Think of the number one, followed by a comma, followed by three zeros, followed by another comma and
three more zeros, then by yet another comma and three final zeros.
Think of the number one, followed by a comma,
followed by three zeros, followed by another comma and
three more zeros, then by yet another comma and three final zeros.
Now – add a dollar sign in front of the total.
The result is $1 billion, which someone once quipped represents “a lot
of money even if you say it fast.”
It also represents a lot of money when one considers that is the cost of addiction
in Louisiana.
Yes – $1 billion.
That is how much Louisiana spends each year to deal with the fallout of alcohol,
tobacco and drug addictions.
Again- $1 billion.
That represents 10 percent of the annual state budget – or 10 cents out of
every dollar handled by Louisiana officials.
It also represents about $243.33 per Louisiana resident. In other words, each
person in the state is paying the cost of addiction in Louisiana – literally.
And it is a high price.
Indeed, the total represents more than the state spends on Medicaid every year,
more than it spends on highways and transportation and about two-thirds of what
it spends on higher education.
Think about it – $1 billion.
Now, think about it another way.
How many pay raises could that fund for teachers?
How many roads could it pave?
How many children could it help lift off poverty?
And the worst part of it all is – the $1 billion represents only part of the
cost of substance abuse and addiction for the state of Louisiana.
The number was calculated by the National Center on Addiction and Substance
Abuse at Columbia University. The center recently released a report based on
an intensive, three-year analysis of state budgets. The lengthy report is entitled
“Shoveling Up: The Impact of Substance Abuse on State Budgets.” Included
in it is a breakdown of how much of each states budget is spent related
to substance abuse.
Overall, the numbers are staggering.
In 1998, states spent $81.3 billion on substance abuse and addiction, the report
indicates.That represents about 13.1 percent of total state spending during
that year.
It also represents a very conservative estimate.
Indeed, the study says it “significantly underestimates” the impact
of substance abuse on state finances.
For instance, it does not include federal spending within the state, local
spending or even private spending. It also does not include the cost of lost
productivity or premature deaths related to substance abuse.
And who can calculate the emotional cost?
“There is no way to measure the cost of human suffering – destroyed lives,
broken families, addicted children,” the Center on Addiction and Substance
Abuse study states.
All in all, substance abuse ranks as “the number one domestic problem”
facing the nation, the report insists.
“Abuse and addiction involving illegal drugs, alcohol and cigarettes are
implicated in virtually every domestic problem our nation faces – crime; cripplers
and killers like cancer, heart disease, AIDS and cirrhosis; child abuse and
neglect; domestic violence; teen pregnancy; chronic welfare; the rise in learning
disabled and conduct disordered children; and poor schools and disrupted classrooms,
…” says Joseph Califano Jr., president of the national addiction organization.
“Substance abuse and addiction is the elephant in the living room of state
government, overwhelming social
service systems, impeding education, causing illness, injury, death and crime,
savaging our childrenand slapping
a heavy tax on citizens of
every state.”
The problem is not limited to Louisiana.
Unfortunately, however, it is a problem “that too many of us prefer to
deny or ignore,” the study warns.
Part of the problem is that alcohol is such an accepted drug that persons have
a hard time acknowledging its devastating effects, other observers have warned.
Part of the problem also is that so much of the cost is hidden in state budgets.
It is felt in the judicial and prison systems that must deal with persons who
have committed substance abuse-related crimes, in the welfare systems overburdened
with cases exacerbated by substance abuse, in the educational system that must
spend precious money guarding against the dire effects of substance abuse on
children.
All in all, states bear an in-ordinate amount of the cost of dealing with the
problem as it impacts Medicaid programs, welfare systems, prisons, schools,
law enforcement, public safety and other areas, Califano reports.
And as if that is not enough, states also are expected to give the most support
to prevention and treatment of substance abuse, the national leader explains.
As it stands, however, precious little state money goes for those ends, the
Center on Addiction and Substance Abuse report notes. Indeed, of every such
dollar states spend related to substance abuse, only about four cents is used
to prevent and treat it, the study indicates.
“The states spend 113 times as much to clean up the devastation substance
abuse and addiction visit on children as they do to prevent and treat it,”
Califano notes.
“Each American paid $277 per year in state taxes (during 1998) to deal
with the burden of substance abuse and addiction in their social programs and
only $10 a year for prevention and treatment.”
In Louisiana, that number is even more discouraging.
Of the $1.06 billion spent on substance abuse in the state in 1998, only about
$14.5 million was allocated for prevention, treatment and research. That is
about 1.4 percent of funds related to substance abuse – or less than 2 cents
of every state dollar spent related to substance abuse.
In Louisiana, the study estimates almost 40 percent of the states $1.06
billion share is spent in the area of justice, which includes juvenile justice
and bringing people to trial and keeping them in prison or on probation.
The study also estimates that 82.7 of the annual adult corrections budget for
the state and 68.8 percent of the total juvenile justice budget are spent on
substance abuse and addiction cases.
A little more than 24 percent of the states $1.06 billion is spent in
the area of education, as elementary and secondary schools deal with the effects
of substance abuse.
Not quite 20 percent is related to health, while 6.2 percent goes for child
and family assistance matters. Once again, the report estimates 72.3 percent
of the states entire child welfare budget is spent on substance abuse-related
cases.
The rest of the states $1.06 billion includes funds related to mental
health and developmentally disabled matters, public safety and regulation and
compliance concerns.
The story is repeated in state after state – unbelievable numbers reflecting
the devastation of substance abuse.
Something has to be done, the center report concludes.
Changes have to be made.
“States that want to reduce crime, slow the rise in Medicaid spending,
move more mothers and children from welfare to work and responsible and nurturing
family life must shift from shoveling up the wreckage to preventing children
and teens from abusing drugs, alcohol and nicotine and treating individuals
who get hooked, …” Califano says.
“The choice for governors and state legislators is this: either continue
to tax their constituents for funds to shovel up the wreckage of alcohol, drug
and nicotine abuse and addiction or recast their priorities to focus on preventing
and treating such abuse and addiction.”
The most discouraging aspect of the current situation relates to children,
Califano indicates. Indeed, he refers to it as “the cruelest misallocation
of taxpayer funds.
“We know that a child who gets through age 21 without smoking, abusing
alcohol or using illegal drugs is virtually certain never to do so,” Califano
explains.
“It is a slap in the face of this knowledge for states to spend 113 times
more to shovel up the wreckage of children savaged by substance abuse and addiction
in social, criminal justice and education programs than they spend to encourage
children to stay away from these substances and treat those who ignore that
advice, …” the addiction center leader noted.
“Children are key to the lasting success of any effort to curb the costs
of substance abuse.”
Obviously, there is a need to hold persons engaging in abuse-related behaviors
accountable, Califano notes. However, states also can – and must – do a better
job at prevention and treatment, he emphasizes.
The study affirms the importance of such steps, urging states to move from
just managing the consequences of substance abuse to investing in prevention
and treatment.
Such an approach works, it emphasizes.
The study notes some balk at the idea of treating addiction. But it also warns
that unless substance abuse and addiction is treated, it will continue “to
visit more misery and costs to the people of the state.
“Only if we treat this condition do we have any hope of stemming the burdensome
social consequences,” the Center on Addiction and Substance Abuse report
contends.
The report says Oregon officials estimate that for every dollar they spend
on treatment services, they save $5.62 in state costs related to substance abuse.
Even so, Oregon currently only spends about 8.6 percent of substance abuse-related
monies on treatment and prevention – and that is the second-highest percentage
among states.
Louisiana ranks 38th in that regard, spending only about half of the national
average of $3.70.
The center study recommends that average change. It specifically calls on states
to offer help to those most likely to engage in substance abuse or to repeat
behavior related to addiction, such as prisoners and mental health clients and
parents of children in the foster care system.
It also calls on states to use regulation and taxation to reduce the impact
of substance abuse. For instance, states could require treatment for substance
abusers in state-funded programs, such as prison and the welfare system.
It also could raise taxes on substances in order to discour-
age use. For instance, in Maine, a doubling of tobacco taxes, combined with
a public anti-smoking campaign, has been credited with fostering a 27 percent
drop in smoking among high school students, the report notes.
Indeed, a 1981 study indicated a 10 percent increase in the price of cigarettes
results in a 12 percent decline in consumptions by young people ages 12 to 17.
Others studies indicate a 1 percent increase in the cost of beer results in
a 1 percent drop in traffice fatalities. They also suggest a doubling of the
federal beer tax would reduce total robberies by 4.7 percent – and murders and
rapes by 3 percent..
The study cites Louisiana as an example of effective programs. It notes a rigorous
enforcement effort in the state reduced the number of stores selling tobacco
products to minors from 75 percent in 1996 to 7 percent three years later.
The study also suggests that taxes from tobacco and alcohol sales be dedicated
to prevention and treatment efforts. It suggests that the money states are receiving
from the recent tobacco settlement provides a perfect opportunity to dedicate
funds for substance abuse prevention, treatment and research – if legislators
will do so.
Other steps are proposed as well, all aimed at helping the state focus on the
problem and deal with it.
But the report also acknowledges change will be difficult to achieve. It will
take a change of perspective on the part of state leaders used to budgeting
on a year-to-year basis.
It also will take concerned citizens promoting – and fighting – for changes
in their state legislatures.
It will take long-term commitment.
It will take hard choices.
It will take courage.
But something must be done. Simply put, the substance abuse elephant has absolutely
no intention of leaving the living room on its own.
The stakes are very high, Califano and others warn.
But the cost of not doing anything is high as well.
Indeed, as it stands, the cost literally is too high for Louisiana – and Louisiana
citizens – to keep paying.
(To download or view the entire Center on Addiction and Substance Abuse report
related to state spending on addiction, persons may visit the Web site at www.casacolumbia.org)
