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Alcohol and Drug Abuse
Substance Abuse Treatment Works!

Adolescent Substance Abuse Treatment Outcomes in Hawai`i

During the state fiscal year 1997 (July 1, 1996 to June 30, 1997), six-month follow-ups were completed for a sample of 532 adolescents. Listed below are the outcomes for this sample:

Measure Performance Outcome
Achieved Six-Month
Employment/School/Vocational Training
No Arrests Since Discharge
No Substance Use in 30 Days Prior to Follow-Up
No New Substance Abuse Treatment
No Hospitalizations
No Emergency Room Visits
Stable Living Arrangements		 82.7%
80.6%
50.2%
76.7%
95.9%
80.3%
93.0%

Adult Substance Abuse Treatment Outcomes in Hawai`i

During the state fiscal year 1997 (July 1, 1996 to June 30, 1997), six-month follow-ups were completed for a sample of 1,041 adults. Listed below are the outcomes for this sample:

Measure Performance Outcome
Achieved Six-Month
Employed/School/Vocational Training
No Arrests Since Discharge
No Substance Use in 30 Days Prior to Follow-Up
No New Substance Abuse Treatment
No Hospitalizations
No Emergency Room Visits
Stable Living Arrangements		 44.1%
84.3%
65.8%
69.3%
84.5%
75.6%
77.3%

Substance Abuse Treatment Reduces Costs to Society

  1. Fact: Alcohol and drug abuse cost over $166 billion each year in lost productivity, law enforcement, criminal case processing, treatment and health care costs.

  2. Fact: In 1995, an estimated 12.8 million Americans were current illicit drug users, meaning they had used an illicit drug in the month prior to interview; this is 6.1% of the population 12 years and older.

  3. Fact: Treatment is seven times more cost effective in reducing cocaine consumption than the best supply control program in the United States.

  4. Fact: Treatment is far less expensive than the likely alternatives. One year of methadone treatment for heroin addiction costs $3,500. One year of incarceration costs $39,600. One year of untreated addiction costs society an estimated $43,200.

  5. Treatment works: Studies in various states found that:
  • $1 invested in substance abuse treatment saves taxpayers $7 in future costs;
  • that $1 invested in treatment could save $11.54 in combined medical and social costs
  • for every $1 spent on substance abuse treatment $5.60 was returned in reduced welfare, food stamps, Medicaid, crime courts, and imprisonment.
  1. Treatment works: A comparison study of drug use one year before admission to treatment and one year following discharge from substance abuse treatment shows that:
  • client's use of their primary drug decreased from 72.8% to 37.7%;
  • crack use decreased from 50.4% to 24.8% one year after treatment;
  • cocaine use decreased by more than one-half from 39.5% before treatment to 17.8% one year after treatment;
  • heroin use decreased from 23.6% to 12.6%.

    The before/after differences for all categories were statistically significant at the 0.05 level.

  1. Treatment works: California spent $209 million on substance abuse treatment for 150,000 people. Benefits received during treatment and in the first year after treatment were approximately $1.4 billion in savings to taxpayers, due mostly to reductions in crime. The average per-person annual medical bills dropped from $3,227 to $2,469, emergency room visits were cut by 38% and hospital admissions were cut by 33%.

  2. Treatment works: Results from a CSAT funded treatment evaluation shows that:
  • Crack use decreased by 85% during treatment and after one year of treatment remained down by 60%;
  • Cocaine use decreased by 62% during treatment and after one year of treatment remained down by 42%;
  • Heroin use decreased by 40% during treatment and after one year of treatment remained down by 45%;
  • Marijuana use decreased by 73% during treatment and after one year of treatment remained down by 41%;
  • Alcohol use decreased by 67% during treatment and after one year of treatment remained down by 25%.

References:

  1. Institute for Health Policy, Brandeis University. Substance Abuse: The Nation's Number one Health Problem. Robert Wood Johnson Foundation, Princeton, NJ, 1993.
  2. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Preliminary Estimates from the 1995 National Household Survey on Drug Abuse, Advance Report No. 18, August 1996.
  3. RAND Drug Policy Research Center. Modeling the Demand for Cocaine and Controlling Cocaine: Supply Versus Demand Programs, 1994.
  4. NIDA, Department of Health and Human Services. Drug abuse treatment: An economical approach to addressing the drug problem in America, 1991.
  5. Evaluating Recovery Services: The California Drug and Alcohol Treatment Assessment (CALDATA) General Report. California Department of Alcohol and Drug Programs, Sacramento, CA., 1994.
  6. Tabbush, V. "The effectiveness and efficiency of publicly funded drug abuse treatment and prevention programs in California: A benefit-cost analysis." UCLA, March 1986.
  7. Turnure, Cynthia. "The change role of State alcohol and drug agencies in State health care reform." CSAT TIE Communique, Spring 1995.
  8. National Treatment Improvement Evaluation Study, Center for Substance Abuse Treatment, 1996.
  9. Evaluating Recovery Services: The California Drug and Alcohol Treatment Assessment (CALDATA) General Report. California Department of Alcohol and Drug Programs, Sacramento, CA., 1994.
  10. National Treatment Improvement Evaluation Study, Center for Substance Abuse Treatment, 1995.

Substance Abuse Treatment Reduces Crime

  1. Fact: Thirty three percent of all criminal justice costs relate to substance abuse.

  2. Fact: State court data shows that the majority of state felony convictions in 1994 were for drug (31%) or property offenses (32%).

  3. Thirty three percent of all murders or manslaughter incidents are related to illicit drug and alcohol use. Over 50% of spousal murders are drug or alcohol related.

  4. Fact: Over 1.6 million adults (55%) in probation and parole programs need alcohol or drug treatment. Only 1.1 million (37%) of the total population of inmates receive any kind of drug treatment.

  5. Treatment works: Results of a treatment study report significant declines in criminal activity.
  • Reports of arrests of selling drugs decreased by 78.2%, from 64% to 13.9%.
  • Reports of arrests of shoplifting decreased by 81.6%, from 63.7% to 11.7%.
  • Reports of "beating someone up" decreased by 77.6%, from 49.3% to 11%.
  • Reports of arrests for any crimes decreased by 64.2%, from 48.2% to 17.2% in the comparison years.

    The before/after differences for all categories were statistically significant at the 0.05 level.

  1. Treatment works: A study in California shows that criminal behavior decreased after one year in treatment:
  • Drug sales dropped by 68%;
  • Breaking and entering dropped by 61%;
  • Selling sex dropped by 54%;
  • Use of weapons or physical force dropped by 75%.
  1. Treatment works: Treatment is 23 times more effective in reducing cocaine consumption than source country control through interdiction methods and 7.3 times more effective than domestic law enforcement methods. Treatment can effectively support law enforcement efforts.

  2. Treatment works: Treatment is an effective partner in drug court programs. Results from a Drug Court program show that drug use dropped from 100% to 40% during treatment, compared with a reduction from 100% to 70% for those not receiving treatment.

  3. The Bureau of Justice Assistance reports that drug courts, diverting nonviolent defendants from jail time to treatment, could lower the recidivism rate, increase successful treatment outcomes, and save tax payers $5,000 per defendant in jail costs alone.

  4. Treatment works: The national average of rate of recidivism and repeat arrests without substance abuse treatment is 47%. After one year of treatment:
  • Arrests in Ohio dropped by 90%;
  • Arrests in Texas dropped by 80%;
  • Arrests in California dropped by 60%;
  • Arrests in Iowa dropped by 50%.
  1. Treatment works: A drug and alcohol treatment follow-up study found that criminal activity declined by 66% following treatment, and the longer the individual remained in treatment, the greater the reduction in criminal activity.

References:

  1. Institute for Health Policy, Brandeis University. Substance Abuse: The Nation's Number one Health Problem. Robert Wood Johnson Foundation, Princeton, NJ, 1993.
  2. Felony Sentences in State Courts, 1994. Bureau of Justice Statistics Bulletin, January 1997.
  3. Criminal Victimization in the United States 1992. Bureau of Justice Statistics, January 1994.
  4. Bureau of Justice Statistics, Press Release, 1995.
  5. National Treatment Improvement Evaluation Study, Center for Substance Abuse Treatment, 1996.
  6. Evaluating Recovery Services: The California Drug and Alcohol Treatment Assessment (CALDATA) General Report. California Department of Alcohol and Drug Programs, Sacramento, CA., 1994.
  7. Rydell, Peter C. and Everingham, Susan S., Controlling Cocaine, Supply Versus Demand Program, Drug Policy Research Center, Rand. Santa Monica, California, 1995.
  8. National Treatment Improvement Evaluation Study, Center for Substance Abuse Treatment, 1995.
  9. U.S. Department of Justice, 1995.
  10. Young, N.K. Invest in Treatment for Alcohol and Other Drug Problem: It Pays. National Association of State Alcohol and Drug Directors. Washington, D.C., 1994.
  11. Evaluating Recovery Services: The California Drug and Alcohol Treatment Assessment (CALDATA) General Report. California Department of Alcohol and Drug Programs, Sacramento, CA., 1994.

Substance Abuse Treatment Reduces Health Care Costs

  1. Fact: More than 70 conditions requiring hospitalization (including cancer, heart disease, and HIV/AIDS) have risk factors associated with substance abuse; and $1 of every $5 Medicaid spends on hospital care is attributable to substance abuse or a related condition.

  2. Fact: On the average, untreated alcoholics generally incur general health care costs that are at least 100% higher than those of the non-alcoholic. In the 12 months before treatment, the alcoholic's costs are close to 300% higher.

  3. Treatment works: Substance abuse treatment reduces overall hospital admission rates by at least 38%. Hospital admissions for drug overdose decreased by 58% among those who had been treated.

  4. Treatment works: Studies in various states showed that:
  • Hospital admissions in Ohio decreased by 66% and emergency room use dropped by 41% within one year after treatment.
  • A Minnesota study found that by providing drug treatment services, the number of hospitalizations decreased by 5% in the first six months following treatment, producing $22 million in annual health care savings for 18,000 clients.
  • Among those treated for alcohol and illicit drug abuse problems in California, there was a 36% decrease in hospitalizations for physical health problems; 58% decrease in hospitalizations for drug overdoses; 44% decrease in hospitalization for mental health problems; and 25% cut in the total number of hospital days.
  1. Treatment works: Massachusetts implemented a comprehensive managed care program for delivering substance abuse and mental health services to Medicaid recipients. In the first year, use of substance abuse treatment services increased 10%, while the cost of these services declined 45% (from $28 million to $15.8 million). Savings were achieved primarily through reduced use of hospitals and increased used of detoxification centers.

  2. Treatment works: Blue Cross/Blue Shield found that families' health care costs dropped by 50% after treatment, showing a reduction from $100 a month in the two years prior to treatment to $13.34 per month in the fifth year after treatment.

  3. Treatment works: Aetna Federal Employees Health Plan showed overall health care costs of alcoholics rose from $130 to $1,370 per month prior to treatment; three years after treatment health care costs were $190 per month.

  4. Treatment works: Alcohol Health & Research World reported findings that 50 percent of the costs of alcohol and drug abuse treatment are offset within one year by subsequent reductions in medical costs by the affected family, and not just the primary patient.

  5. Treatment works: After treatment, alcohol and drug related medical visits fell from 24.7% to 11.5% and inpatient mental health visits decreased from 6.5% to 4.7%. Both of these findings indicate the potential for significant health care cost savings.

References:

  1. Center on Addiction and Substance Abuse, Columbia University. The Cost of Substance Abuse to America's Health Care System,1996.
  2. The Rutgers Study: Socioeconomic Evaluations of Addictions Treatment, 1992.
  3. Evaluating Recovery Services: The California Drug and Alcohol Treatment Assessment (CALDATA) General Report. California Department of Alcohol and Drug Programs, Sacramento, CA., 1994.
  4. Ohio Department of Alcohol and Drug Addiction Services. Unpublished data from the Comprehensive Assessment Treatment Outcome Registry (CATOR) by New Standards, Inc. St.Paul, MN., 1994.
  5. Turnure, C. Implications of the State of Minnesota's Consolidated Chemical Dependency Treatment Fund for Substance Abuse Coverage Under Health Care Reform. Testimony presented to the US Senate Labor and Human Resources Committee. Washington, D.C., March 8, 1994.
  6. Evaluating Recovery Services: The California Drug and Alcohol Treatment Assessment (CALDATA) General Report. California Department of Alcohol and Drug Programs, Sacramento, CA., 1994.
  7. McCarty, Dennis. Managed Care for Substance Abuse Treatment Services. Brandeis University, Institute for Health Policy, October 27, 1995.
  8. Holder, H.D. and Hallan, J.B. "Impact of alcoholism treatment on total health care costs: A six year study." Advances in Alcoholism and Substance Abuse, 1986:6, 1-15.
  9. Holder, H.D. and Blose, J.O. "Alcoholism treatment and total health care utilization and costs." Journal of American Medical Association, 1986:256:(11), 1456-1460.
  10. Luckey, J. "Justifying alcohol treatment on the basis of cost savings: The offset literature." Alcohol Health & Research World. National Institute of Alcoholism and Alcohol Abuse. 1987: Fall:8-15.
  11. National Treatment Improvement Evaluation Study, Center for Substance Abuse Treatment, 1996.

Substance Abuse Treatment and Women, Mothers and Infants

  1. Fact: Over 5% of the 4 million women who gave birth in the US in 1992 used illegal drugs sometime during their pregnancy; and over 750,000 women (18.8%) used alcohol at some time during their pregnancy.

  2. Fact: Over 60% of all pediatric AIDS cases are related to maternal exposure to HIV through drug use or sex with a drug user.

  3. Treatment works: In a CSAT funded program, 95% of women reported uncomplicated, drug-free births after one year of treatment; and $43,000 to $145,000 can be saved for each pregnancy and delivery uncomplicated by alcohol or substance abuse.

  4. Treatment works: Injecting drug use is the primary mode of transmission of HIV among women and is responsible for 71% of AIDS cases among women. 5. During treatment, 4% of participants became HIV-positive, compared with 16% among those who were not in treatment.

  5. Treatment works: Of women in treatment for substance abuse:
  • 95% reported uncomplicated, drug-free births;
  • 81% had no new criminal charges following treatment;
  • 75% who successfully completed treatment remained drug-free;
  • 46% obtained employment following treatment;
  • 40% eliminated or reduced their dependance on welfare.

References:

  1. National Institute on Drug Abuse. National Pregnancy and Health Survey, 1994.
  2. Center for Disease Control and Prevention, 1996.
  3. Center for Substance Abuse Treatment. Study of grantees administered by the Women and Children's Branch, 1995.
  4. Health Insurance Association of America. "Cost of maternity care, physician's fees, and hospital charges, by census region, based on Consumer Price Index, 1991. In: The Sourcebook of Health Insurance Data - 1993. Health Insurance Association of America, Washington, D.C., 1994.
  5. National Commission on AIDS. "The twin epidemics of substance use and HIV.", July 1991.
  6. Metzger, D.M., Woody, G.E., DePhillips, D. "Risks for AIDS behaviors in opiate addicts in and out of methadone treatment." Manuscript submitted. 1991.
  7. Center for Substance Abuse Treatment, quarterly report data from sampling of grant programs, Women and Children's Branch, 1995.

Substance Abuse Treatment and Business

  1. Fact: Untreated addictions cost American businesses from $50 to $100 billion each year in increased medical claims and disability costs from illnesses and injuries, theft, absenteeism, and decreased productivity.

  2. Fact: Thirty eight to 50% of all workers' compensation claims are related to the abuse of alcohol or illicit drugs in the workplace.

  3. Treatment works: Following treatment, the rate of employment increased from 50.8% to 60.3%, while the rates for homelessness and welfare receipts both decreased.

  4. Treatment works: Employment increased by 44% during treatment, and stabilized at an increase of 94% after one year of treatment.

  5. Treatment works: Annual earnings for those who completed treatment ranged from 49% higher for those who completed outpatient treatment to 136% higher among those who completed methadone treatment.

  6. Treatment works: Colorado found that substance abusers who completed treatment had an average salary increase of $2,760 a year; and the percentage of clients employed improved by 70%.

  7. Treatment works: Following treatment, worker absenteeism in Ohio decreased by 89%, tardiness by 92% and on-the-job injuries by 57%.

References:

  1. President's Commission on Model State Drug Laws, Socioeconomic Evaluations of Addictions Treatment. Rutgers University, 1993.
  2. National Council on Compensation Insurance, 1993.
  3. National Treatment Improvement Evaluation Study, Center for Substance Abuse Treatment, 1996.
  4. National Treatment Improvement Evaluation Study, Center for Substance Abuse Treatment, 1995.
  5. Finigan, M. "Societal Outcomes of Drug and Alcohol Treatment in the State of Oregon." Oregon Office of Alcohol and Drug Abuse Programs, 1996.
  6. The National Association of State Alcohol and Drug Abuse Directors. Invest in Treatment for Alcohol and Other Drug Problems; It Pays, 1994.
  7. The National Association of State Alcohol and Drug Abuse Directors. Invest in Treatment for Alcohol and Other Drug Problems; It Pays, 1994.

 

Hawaii Department of Health
Alcohol and Drug Abuse Division
601 Kamokila Blvd. Room 360
Kapolei, Hawai'i, 96707
(808) 692-7506

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