health care costs compared to families with
similar demographic characteristics who do not
have a member with an addiction diagnosis.^22
The health care costs associated with addiction
also stem from the impact that addiction has on
the ability to treat other diseases. Addiction
affects the body in ways that complicate health
care, for example, by weakening the immune
system.^23 These costs, however, rarely are
recognized. One study found that from 1994 to
2002, admissions of patients with addiction
increased 46 percent but hospital costs increased
134 percent; because only one percent of these
patients had a primary diagnosis of addiction,
the rise in costs was attributed to treating the co-
occurring medical illness (i.e., the primary
diagnosis).^24
In 2010, only $28.0 billion (1.0 percent) of total
health care costs* was spent on addiction
treatment-related services involving alcohol or
drugs other than nicotine. Approximately $13.0
billion was spent on treatment-related services
involving alcohol and $15.0 billion on
treatment-related services involving controlled
prescription or illicit drugs.† 25 Total costs of
treatment for addiction involving nicotine are
unknown.
In 2010, the U.S. spent $43.8 billion to treat
diabetes^26 which affects 25.8 million people,^27
$86.6 billion to treat cancer^28 which affects 19.4
million people^29 and an estimated $107.0 billion
to treat heart conditions^30 which affect 27.0
million people,^31 but only $28.0 billion to treat
addiction‡ 32 which affects 40.3 million
people.§ 33
*Including medical, mental health and direct
treatment costs.
† Treatment-related services include: detoxification
(which is not considered treatment) and diagnostic
and treatment services provided in inpatient settings
(usually a hospital), outpatient/ambulatory settings
(such as in a hospital outpatient department or
emergency department and in physicians’ and other
medical professionals’ offices and clinics) and
residential settings (24-hour care).
‡ There are no national data that document spending
on treatment for addiction involving nicotine;
although the cost estimate of $28.0 billion applies to
Cost Savings of Addiction Screening, Intervention and Treatment ................................
There are no national data available on total
health care spending for screening or
intervention services;** 34 therefore, data on cost
savings from these services and from addiction
treatment come from individual studies rather
than national data sets.In an effort to increase resources directed to
screening, intervention and treatment, much
attention has been focused on highlighting the
cost effectiveness of these services.^35 While cost
effectiveness certainly is an important
component of resource allocation and targeting,
this standard as applied to addiction is a stark
reminder of the stigma attached to the disease.^36
The United States does not use cost
effectiveness as a measure to determine which
health care treatments should be covered; in fact,the treatment of addiction involving alcohol and other
drugs excluding nicotine, the prevalence estimate of
those with addiction (40.3 million) includes those
with addiction involving nicotine.
§ Due to data limitations, the prevalence estimates for
cancer and heart conditions include individuals ages
18 and older who have ever been told by a doctor or
other health professional that they have the condition
(cancer/malignancy or a heart condition). The
prevalence estimate for diabetes includes all ages and
the estimate for addiction includes individuals ages
12 and older; for diabetes and addiction, the
prevalence estimates include both diagnosed and
undiagnosed cases. In each case, total costs of
treatment are included without regard to age. The
cost estimates for treating diabetes, cancer and heart
conditions were inflated to 2010 dollars using the
medical inflation factor (7.9 percent) found in the
Substance Abuse and Mental Health Services
Administration’s (SAMHSA) National Expenditures
for Mental Health Services and Substance Abuse
Treatment, 1986-2005 publication.
** The 2010 National Drug Control Strategy reports
on spending in one grant program through SAMHSA,
which spent $29.1 million in grants to eight states to
provide screening, brief intervention and referral to
treatment services in general medical settings, and to
11 grant recipients to include training in these
services in medical residency training programs.