New Study Pegs 1988 Costs of ADM Disorders at $273.3 Billion

The Alcoholism Report, November 1990 | Go to article overview

New Study Pegs 1988 Costs of ADM Disorders at $273.3 Billion


New Study Pegs 1988 Costs of ADM Disorders at $273.3 Billion

A major new study estimates alcohol, drug abuse and mental (ADM) disorders cost the nation a total $218.1 billion in 1985. Updated for inflation and other factors, the 1988 economic toll rises to $273.3 billion. Mental illness was the costliest at $129.3 billion in 1988, followed by $85.8 billion for alcohol abuse and $58.3 billion for drug abuse.

Results of the study, which has been ready for some months but held up by HHS, jolted alcohol field advocates because the alcohol costs fall short of the previous estimates made in a 1984 study by Research Triangle Institute (RTI) (AR, July 31, '84). The RTI estimates, using 1980 figures updated for inflation to 1983, placed the cost of alcohol abuse to the nation at $116.7 billion, with drug abuse at $59.7 billion and mental disorders at $72.8 billion. The alcohol figure was updated most recently by NIAAA to an estimated $136.3 billion in 1990 in its Seventh Report to Congress on Alcohol and Health (AR, January, '90). The previous RTI estimates have gained wide currency in the advocacy area and have been the most consistently cited in media stories about the impact of alcohol abuse.

The new study was conducted for the Alcohol, Drug Abuse and Mental Health Administration (ADAMHA) by the University of California, San Francisco (UCSF), under the direction of Dorothy Rice, Ph.D., formerly chief of the National Center for Health Statistics. In the Executive Summary of the study, it was explained that the UCSF estimates differ from the RTI results mainly because of the use of new sources of data and "different estimation methods."

ADAMHA Administrator Frederick Goodwin, MD, said the study "reports very substantial costs, which represent imposing health and social problems," but added, "yet, we know these totals are only rock bottom estimates. They still do not represent the full economic impact of alcohol, drug and mental illness problems today. In fact, among health problems, the mental and addictive disorders in particular have been underreported consistently to avoid stigma to the patient or a negative impact on insurance reimbursements. We have no way of knowing the magnitude of the underestimates -- which clearly will vary among the three areas -- but we believe them to be substantial, especially for costs associated with alcohol and drug abuse."

Of the total economic loss of $273.3 billion, 36% was ascribed to lost and reduced productivity, measuring lost earnings of those suffering from ADM disorders; 24% went for treatment-related costs; and 16% for lost earnings due to premature death. Law enforcement, auto crashes, fires and lost productivity by crime victims and care-givers accounted for the remaining 24%.

Highlights from the study include:

* Of the total $85.8 billion projected in 1988 costs of alcohol abuse, reduced productivity accounted for $33 billion, or 38%, and mortality losses for $28.5 billion or 33%. Treatment costs were estimated at $8.7 billion, and non-health costs at $13.8 billion. * The estimated $58.3 billion cost of drug abuse in 1988 included $42.2 billion, or 72%, for non-health costs related to crime, including law enforcement, private legal expenditures and property destruction. Lost productivity cost $7.3 billion; treatment, $2.7 billion; and mortality, $3 billion. * Of the total $129.3 billion estimated costs of mental illness in 1988, lost productivity contributed $57 billion or 44%; and treatment, $55.4 billion or 43%. Mortality costs were estimated at $11 billion and nonhealth costs at $5.8 billion.

The study used new data on the prevalence of alcohol, drug and mental disorders provided by the Epidemiologic Catchment Area (ECA) survey, the first diagnosis-based population survey on mental and addictive disorders. The ECA surveys are conducted by the National Institute of Mental Health.

The executive summary of the UCSF study noted that the new estimates of ADM morbidity costs in the base year of 1985 were 21% less than those estimated for the RTI 1980 base year with substantial differences by disorder; alcohol abuse costs were 50% lower, drug abuse 77% lower, and mental illness costs 119% higher. …

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