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National Assembly: Drugs, Alcohol Abuse,
and the Criminal Offender
Tuesday, December 7, 1999

The Economics of Substance Abuse Policy

Robert Taylor, Senior Administrator
Illinois Criminal Justice Information Authority
Chicago, Illinois

Henrick Harwood, Vice President
The Lewin Group
Falls Church, Virginia

Mark Shurtleff, Commissioner
Salt Lake County, Utah

Susan Foster, Vice President and Director,
Policy Research and Analysis
National Center on Addiction and Substance Abuse at Columbia University
New York, New York

Summary of Proceedings

Substance abuse is responsible for imposing multibillion dollar costs on society. It accounts for a large proportion of spending on criminal justice, public health, and mental health. It contributes to significant property and personal crime, including child abuse, domestic violence and sexual assault, and even helps generate environmental costs related to cleaning up wastes from illegal drug production. Acknowledging these costs, panelists argued that advocates must make the case for comprehensive treatment to policymakers and the public more effectively to generate support and funding.

Moderator Robert Taylor of the Illinois Criminal Justice Information Authority noted that the United States annually spends $100 billion just to incarcerate offenders in the nation's prisons; Illinois alone spends $3 billion a year. Because the vast majority of prisoners have substance abuse problems, the costs are significantly greater than they would be otherwise. Illinois, for example, funds a 660-bed corrections facility devoted to substance abusers, and treatment programs are in place in many of the state's other facilities.

Susan Foster of the National Center on Addiction and Substance Abuse at Columbia University estimated that 80 percent of the costs of incarcerating the nearly 2 million prisoners in the United States is linked to substance abuse. Substance abuse is related to 70 percent of all child welfare expenditures and consumes 20 percent of New York City's tax dollars, she said.

If the country does not put sufficient resources into a comprehensive approach that includes prevention and treatment, expenses will continue to rise. "Unless we ... focus on how we plug the drain of spending on consequences, we're never going to get ahead," Foster said. "Addiction is a disease with some particularly nasty social consequences, and people have to be held accountable for those consequences. Unless we treat the disease, we're never going to plug the drain of throwing money after this problem."

Henrick Harwood of The Lewin Group agreed, saying his research has found that two-thirds of the total economic costs associated with drug abuse relate to criminal activities. Studies that estimate the payback of treatment show that within 1 year of a treatment episode, the payback is four to six times greater than the cost of the treatment episode, he said. When effective treatment helps bring about long-term recovery, these benefits are multiplied many times over.

The discussion also focused on ways to convince elected officials to support a comprehensive, systems approach to these issues. Foster said that her agency is committed to providing a "map of spending" for elected officials and policymakers so that they will be aware not only of the costs of prevention and treatment but also of the costs that result from not funding these programs.

Mark Shurtleff, a County Commissioner in Salt Lake City, Utah, noted the difficulty faced by elected officials in making funding and programmatic decisions. In addition to understanding statistics and reports, elected officials must take into account political factors and public perceptions. With pressure from constituents to cut social welfare spending, it is difficult to educate people on the subject of effective spending for treatment now to save money later, he noted.

The key to gaining public support lies in framing the issue so that the public understand that their safety will be enhanced and that spending will decrease if treatment programs are put in place. Regardless of whether the public supports social programs, everybody understands "that big dollar sign," said Shurtleff.

Harwood added that researchers need to keep in mind the audience that ultimately will need to understand the research outcomes. If researchers can demonstrate that drug courts or monitoring or treatment programs reduce recidivism, they will be able to influence public perception, Harwood said. Similarly, Foster said the challenge is to put the findings and the knowledge from research into a form and a context that are consumable. We need to focus on subjects that are meaningful to the general public, such as crime reduction, she said. Shurtleff agreed, indicating that if elected officials and researchers spent more time together, lawmakers could have the information needed to explain policy to the voters.

Elected officials tend to have less favorable perceptions of treatment for offenders than do professionals in the public health or criminal/juvenile justice arena, panelists said—an argument supported by a poll of conference participants during the session. Foster asserted that the main reason for this difference is that tension exists over the concept that being "tough on crime" does not include treatment.

Accountability is the main reason for that tension, said Harwood. The public fears that offering treatment comes at the expense of accountability. However, he noted, accountability for one's behavior is one of the key components of an effective treatment program. Foster added that among people who have gone through treatment, many prefer prison, because treatment is very tough. She also noted that treatment and incarceration are not mutually exclusive.

In offering additional advice for collaborative work, other session participants made the following suggestions:

  • Provide cross-jurisdictional access to one another's records. Such access will enhance the ability to compile accurate information and to track program effectiveness.
  • Reframe the issues to increase the likelihood of funding. For example, in examining outcomes of drug treatment, focus on the changes in crime rates rather than on the number of people treated.
  • Deliver the message in a way elected officials can best understand it. For example, have some treatment program participants talk directly to the legislature about these programs and how they will save money.


Last Updated: March 4, 2002

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