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The National Center on Addiction and Substance Abuse at Columbia University is conducting a study on the impact of substance abuse on the budgets of the governments of the 50 states in the United States of America, the District of Columbia and Puerto Rico. The goals of the study are to provide policy makers with a map of how substance abuse affects the costs of state governments; to document the total bill for substance abuse that states pay, itemizing expenditure on prevention, treatment, research and consequences; and to point the way to more cost-effective investments.
The present article documents the methodology used in the study by the National Center on Addiction and Substance Abuse to estimate state costs linked to substance abuse. The methodology relies on previously documented costs of illness research to estimate the costs imposed by substance abuse on the health-care system and on the state workforce. It also documents costs that are directly attributable, namely, prevention, treatment, research and regulation. Finally, the methodology establishes the pool of substance-involved individuals for whom prevention and treatment may be a necessary condition of reducing public spending. The study demonstrates that states devote tremendous resources to managing the effects of substance abuse, while only a small portion of state spending is aimed at reducing substance abuse through treatment and prevention programmes. By providing a map of state spending on substance abuse, the study has established a base against which policy makers can begin to compare the value of alternative policies concerning prevention, treatment, regulation and tax that might reduce the consequences of substance abuse and addiction. Understanding the enormous costs attached to current policy choices with regard to substance abuse should help policy makers think more strategically about how they might invest in interventions that would yield a better return.
