Treating Addiction Is Expensive. Not Treating It Is More Expensive.
“Taxpayers shell out $100M for addicts” the headlines stated on the front page of the local daily newspaper. According to the story under the headline, the $100 million was made up of $37.5 million for Medicaid-funded treatment and $71 million in other publicly funded treatment.
Clearly, the cost of treating addiction is expensive. And I’m sure the headline upset a lot of hard-working citizens. But the point the article fails to point out, is the cost to taxpayers of untreated addiction. That cost is much, much higher.
According to studies by the National Center on Addiction and Substance Abuse at Columbia University, far more government money is spent on dealing with the consequences of substance abuse than on taking steps to reduce the problem (e.g., education, research, treatment and prevention).
In fact, figures for these expenditures are calculated in billions of dollars rather than millions. How is that possible?
Consider these expenditures related to substance abuse: Criminal justice/public safety — $2 billion. Healthcare-related — $1.3 billion. Education— $1 billion. That comes to an astounding $4.3 billion. That’s before you add in another $1.5 million for additional welfare system expenditures.
Looking at it another way, for every dollar allocated to the overall problem of substance abuse, drug treatment and prevention services receive one cent. The consequences of drug abuse — such as mental health services, criminal justice, healthcare, etc. — receive the other ninety-nine cents.
So which is smarter — treating and trying to prevent addiction? Or dealing with it later?
The increase in addiction problems, especially opioid addiction, is unprecedented. A 2012 report presented by the Ohio Alliance of Recovery Providers and the Kent State University College of Public Health sheds some light on these issues.
In the early years of the 21st century, opioid use in the State of Ohio was confined mostly to urban counties and involved primarily heroin. While heroin use has increased in the intervening ten years, there has been an even more dramatic surge in prescription opioids used for non-medical purposes, as well as a significant increase in overdose deaths attributable to these drugs.
In fact, since 2007, unintentional drug poisoning/overdoses became the leading cause of injury death in Ohio, surpassing motor vehicle crashes for the first time on record. This trend continues today. At the same time, the use of opioids has spread to the majority of Ohio’s counties and is no longer just an urban phenomenon.
What can this increase in opioid use be attributed? There are several factors:
Misperceptions about safety. There is a significant disconnect between the public perception of the safety of “hard” drugs (e.g. heroin) and prescription medications. Prescription drugs are prescribed by a physician, and therefore perceived to be less of a risk that so-called “hard” drugs.
More prescription drugs are being dispensed. There has been an overall upward trend in dispensing of prescription drugs, both in individual prescriptions written and dosages prescribed. Indeed, when measured in terms of milligrams-per-person, there was a 402% increase (from 74 to 369 milligrams) between 1997 and 2007.
The rise of “Pill Mills” and the Internet. The increase has been fueled by the rise of “Pill Mills” and the Internet as sources for opioids. Some physicians see opioids as a source for profit, and dispense them freely with little regard to the health of individuals who request them.
Less funding made available for treatment and prevention. Increases in these areas have been accompanied by a corresponding decrease in funding for alcohol and drug treatment and prevention services. State funding for substance abuse treatment has eroded steadily in the last several years, by roughly one-third.
Remember, headlines don’t always tell the full story. Yes, treating addiction is expensive — but not treating it is even more expensive.
Larry Moliterno is CEO of Meridian HealthCare and currently serves as President of the Ohio Alliance of Recovery Providers. Send email to lmoliterno@MeridianCommunityCare.org