The federal government has long claimed that there is a seven to one benefit ratio as to substance abuse treatment; for every dollar spent, we get seven dollars in benefits.
If we were to tell you that you would get one dollar back for every dollar invested, would you buy that investment? If General Motors told you that your purchase today would result in a vehicle worth seven times as much in five years, would you purchase the car?
Then why don’t we invest in drug treatment, especially as it applies to drug treatment for criminal offenders? If you go to http://crimeinamerica.net/category/drug-treatment/page/3 you will see studies stating that only a small percentage of offenders get drug treatment.
Obviously, states and counties are in the midst of a budget crisis (see http://crimeinamerica.net/category/budgetimpact/) and it’s obvious that lack of funding plays a significant factor in the lack of treatment.
But if we were honest, we would acknowledge that the percentage of criminal offenders receiving treatment has never been very large principally due to the reluctance of citizens to fund anything related to rehabilitation programs.
We within the criminal justice system need to do a much better job of selling programs for offenders. True, it’s never as simple as spend one dollar and get seven. Offenders often need several bites at the treatment apple before success, and in California, two-thirds never completed or showed up for drug treatment for a state-wide effort. There is data stating that that the principle reason for not entering treatment is that the person does not feel it’s necessary.
But in the final analysis, we get fewer crimes and a saner society if we provide sufficient drug treatment. The problem seems to be that we can’t seem to convince policy makers and citizens to support it.
Crime in America.Net staff.
Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis
Executive Summary—Substance Abuse and Mental Health Administration (SAMHSA)
Policymakers and other stakeholders can use cost-benefit analysis as an informative tool for decision making for substance abuse prevention. 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, only 20 percent were exposed to effective prevention programs . 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. 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 recognition 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. SAMHSA’s Strategic Prevention Framework should include a planning step that considers cost-benefit ratios. 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.