168632.

  • There are more deaths and disabilities each year in the U.S. from substance abuse than from any other cause. 1

     
  • About 18 million Americans have alcohol problems; about 5 to 6 million Americans have drug problems. 2

     
  • More than half of all adults have a family history of alcoholism or problem drinking. 3

     
  • More than nine million children live with a parent dependent on alcohol and/or illicit drugs. 4

 

Addiction is a Brain Disease

The World Health Organization acknowledged alcoholism as a serious medical problem in 1951, and the American Medical Association declared alcoholism as a treatable illness in 1956.
The American Psychiatric Association began to use the term disease to describe alcoholism in 1965, and the American Medical Association followed in 1966.

As with many concepts and theoretical models in the addiction field, the disease concept was originally applied to alcoholism and has been generalized to addiction to other drugs as well. The "disease of addiction" is viewed as a primary disease.

ASAM-American Society of Addiction Medicine- "The nation's medical specialty society dedicated to educating physicians and improving the treatment of  individuals suffering from alcoholism and other addictions." more information

The Need for Treatment

  • Untreated addiction costs America $400 billion per year (Source: Substance Abuse: The Nation’s Number One Health Problem, Brandeis University, Schneider Institute for Health Policy, 2001)

     
  • 23 million Americans suffer from substance abuse addiction (Source: Substance Abuse: The Nation’s Number One Health Problem, Brandeis University, Schneider Institute for Health Policy, 2001)  

     
  • Untreated addiction is more expensive than 3 of the nation’s top 10 killers: 6 times more expensive than America’s number one killer: heart disease ($133.2 billion/year), 6 times more than diabetes ($130 billion/year), 4 times more than cancer ($96.1billion/year) (Source: Substance Abuse: The Nation’s Number One Health Problem, Brandeis University, Schneider Institute for Health Policy, 2001)

     
  • Drug related deaths have almost doubled since 1990--approximately one in four deaths each year is attributable to substance abuse. (Source: Substance Abuse: The Nation’s Number One Health Problem, Brandeis University, Schneider Institute for Health Policy, 2001)  

     
  • More than half of all adults have a family history of alcoholism or problem drinking. (Source: Position Paper on Drug Policy, Physician Leadership on National Drug Policy (PLNDP), Brown University Center for Alcohol and Addiction Studies, 2000)  

     
  • More than 9 million children live with a parent dependent on alcohol and/or illicit drugs. (Source: Position Paper on Drug Policy, Physician Leadership on National Drug Policy (PLNDP), Brown University Center for Alcohol and Addiction Studies, 2000)  

     
  • Heavy drinking contributes to illness in each of the top three causes of death: heart disease, cancer and stroke. (Source: Position Paper on Drug Policy, Physician Leadership on National Drug Policy (PLNDP), Brown University Center for Alcohol and Addiction Studies, 2000)

Social and Medical Barriers to Treatment

  • 82% of doctors admit that MD’s avoid addressing alcoholism in their patients. (Source: The Road to Recovery: A Landmark National Study on Public Perceptions of Alcoholism and Barriers to Treatment.  Peter D. Hart Research Associates, Inc. 1998.)  

     

  • Families need and want help: 72% of families whose doctor has not intervened to arrest addiction say they would want the doctor to do so. (Source: The Road to Recovery: A Landmark National Study on Public Perceptions of Alcoholism and Barriers to Treatment.  Peter D. Hart Research Associates, Inc. 1998.)  

     
  • A 58% majority of employers acknowledged that managers avoid addressing alcoholism in their employees. (Source: The Road to Recovery: A Landmark National Study on Public Perceptions of Alcoholism and Barriers to Treatment.  Peter D. Hart Research Associates, Inc. 1998.)  

     
  • 58% of clergy acknowledge that they avoid addressing alcoholism among the individuals and families they counsel. (Source: The Road to Recovery: A Landmark National Study on Public Perceptions of Alcoholism and Barriers to Treatment.  Peter D. Hart Research Associates, Inc. 1998.)

Treatment Works:

  • Treatment of addiction is as successful as treatment of other chronic diseases, diabetes, hypertension and asthma (Source: National Institute on Drug Abuse, Principles of Drug Addiction Treatment, 1999)

     
  • Drug treatment reduces drug use by 40-60%. (Source: National Institute on Drug Abuse, Principles of Drug Addiction Treatment, 1999)  

     
  • One year of methadone treatment costs $4700 per patient—one year of imprisonment is $18,400. (Source: National Institute on Drug Abuse, Principles of Drug Addiction Treatment, 1999)  

     
  • For every $1 spent on treatment yields a return of up to $7 in a reduction of drug related crime and criminal justice costs.  (Source: National Institute on Drug Abuse, Principles of Drug Addiction Treatment, 1999)  

     
  • When adding savings related to health care, the savings exceed costs by a ratio of 12:1. (Source: National Institute on Drug Abuse, Principles of Drug Addiction Treatment, 1999)  

     
  • No differences in success of treatment between genders, age or ethnicity. (Source: National Institute on Drug Abuse, Principles of Drug Addiction Treatment, 1999)  

     
  • The majority of employee managers (83%) believe its better for a company’s bottom-line to help employees recover from addiction than it is to terminate them for alcohol-related incidents. (Source: The Road to Recovery: A Landmark National Study on Public Perceptions of Alcoholism and Barriers to Treatment.  Peter D. Hart Research Associates, Inc. 1998.)  

     
  • Treatment saves money: A Chevron Corporation analysis indicated that $10 is saved for every $1 spent on employee rehabilitation (figure does not include savings for reduction in workplace accidents as a result of employee rehabilitation)  (Source:  Chevron Corporation, Testimony on Workplace Substance-Abuse Prevention Programs before the Subcommittee on National Security, International Affairs and Criminal Justice of the Committee on Government Reform and Oversight, U.S. House of Representatives, June 1996).  

     
  • Treatment Works: According to American Airlines, 75% to 80% of employees who received alcohol and other drug treatment had remained abstinent from substances through the entirety of the one-year monitoring activities.  (Source:  John Saylor, Manager of Employee Assistance Programs for AMR Corporation and for American Airlines, AMR’s largest subsidiary, July 28, 1998 testimony before the Senate Labor and Human Resources Committee.)  

     
  • The largest study to date on the benefits of substance abuse treatment was conducted by the University of Chicago’s National Opinion Research Center and Lewin-VHI of Fairfax, Virginia for the State of California Health and Welfare Agency’s Department of Drug and Alcohol Programs in 1994.
    • State-wide emergency room admissions dropped by 1/3 after treatment
    • The initial cost for treating 150,000 people totaled $200M, the cost savings totaled $1.5 billion.  Each day of treatment paid for itself primarily through savings incurred by avoidance of crime—benefits to California taxpayers equaled or exceeded the costs.
    • Crime declined by two-thirds from before treatment to after treatment.  The greater the length of time spent in treatment, the greater the percent reduction in criminal activity.
    • Treatment for addiction to major stimulant drugs (crack cocaine, powdered cocaine, and methamphetamine), proved equally effective to treatment for alcohol problems, and somewhat more effective than treatment for heroin problems.
    • No differences in success of treatment between genders, age or ethnicity.

Costs are Minimal for Parity in Health Plans:

  •   Providing parity for drug and alcohol treatment services does NOT increase health insurance premiums significantly: The most current governmental and private actuarial studies indicate that parity in health insurance plans costs a maximum of $1 per month of all studies conducted:

     

    • Substance abuse treatment services can be made available to employees for $5.11 a year, or 43¢ per month.  (Source: The Journal of Behavioral Health Services & Research, May 1999.  How Expensive Are Unlimited Substance Abuse Benefits Under Managed Care? By Roland Sturm, Ph.D.)

    • According to the actuarial firm of Milliman and Robertson, substance abuse parity will increase premiums by less than one percent or less than $1 per family member per month.  (Source: Milliman & Robertson, Inc., 1997.  Premium Estimates for Substance Abuse Parity Provisions for Commercial Health Insurance Products.)

    • A Dept. Health and Human Services (Substance Abuse and Mental Health Administration) study found that “if parity was limited to substance abuse, premiums would rise by only 0.2 percent.”  Substance Abuse and Mental Health Services Administration (SAMHSA) March 1998 study examined expansion of mental health and substance abuse insurance benefits found that “based on an updated actuarial model, full parity for mental health and substance abuse services is estimated to increase premiums by 3.6 percent, on average.  Mental health accounts for most of this increase.”  (Source:  SAMHSA, March 1998)

  • 5 states with parity in their health plans (California, Ohio, Oregon, Minnesota and Washington) found that costs associated with substance abuse benefits tend to have little impact on premiums or the overall spending of insurance companies and that the initial costs are offset by the resultant social benefits of treatment  (The Center for Substance Abuse Treatment’s Office of Managed Care and the Center for Mental Health Services)

1.     According to the federal Household Survey, more than 48 million Americans use alcohol an average of one or more days each week of the year. This is more than the combined total number of Americans who have ever tried cocaine, crack, and/or heroin (29.7 million), and two and a half times the number of Americans who have used marijuana once in the last year (18.7 million).

Source: Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services, National Household Survey on Drug Abuse: Population Estimates 1998 (Washington DC: US Department of Health and Human Services, 1999), pp. 19, 25, 31, 37, 85, 91, 105.

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2003 Report on Most Abused Drugs in America
Alcohol is by far the most abused drug.
Read the entire report here:
 Highlights from National Survey on Drug Use and Health (SAMHSA 2003)
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