Costs of Addiction

Economic and Healthcare Costs

  • It is estimated that the yearly economic impact of substance misuse is $249 billion for alcohol and $193 billion for illicit drugs. This includes costs related to crime, work productivity and healthcare.[i]
  • Excessive drinking is estimated to cost the United States $223.5 billion.[ii] 
  • Prescription opioid overdose, abuse, and dependence carries high costs for American society, with an estimated total economic burden of $78.5 billion.[iii]
  • U.S. healthcare costs attributable to the abuse of prescription painkillers totaled an estimated $25 billion in 2007. [iv]
  • Addiction is a serious driver of healthcare costs, with estimates for all substances estimated at $216B annually (2006).[v]

Employer-Related Costs

  • Health care costs for employees who have addiction problems are twice those for other employees.[i]
  • Almost half of all emergency room visits for trauma and/or injury are alcohol related.[ii]
  • Individuals who abuse alcohol use four times as many hospital stays as non-drinkers.[iii]
  • An estimated 500 million workdays are lost annually due to addiction problems.[iv]
  • Employees with addiction problems function at about two-thirds of their capability and employees who use drugs are three times more likely to be late for work.[v]
  • Substance use problems by employees have been linked to:[vi]
    • Higher healthcare expenses for injuries and illnesses
    • Higher rates of absenteeism
    • Reductions in job productivity and performance
    • More workers’ compensation and disability claims; and
    • Safety and other risks for employers.
  • Regardless of where illicit drug use or heavy alcohol use takes place, workers reporting substance use and abuse have higher rates of turnover and absenteeism: [vii]
    • Workers reporting heavy alcohol use or illicit drug use, as well as workers reporting dependence on or abuse of alcohol or illicit drugs, are more likely to have worked for more than three employers in the past year.
    • Likewise, those workers are more likely to have skipped work more than two days in the past month.
    • Workers reporting illicit drug use or dependence on or abuse of alcohol or illicit drugs were also more likely to have missed more than two days of work due to illness or injury.
  • 67% of HR professionals believe that addiction is one of the most serious issues they face in their company.[viii]
  • Only one in five HR professionals say their company openly and proactively deals with employee addiction issues.[ix]
  • The most significant problems that companies experienced due to addiction are absenteeism (62%); reduced productivity (49%); missed deadlines (31%); and increased health care costs (29%).[x]
 

Human & Social Costs

  • Many more people now die from alcohol and drug overdose each year than are killed in automobile accidents.[xi]
  • In 2014, nearly 30,000 people died due to an overdose on heroin or prescription opioids.[xii]
  • An additional roughly 20,000 people died as a result of an unintentional overdose of alcohol, cocaine, or non-opioid prescription drugs.[xiii]
  • An estimated 12 percent of children in this country live with a parent who is dependent on or abuses alcohol or other drugs.[xviii]
  • The National Survey of Child and Adolescent Well-Being (NSCAW) estimates that 61 percent of infants and 41 percent of older children in out-of-home care are from families with active alcohol or drug abuse.[xix]
  • For almost 31 percent of all children placed in foster care in 2012, parental alcohol or drug use was the documented reason for removal, and in several states that percentage surpassed 60 percent.[xx]
  • Most inmates in our nation’s prison population are there, in large part, because of substance use problems:
    • 80 percent of offenders abuse drugs or alcohol.[xxi]
    • Nearly half of jail and prison inmates are clinically addicted.[xxii]
    • About 60% of individuals arrested for most types of crimes test positive for illicit drugs at arrest.[xxiii]
  • Drinking accounts for as much as one third of all accidental deaths.[xiv]
  • Nearly 88,0009 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the fourth leading preventable cause of death in the United States.[xv]
  • In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths (31 percent of overall driving fatalities).[xvi]
  • More than 10 percent of U.S. children live with a parent with alcohol problems, according to a 2012 study. [xvii]

 

Public Sector Costs

  • In 2009, state and local governments spent $7.6 billion in 2009 (nearly a third of the U.S. total) to combat substance use disorders. These funds were disbursed across several state agencies and departments, including those devoted solely to addressing substance use disorders, as well as child protective services, corrections, and the judiciary. This total does not include state and local Medicaid expenditures; adding those contributions brings total state and local spending up to $9.4 billion. [i]
  • State governments spent almost 16% of their budgets to deal with substance abuse and addiction in 2005, up from 13% in 1998.[ii]
  • Local governments spent $93.8 billion on substance abuse and addiction, outstripping local spending on transportation and public welfare.[iii]
 



[i] The Pew Charitable Trusts and the John D. and Catherin T. MacArthur Foundation. Substance Use Disorders and the Role of the States. March 2015. http://www.pewtrusts.org/~/media/assets/2015/03/substanceusedisordersandtheroleofthestates.pdf

[ii] The National Center on Addiction and Substance Abuse. Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets. Published May 2009. http://www.centeronaddiction.org/addiction-research/reports/shoveling-ii-impact-substance-abuse-federal-state-and-local-budgets.

[iii] The National Center on Addiction and Substance Abuse. Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets. Published May 2009. http://www.centeronaddiction.org/addiction-research/reports/shoveling-ii-impact-substance-abuse-federal-state-and-local-budgets.

[i] Schneider Institute for Health Policy, Brandeis University. Substance Abuse, The Nation’s Number One Health Problem, Princeton, NJ: Robert Wood Johnson Foundation, February 2001. http://www.rwjf.org/content/dam/farm/reports/reports/2001/rwjf13550 

[ii] American College of Surgeons, Committee on Trauma. Alcohol and Injury. https://www.facs.org/~/media/files/quality%20programs/trauma/alcoholinjury.ashx

[iii] National Business Group on Health. An Employer’s Guide to Workplace Substance Abuse. August 2009. https://www.businessgrouphealth.org/pub/f3151957-2354-d714-5191-c11a80a07294

[iv] U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.  Drugs in the workplace: What an employer needs to know. Accessed Feb. 2009.

[v] U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.  Drugs in the workplace: What an employer needs to know. Accessed Feb 2009.

[vi] U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. 14 Short Employer Cost Savings Briefs. https://store.samhsa.gov/shin/content/SMA08-4350/SMA08-4350.pdf

[vii]  Larson, S.L., Eyerman, J., Foster, M.S., and Gfroerer, J.C. (2007). Worker Substance Use and Workplace Policies and Programs (DHHS Publication No. SMA 07-4273, Analytic Series A-29). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.  https://www.samhsa.gov/data/sites/default/files/NSDUH-SR169-WorkUsePandPs-2014/NSDUH-SR169-WorkUsePandPs-2014.htm

[viii] Hazelden Foundation. National Survey of Human Resources Professionals, 2007.  http://www.jtnn.org/wp-content/uploads/2013/05/Workplace-Use.pdf

[ix] Hazelden Foundation. National Survey of Human Resources Professionals, 2007.  http://www.jtnn.org/wp-content/uploads/2013/05/Workplace-Use.pdf

[x] Hazelden Foundation. National Survey of Human Resources Professionals, 2007.  http://www.jtnn.org/wp-content/uploads/2013/05/Workplace-Use.pdf

[xi] U.S. Surgeon General’s Report on Alcohol, Drugs and Health. Sidebar: The Many Consequences of Alcohol and Drug Misuse. https://addiction.surgeongeneral.gov/content/sidebar-many-consequences-alcohol-and-drug-misuse#4

[xii] U.S. Surgeon General’s Report on Alcohol, Drugs and Health. Sidebar: The Many Consequences of Alcohol and Drug Misuse. https://addiction.surgeongeneral.gov/content/sidebar-many-consequences-alcohol-and-drug-misuse#4

[xiii] Rudd, R. A., Aleshire, N., Zibbel, J. E., & Gladden, R. M. (2016). Increases in drug and opioid overdose deaths — United States, 2000–2014. MMWR, 64(50), 1378-1382. Centers for Disease Control and Prevention. (2015). Alcohol poisoning deaths. Vital signs: Alcohol poisoning kills six people each day(link is external). Accessed on April 6, 2016.  Centers for Disease Control and Prevention. (2016). CDC Wonder: Multiple cause of death 1999 - 2014.

[xiv] Hingson, R.W., Heeren, T., Jamanka, A., and Howland, J. 2000. Age of Drinking Onset and Unintentional Injury Involvement after Drinking. The Journal of the American Medical Association, 284(12): 1527-1533. Veazie, M.A., Smith, G.S. 2000. Heavy drinking, alcohol dependence and injuries at work among young workers in the United States labor force. Alcoholism: Clinical and Experimental Research. 24(12):1811-9; Dawson, D.A. 2000. Heavy Drinking and the Risk of occupational injury. Accident Analysis & Prevention. 26(5):655-65.

[xv] Centers for Disease Control and Prevention (CDC). Alcohol and public health: Alcohol-related disease impact (ARDI). Available at: http://nccd.cdc.gov/DPH_ARDI/Default/Report.aspx?T=AAM&P=f6d7eda7-036e-4553-9968-9b17ffad620e&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=AD96A9C1-285A-44D2-B76D-BA2AE037FC56&F=&D=;  

[xvi] Stahre, M.; Roeber, J.; Kanny, D.; et al. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Preventing Chronic Disease 11:E109, 2014; National Center for Statistics and Analysis. (2015, November). 2014 Crash Data Key Findings (Traffic Safety Facts Crash Stats. Report No. DOT HS 812 219). Washington, DC: National Highway Traffic Safety Administration. Available at:  http://www-nrd.nhtsa.dot.gov/Pubs/812219.pdf

[xvii] Substance Abuse and Mental Health Services Administration (SAMHSA). Data spotlight: More than 7 Million Children Live with a Parent with Alcohol Problems, 2012. http://media.samhsa.gov/data/spotlight/Spot061ChildrenOfAlcoholics2012.pdf

[xviii] U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration [SAMHSA], Office of Applied Studies, 2009.

[xix] Wulczyn, F., Ernst, M., & Fisher, P. (2011). Who are the infants in out-of-home care? An epidemiological and developmental snapshot. Chicago: Chapin Hall at the University of Chicago. http://www.chapinhall.org/sites/default/files/ publications/06_08_11_Issue%20Brief_F_1.pdf

[xx] National Data Archive on Child Abuse and Neglect, 2012.

[xxi] Belenko & Peugh (2008). Behind bars: Substance abuse and America’s prison population. New York: Center on Addiction & Substance Abuse at Columbia University.  http://www.centeronaddiction.org/addiction-research/reports/substance-abuse-prison-system-2008

[xxii] Karberg & James (2005). Substance dependence, abuse, and treatment of jail inmates, 2002. Washington, DC: Bureau of Justice Statistics, U.S. Dept. of Justice; Fazel et al. (2006). Substance abuse and dependence in prisoners: A systematic review. Addiction, 101, 181-191.  http://fazel.org/docs/Addiction%20paper.pdf 

[xxiii] National Institute of Justice. (1999). Annual report on drug use among adult and juvenile arrestees. Washington DC: U.S. Dept. of Justice. 

[i] Sacks, J. J., Gonzales, K. R., Bouchery, E. E., Tomedi, L. E., & Brewer, R. D. (2015). 2010 National and State Costs of Excessive Alcohol Consumption. American Journal of Preventive Medicine, 49(5), e73-e79. National Drug Intelligence Center. (2011). National drug threat assessment. Washington, DC: U.S. Department of Justice.

[ii] Centers for Disease Control and Prevention. Excessive Drinking Costs U.S. $223.5 Billion. http://www.cdc.gov/features/alcoholconsumption/

[iii] Curtis S. Florence et al. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013, Medical Care (2016). http://journals.lww.com/lww-medicalcare/Abstract/2016/10000/The_Economic_Burden_of_Prescription_Opioid.2.aspx

[iv] Matrix Global Advisors. Healthcare Costs from Opioid Abuse: A State-by-State Analysis. April 2015. http://www.drugfree.org/wp-content/uploads/2015/04/Matrix_OpioidAbuse_040415.pdf

[v] Robin E. Clark, Ph.D., Elizabeth O’Connell, M.S., and Mihail Samnaliev, Ph.D.; Substance Abuse and Healthcare Costs Knowledge Asset, Web site created by the Robert Wood Johnson Foundation's Substance Abuse Policy Research Program; March 2010.  http://saprp.org/knowledgeassets/knowledge_detail.cfm?KAID=21