Less than Half of Treatment Admissions Result in Treatment Completion ................
In 2008,* less than half (42.1 percent) of
discharges from formal addiction treatment
services were of admissions in which treatment
was completed.^66 The highest completion rates
were from venues to which there were the
fewest admissions:
14.8 percent of admissions were to short-
term residential services which had the
highest completion rate of 54.8 percent;
11.4 percent of admissions were to longer-
term residential treatment which had a
completion rate of 45.5 percent; and
73.8 percent of admissions were to non-
residential services which had the lowest
completion rate of 39.1 percent.^67
No data are available on the extent to which
referrals were based on matching providers with
individual treatment needs.
Patients Face Formidable Barriers to Receiving Addiction Treatment .......................
In addition to the lack of treatment referrals
from the health care system, many other barriers
stand in the way of individuals accessing and
completing addiction treatment. These include:
a misunderstanding of the disease, negative
public attitudes and behavior toward those with
the disease, privacy concerns, insufficient
insurance coverage of the costs of treatment,
lack of information on how to get help, limited
availability of services including a lack of
addiction physician specialists, insufficient
social support, conflicting time commitments,
negative perceptions of the treatment process
and legal barriers. Rarely is there only one
obstacle to a person receiving needed
treatment.^68 Although comparable national data
for barriers to accessing smoking cessation
treatment are not available, research indicates
that barriers similar to those facing individuals
- Most recent available data on discharges.
seeking treatment for addiction involving
alcohol or other drugs stand in the way of
smokers accessing tobacco cessation services.^69The Spending Gap........................................................................................................
In 2010, the United States spent $43.8 billion to
treat diabetes^70 which affects 25.8 million
people,^71 $86.6 billion to treat cancer^72 which
affects 19.4 million people^73 and an estimated
$107.0 billion to treat heart conditions^74 which
affect 27.0 million people,^75 but only $28.0
billion to treat addiction† which affects 40.3
million people.‡ 76 Looking just at government
spending, CASA Columbia calculated that in
2005, risky substance use- and addiction-related
spending accounted for 10.7 percent of federal,
state and local spending, and that for every
dollar federal and state governments spent, 95.6
cents went to pay for the consequences of
substance use; only 1.9 cents was spent on any
type of prevention or treatment.§ The taxpayer
tab for government spending on the
consequences of risky substance use and
addiction alone totals almost $1,500 a year for† There are no national data that document spending
on treatment for addiction involving nicotine;
although the cost estimate of $28.0 billion applies to
the treatment of addiction involving alcohol or 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
SAMHSA’s National Expenditures for Mental
Health Services and Substance Abuse Treatment,
1986-2005 publication.
§ In addition, 0.4 cents was spent on research, 1.4
cents on taxation or regulation and 0.7 cents on
interdiction.