Shot of reality
BY JULIE DELCOUR Associate Editor
Sunday, June 21, 2009
6/21/09 at 3:54 AM
It was a big story three weeks ago when U.S. Rep. John Sullivan, R-Okla., took a leave from Congress and checked himself into the Betty Ford Center in Rancho Mirage, Calif., for an intensive 30-day alcohol treatment program.
Sullivan, 44, who's battled alcohol addiction off and on since he was a teenager, is among an estimated 140,000 adult Oklahomans — about 5 percent of the state's population — in need of treatment for alcohol addiction. Also in need of treatment for drug and alcohol addiction is 6 percent of the state's 323,000 adolescents, about 20,000 teenagers.
What should have been an even bigger story that same week was a report by Columbia University's National Center on Addiction and Substance Abuse assessing the costs of tobacco, alcohol and illegal and prescription drug abuse to all levels of government. The three-year study is the first to calculate substance abuse-related spending by federal, state and local governments.
The report is enlightening and discouraging. For every dollar in tobacco and alcohol taxes collected, federal and state governments spend almost $9 dealing with the consequences of substance abuse and addiction. To put that in context, if substance abuse/addiction were its own budget category at the federal level, it would rank sixth behind Social Security, Medicare and other health programs including the federal share of Medicaid. If substance abuse/addiction were a state budget category, it would rank second behind spending on elementary and secondary education.
In 2005, the latest figures available, government spending related to smoking and abuse of alcohol and illegal drugs accounted for one-tenth of combined federal, state and local expenditures for all purposes. Most of that $468 billion went toward direct health care costs for such medical problems as cirrhosis and lung diseases. Another chunk paid law enforcement, incarceration, probation, parole and court costs. Of that $468 billion, only a piddling 1.9 percent went toward prevention, treatment and addiction research.
Joseph Califano Jr., the center's director, had this to say about that:
"This is such a stunning misallocation of resources. Under any circumstances, spending more than 95 percent of taxpayer dollars on the crime, health care costs, child abuse, domestic violence, homelessness and other consequences of tobacco, alcohol and illegal and prescription drug abuse and addiction and only 2 percent to relieve individuals and taxpayers of these burdens is a reckless misallocation of public funds."
Califano, of course, is right. But he's not running for office in Oklahoma. It's a political reality that re-directing more tax dollars toward treatment and research is not an easy sell despite indications that doing just that would pay off for the general public in the long run.
Califano attributes this imbalance to the stigma attached to addictions and the failure of governments to make investments in the short run that would pay enormous dividends to taxpayers in the long run.
It's no secret that state Secretary of Health Terri White, also commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services, has had to preach long and hard about the advantages of prevention and treatment and its benefits not only to individuals but to the taxpaying public.
And now, with state revenues lagging, spending for treatment and prevention will be lucky to remain stable much less register any major increases. I doubt White's mental health and substance abuse agency is expecting a giant stimulus check in the mail.
It's a testament to her efforts along with so many others in state government — who see the value of such programs as drug courts — that Oklahoma ranks No. 22 in the nation in the percentage of substance-abuse spending directed toward prevention and treatment. That's fairly impressive considering Oklahoma's high rate of substance abuse and given that the state usually ends up near the bottom in other measures of well-being. But even with its middle-of-the-pack ranking Oklahoma spends relatively little on prevention and treatment. For every $100 spent by state taxpayers on substance abuse problems, only $2.30 was dedicated to prevention and treatment.
We're very good at paying for the consequences of substance abuse or distancing ourselves from a problem that might have been prevented or ameliorated in the first place.
In many cases, substance abuse addiction is a preventable, treatable and manageable disease. But as the study authors noted, our nation and our state far too often continue to look the other way while addictions cause illnesses, injury, death and crime as well as filling up our prisons and overwhelming our social service systems.
We can do better. So why aren't we?
Julie DelCour, 581-8379
julie.delcour@tulsaworld.com
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