A REPORT AND COMMENTARIES

Economic cost of alcohol and drug abuse in the United States, 1992: a report

Henrick J. Harwood, Douglas Fountain & Gina Livermore

Overview

In 1992 the economic cost to society from alcohol and drug abuse was an estimated $246 billion. Alcohol abuse and alcoholism cost an estimated $148 billion, while drug abuse and dependence cost an estimated $98 billion. Adjusted for inflation and population growth, the alcohol estimates for 1992 are relatively similar to cost estimates produced over the past 20 years, while the drug estimates demonstrate a steady and strong pattern of increase. The estimates focus on costs and impacts associated with harmful use (using clinical criteria) and improper use. They represent an inventory or rollup of many different types of impacts and costs of drug and alcohol problems. This includes the costs of efforts to prevent and reduce these problems, and the costs of various types of damage attributable to abuse of alcohol or illicit drugs. Costs and impacts are included that fall on those that do and do not misuse alcohol and/or drugs, respectively.

Cost of illness (COI) studies in general, and those for alcohol and drug abuse in particular, have a well established general approach. This study and the past several have followed guidelines created by the US Public Health Service to help standardize the methods used in assess ments of the costs of different illnesses. Underlying the study of alcohol and drug abuse COI is the premise that an illness or social problem imposes ª costsº when resources are redirected as a result of that illness or problem from purposes to which they otherwise would have been devoted, including goods and services and productive time.

The general approach to this cost methodology (termed the human capital approach) in the United States was articulated by a task force of the US Public Health Service (PHS) chaired by Dorothy Rice (see Hodgson & Meiners 1979, 1982). The Guidelines were intended to reduce methodological differences between studies for different illnesses or for the same illnesses over time. The principles are general and have been applied to the alcohol and drug abuse studies performed since the Guidelines were developed. The human capital approach yields an estimate of the value of resources used or lost/foregone as a result of actual or anticipated adverse impacts of drug and alcohol dependence and or abuse.

Source: Addiction. 1999; 94: 631 635.