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High Price Of Substance Abuse

Dealing with the effects of drug, alcohol and cigarette abuse cost states about as much as they pay for higher education, a private study estimates.

States spent $81.3 billion dealing with substance abuse in 1998 or about 13 percent of their budgets, according to the study released Monday by the National Center on Addiction and Substance Abuse at Columbia University.

The three-year, state-by-state study, titled Shoveling Up: The Impact of Substance Abuse on State Budgets, put New York at the top in percentage of funds -- 18 percent of its budget spent to "shovel up the wreckage" of abuse. South Carolina had the lowest percentage -- under 7 percent.

"Substance abuse and addiction is the elephant in the living room of state government, creating havoc with service systems, causing illness, injury and death and consuming increasing amounts of state resources," Joseph A. Califano Jr., the center's president, said at a press conference.

State Costs
Per Capita/ % /Total
  • Ala. $277; 13; $1,197,105
  • Alaska $532; 9.8; $323,874
  • Ariz. $205; 9.6; $931,164
  • Ark. $206; 7.8; $518,892
  • Calif. $340; 16; $10,942,032
  • Colo. $217; 12.4; $845,923
  • Conn. $267; 7.6; $873,380
  • Del. $500; 10.2; $367,591
  • D.C. $812; 15.6; $429,560
  • Fla. $215; 9.7; $3,152,481
  • Ga. $210; 9.7; $1,570,005
  • Hawaii $368; 8.6; $437,826
  • Idaho $196; 10.8; $237,025
  • Ill. $239; 12.6; $2,868,512
  • Iowa $257; 9.4; $733,857
  • Kansas $223; 9.4; $584,534
  • Ky. $245; 9.4; $956,943
  • La. $243; 10.1; $1,058,834
  • Md. $253; 10.5; $1,288,941
  • Mass. $442; 17.4; $2,701,042
  • Mich $282; 12.3; $2,754,910
  • Minn. $433; 15.8; $2,031,180
  • Miss. $178; 9.4; $486,594
  • Mo. $254; 12.9; $1,371,999
  • Mont. $291; 15.4; $255,818
  • Neb. $176; 8.2; $291,103
  • Nev. $282; 9.1; $473,045
  • N.J. $252; 10.4; $2,030,261
  • N.M. $271; 10; $467,531
  • N.Y. $478; 18; $8,673,254
  • N.D. $155; 8.1; $99,078
  • Ohio $263; 10.3; $2,951,008
  • Okla. $213; 10.5; $705,489
  • Ore. $278; 9; $902,435
  • Penn. $292; 14.5; $3,506,309
  • Puerto Rico $235; 6.1; $898,916
  • R.I. $303; 11.3; $299,421
  • S.C. $158; 6.6; $599,339
  • S.D. $176; 10.9; $128,985
  • Tenn. $173; 10; $931,532
  • Utah $242; 11.6; $499,923
  • Vt. $229; 12.3; $134,835
  • Va. $267; 11.7; $1,798,374
  • Wash. $269; 10.9; $1,509,295
  • W.Va. $187; 10.5; $338,804
  • Wis. $273; 9.5; $1,421,566
  • Wyo. $240; 7.8; $115,234

    State Average $299; 13.1; $1,563,278

    (Ind., Maine, N.H., N.C. and Texas
    not included in this list.)
    Source: National Center on Addiction and Substance Abuse at
    Columbia University.

  • Only about 4 percent of the amount spent, or $3 billion, was for prevention and treatment programs, said Califano. The rest of the money spent was drawn from state services ranging from law enforcement and welfare to health care and education.

    The report recommends greater investment in prevention and treatment, particularly among prisoners to keep them from committing drug-related crimes after their release.

    "Governors who want to curb child abuse, teen pregnancy and domestic violence and further reduce welfare rolls must face up to this reality: Unless they prevent and treat alcohol and drug abuse and addiction, their other well-intentioned efforts are doomed," Califano said.

    Meanwhile, President Bush on Monday established a White House office that would distribute billions of dollars to religious groups and charities over the next 10 years. One role for the groups would be to administer drug treatment programs.

    Califano called the plan "a big help" and said it was "long ovrdue to get the faith community involved with substance abuse prevention."

    Total state spending in 1998 was $620 billion, with 13.1 percent related to substance abuse, the report said. By comparison, states spent on average 13.1 percent of their budgets on higher education, 11.3 percent on Medicaid and 8.3 percent on transportation.

    State justice systems had the largest portion of the expenses attributed to substance abuse, spending $30.7 billion on prisons, juvenile justice and court costs.

    The White House Office of National Drug Control Policy
    said the report demonstrates the need for a "balanced strategy" to deal with drug abuse.

    "We cannot simply arrest our way out of the problem," Edward H. Jurith, acting director of the office, said in a statement. "Treatment programs that follow a criminal from arrest to post-release follow-up must be implemented to end the cycle of drug abuse and crime."

    Federal estimates, using 1995 data, place the overall federal, state and local costs of drug and alcohol use at $277 billion annually, including law enforcement and social programs.

    The new study, which does not include federal funds, relied on data from the states about their spending on prevention programs, research and health care costs directly related to substance abuse. For indirect costs, researchers estimated the "burden" on state resources.

    For example, to estimate substance abuse costs in elementary and high school education, researchers considered the expenses caused by all abusers. Mothers who drink while pregnant and have children with fetal alcohol syndrome influence the costs of special education when those kids go to school. Student drug use affects the need for drug testing and health care, and drug-related violence might require more spending on security and repairs. Teachers who abuse substances can cost the state in productivity, work time and more expensive health insurance.

    Of the states, New York's estimated 18 percent amounted to more than $8.6 billion. Massachusetts was second, spending 17.4 percent of its budget, or $2.7 billion, followed by California, which spent nearly $11 billion, or 16 percent of its state budget.

    Puerto Rico spent the smallest percentage of its budget, 6.1 percent, on substance abuse. South Carolina spent 6.6 percent, and Connecticut spent 7.6 percent of its budget.

    In terms of substance-abuse spending per person, however, the District of Columbia topped the list, laying out $812 per resident. North Dakota spent the least, $155 per person.

    Susan Foster, the study's principal researcher, cautioned against comparisons between states because the report does not include federal funds and states spend different proportions of their budgets on social programs.

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