Substance Abuse Costs $511 Billion: A Cost-Benefit Analysis: Crime News

Crime in America.Net staff

We often take complex and sometimes unreadable government documents and summarize them for your reading enjoyment. The document below, however, is one of the best summations we’ve seen by any government entity. It’s shocking to think that government “might” know how to communicate without boring its readers half-to- death.

Before offering the summation of  “Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis,” by the US Substance Abuse and Mental Health Services Administration (SAMHSA), we would like to dwell once more on the marijuana debate.

We have three posts on this site on marijuana asking for a national debate on the public health consequences of legalization or decriminalization. While public opinion polls seems to be favorably disposed towards a much softer stance by the criminal justice system, there seems to be little to no debate as to what it means for the rest of us as to crime, auto accidents and other social ills.

It’s interesting that our marijuana posts received more comments than any other topic on this site (200 articles). The articles (links below) were posted on other sites (i.e., Blog Catalog) and they received hundreds of comments

Beyond the “prevention is cost effective” message, what SAMHSA is saying is that all substances have their price and that price needs to be paid by taxpayers.

Legalization and decriminalization of marijuana comes with a price and, according to considerable research, part of that price is increased crime.

It’s not the first time that citizens and their representatives approved actions that have public health consequences (i.e., states approving use of motorcycles without helmets, tobacco use) based on the belief that Americans have the right to choose their poisons, but at least voters should know what’s in store for them.

 Executive Summary: Substance Abuse Prevention Dollars and Cents

 This report reveals the importance of supporting effective prevention programs as part of a comprehensive substance abuse prevention strategy. The following patterns of use, their attendant costs, and the potential cost savings are analyzed:

  • Extent of substance abuse among youth;
  • Costs of substance abuse to the Nation and to States;
  • Cost savings that could be gained if effective prevention policies, programs, and services were implemented nationwide;
  • Programs and policies that are most cost beneficial.

Costs of Substance Abuse

 Studies have shown the annual cost of substance abuse to the Nation to be $510.8 billion in 1999 (Harwood, 2000). More specifically,

  • Alcohol abuse cost the Nation $191.6 billion;
  • Tobacco use cost the Nation $167.8 billion;
  • Drug abuse cost the Nation $151.4 billion.

 Substance abuse clearly is among the most costly health problems in the United States.

 Among national estimates of the costs of illness for 33 diseases and conditions, alcohol ranked second, tobacco ranked sixth, and drug disorders ranked seventh (National Institutes of Health [NIH], 2000).

 This report shows that programs designed to prevent substance abuse can reduce these costs.

 Savings from Effective School-Based Substance Abuse Prevention

If effective prevention programs were implemented nationwide, substance abuse initiation would decline for 1.5 million youth and be delayed for 2 years on average.

 It has been well established that a delay in onset reduces subsequent problems later in life (Grant & Dawson, 1997; Lynskey et al., 2003). In 2003, an estimated:

  •  5.6 percent fewer youth ages 13–15 would have engaged in drinking;
  • 10.2 percent fewer youth would have used marijuana;
  • 30.2 percent fewer youth would have used cocaine;
  •  8.0 percent fewer youth would have smoked regularly.

 The average effective school-based program in 2002 costs $220 per pupil including materials and teacher training, and these programs could save an estimated $18 per $1 invested if implemented nationwide.

 Nationwide, full implementation of school-based effective programming in 2002 would have had the following fiscal impact:

  •  Saved State and local governments $1.3 billion, including $1.05 billion in educational costs within 2 years;
  •  Reduced social costs of substance-abuse-related medical care, other resources, and lost productivity over a lifetime by an estimated $33.7 billion;
  •  Preserved the quality of life over a lifetime valued at $65 billion.

 Although 80 percent of American youth reported participation in school-based prevention in 2005 (SAMHSA, 2004), only 20 percent were exposed to effective prevention programs (Flewelling et al., 2005).

 Given this level of participation, it is possible that some expected benefits already exist for these students, and the estimates in this paper are adjusted for these probable benefits.

 These cost-benefit estimates show that effective school-based programs could save $18 for every $1 spent on these programs.

 In a program targeting families with low income, intensive home visitation coupled with preschool enrichment reduced infant/toddler abuse (Aos et al., 1999; Karoly et al., 1998). As these toddlers reach adolescence and adulthood, visitation programs also can reduce a range of problems including substance abuse and violence.

 Among indicated programs (targeted to individuals who have detectable symptoms), cost estimates that primarily focused on substance abuse were not available. However, estimates indicating good returns on the investment were available for several violence prevention interventions that address the roots of multi-risk behavior.

 Moral reconation therapy for adult and youth offenders, and multi-systemic therapy and functional family therapy for youth offenders returned more than $30 per dollar invested.


 The cost of substance abuse could be offset by a nationwide implementation of effective prevention policies and programs.. Communities should consider a comprehensive prevention strategy based on their unique needs and characteristics and use cost-benefit ratios to help guide their decisions. Model programs should include data on costs and estimated cost-benefit ratios to help guide prevention planning.

 See for the report.

 Crime in America.Net articles on marijuana:



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