Columbia University
The National Center on Addiction and Substance Abuse

In 1998, states (including the District of Columbia and Puerto Rico) spent $620 billion of their own funds to operate state government and provide public services such as education, Medicaid, child welfare, mental health and highway safety. A stunning 13.1 percent of that amount--$81.3 billion--went to shoveling up the wreckage of substance abuse and addiction, a problem that too many of us prefer to deny or ignore.

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 children--and slapping a heavy tax on citizens of every state.

This $81.3 billion is only part of the cost tobacco, alcohol, illicit and prescription drug abuse and addiction visits on America. It does not include the financial toll such abuse extracts from federal or local spending or the hefty private costs such as lost productivity or premature death. These costs far exceed the burden on state budgets. And, there is no way to measure the cost of human suffering--destroyed lives, broken families, addicted children.

This report is the result of an intensive three year analysis of the impact of substance abuse on state budgets. As part of this unprecedented study, CASA convened an advisory panel of distinguished public officials, researchers and representatives of the National Governors' Association, the National Conference of State Legislatures, the National Association of State Budget Officers and the National Association of State Alcohol and Drug Abuse Directors. To provide additional guidance, CASA formed a team of consultants with vast experience in economics, epidemiology and state government finance and budgeting.