Phoenix House

The national debate on health care reform has overlooked an area of vast potential savings—the treatment of substance abuse. Untreated or under-treated substance abusers are world-class consumers of health care dollars; they are repeat customers, who crowd emergency rooms and overwhelm clinics. 

A recent study by CASA, Columbia University’s National Center on Addiction and Substance Abuse, found federal and state spending on health care for drug, alcohol and tobacco abusers totaled more than $200 billion a year. A fraction of this money goes to treating addiction and promoting recovery, while the lion’s share is swallowed up by treatment of the many acute and life-threatening conditions caused by the disease. A federal study found 1 out of 14 hospitals stays each year — which account for 2.3 million admissions — are directly related to drug or alcohol abuse alone. 

Not only are substance abusers costly health care consumers, so are their children. One study found children of cocaine users incurred three times the health care costs as children of non-using parents. Another study, examining neonatal health care costs in one hospital, found that costs for newborns of women who had used cocaine during their pregnancies averaged $5,200 more than costs for infants who had not been exposed to the drug.

 Suppose we addressed the cause rather than the effect and invested in appropriate addiction treatment for the estimated 23.3 million substance abusers who need treatment but don’t receive it – and whose addiction will ultimately cost us more?  We now have a wealth of proven, evidence-based programs and practices that deal with substance abuse as the chronic condition it is. Can they bring down the cost of health care? 

They can and they have.

 A California study found that the total medical costs for men who received substance abuse treatment dropped 26 percent, while their in-patient hospital costs and emergency room bills came down by 35 and 40 percent, respectively.   

With substance abusers making up about one eighth of the nation’s Medicaid population, it seems logical to increase what we spent treating the disease, and, in so doing, reduce the enormous economic burden of treating the symptoms.