The Pew Charitable Trusts

Governors and state legislators looking for ways to save money on social programs at a time when many states face projected revenue shortfalls may want to invest more in drug prevention and treatment, according to a new three-year analysis of state spending. It shows that widespread addiction to alcohol and drugs and attendant problems - death, illness, injury, property damage, unwanted pregnancy, learning disabilities, crime, fattened welfare rolls and domestic violence - cost state governments an estimated $81.3 billion in 1998.

Widespread addiction to alcohol and drugs and attendant problems - death, illness, injury, property damage, unwanted pregnancy, learning disabilities, crime, fattened welfare rolls and domestic violence - cost state governments an estimated $81.3 billion in 1998, the study shows.

That figure represents over 13 percent of the $620 billion overall annual spending of the 50 states, Puerto Rico and the District of Columbia that year.

Most of the money went to repair damage linked to the use of drugs and alcohol. Only $3.4 billion was spent on prevention and treatment, the keys to saving money on problems created by substance abusers further down the line, the report's authors say.

"Substance abuse and addiction is the elephant in the living room of state government, creating havoc with service systems, causing illness, injury and death and consuming increasing amounts of state resources," said Joseph A. Califano, Jr., president of the National Center on Addiction and Substance Abuse at Columbia University, which prepared the report.

"Shoveling Up: The Impact of Substance Abuse on State Budgets" offers detailed, state-by-state data on how much the states poured into addiction-related expenses in sixteen categories, including corrections and the courts, education, healthcare, child and family programs, mental health and developmental disabilities, public safety, state employment, regulation, prevention, treatment and research.

Alcohol and drug use imposed the greatest burden on adult prisons, juvenile facilities and court systems, with over $30.6 billion dedicated to cleaning up after abusers, the study shows.

That news comes at a time when states are starting to consider treatment as an alternative to prison time for low-level drug offenders. While Arizona, Michigan and Washington have adjusted some of their sentencing provisions in recent years, a California initiative requiring treatment instead of prison time for first-time non-violent drug offenders passed with 61 percent of the vote in November.

This month, New York Gov. George Pataki (R), whose state lost $8.7 billion to drug and alcohol-related problems in 1998, floated a package of reforms to the mandatory minimum sentencing provisions championed in the 1970s by his predecessor, Gov. Nelson Rockefeller.

Pataki's colleagues in six states Arkansas, Hawaii, Idaho, New Mexico, Utah and Wyoming have acknowledged a need for a shift toward treatment in their annual addresses to their legislatures thus far. Few are as outspoken as New Mexico Gov. Gary Johnson (R), who has even suggested decriminalizing marijuana.

"The answer is not imprisonment and legal attack. The answer lies in sentencing reform, treatment, harm reduction and education ... The days of the "Drug War" waged against our people should come to an end," Johnson told lawmakers in Santa Fe on Jan. 16.

But the impact on other programs, such as public housing, higher education and healthcare for state employees, remains unclear. Lack of accurate data prevented analysis of spending in these areas in a report that Califano, who served as Secretary of Health, Education and Welfare under President Jimmy Carter, calls a "work in progress."

CASA prepared the study with the cooperation of national organizations representing governors, state legislators, and state budget officials and drug program directors. State officials responded to a 66-page survey designed in conjunction with the Urban Institute, the Center for Budget and Policy Priorities and researchers at Harvard University.

It shows that while California spent the most on problems linked to substance abuse (nearly $11 billion), New York's budget was the most deeply sapped by the related costs. The Empire State devoted 18 percent of its total outlay, to alcohol and drug prevention, treatment, and damage control.

Substance abuse drained more than 16 percent of funding away from social programs in Massachusetts and Minnesota as well.

The report also found that:

• Per capita spending on substance abuse cost Alaskans ($532) and Delaware residents ($500) more than residents of any other state.
• North Dakota spent the least per person ($155) of the fifty states, but contributed the highest ratio of its substance abuse funding to prevention and treatment programs, $10.22 out of every $100 spent.
• By comparison, Colorado and Michigan spent six and seven cents of every $100 in 1998 on prevention and treatment while ranking 11th and 13th on the list comparing overall budget burdens, respectively. Last year, Colorado launched three pilot drug court programs with the authority to order intensive treatment and defer sentencing for selected inmates.

Five states - Indiana, Maine, New Hampshire, North Carolina and Texas - did not respond to the survey. The CASA report includes estimated data for these states.