With limited funding available for social services in general, how can I make a case for the cost-benefit of substance abuse prevention?

The economic and social costs of substance abuse are staggering. According to one study, the United States spent 428 billion dollars on substance abuse expenses in 1995, or 1,600 dollars per person (Rice, 1999). This figure includes the following costs:

• Substance abuse treatment, other healthcare, and related expenses
• Criminal justice and victimization costs from crime
• Lost wages, production and taxes resulting from injury and premature death

The majority of these expenses come from the use of tobacco (138 billion dollars), followed by alcohol (176 billion dollars), and finally illicit drugs (114 billion dollars).

Other studies have documented the cost benefit of substance abuse prevention services such as school-based prevention education, parent outreach and training, and community anti-drug coalitions. Seven of these studies are summarized below:

• Caulkins et al. (1999) estimated benefits of two universal prevention programs (ALERT and Life Skills Training) to be a savings of $2.40 for every $1.00 spent based on fewer cocaine users.
• Holder (2000) reported benefits of environmental programs including community task forces, responsible server training, increased drunk-driving enforcement, among others to be $2.88 in savings for every $1.00 spent based on fewer automobile crashes.
• Karoly et al. (1998) estimated benefits of the Perry Preschool Project and the Elmira Prenatal Early Infant Program at $2.00 and $4.00 respectively per $1.00 spent based on reduced crime and welfare, and on increased earnings and education
• Pentz (1995) estimated benefits of a universal tobacco prevention program, which included school curriculum, mass media, parent involvement, among other strategies, to be $8.12 for every $1.00 spent, based on reduced demand for social services.
• Schweinhart et al. (1993) estimated benefits of the Perry Preschool Project—a selective program consisting of classroom activities and home visits—to be $8.74 for every $1.00 spent based on reduced crime, welfare, and victims of crime, and on increased levels of earnings and education.
• Swisher (2001) estimated the benefits of the Life Skills Training program that reduced the number of pack-a-day tobacco smokers to be $19.64 for every $1.00 spent based on reduced health-care costs.

Overall, these studies estimated that for every dollar spent on substance abuse prevention services, between approximately 2 and 20 dollars are saved. Benefits range from reductions in crime, automobile crashes, demand for social services, and health care costs, and increases in education level and earnings. It is important to note the variation among these studies in several areas such as: the population examined; whether the figures are hypothetical, estimated, or based on actual costs; and the type of prevention approach being examined.

This FAQ is based on:
Prevention Works! Costs Benefit Estimates from Prevention Research. Prepared by CSAP/SAMHSA for the 2001 NPN Research Conference.

Related Resources:

• More information on several of these programs, as well as on other effective prevention programs, visit the Database Prevention Programs: http://www.hhd.org/capt/default.asp
• National Institute on Drug Abuse. (1998). Cost-Benefit/Cost-Effectiveness Research of Drug Abuse Prevention: Implications for Programming and Policy. NIDA Research Monograph, Number 176.
• Henrick Harwood, Douglas Fountain, and Gina Livermore. (1998). The Economic Costs of Alcohol and Drug Abuse in the United States 1992. Bethesda, MD: National Institute on Drug Abuse: http://www.drugabuse.gov/about/AboutNIDA.html

References
Caulkins, J. P, et al. (1999). An Ounce of Prevention, a Pound of Uncertainty: The Cost-effectiveness of School-based Drug Prevention Programs. Rand Corporation, Santa Monica, CA.

Holder, H. D. (2000). Community Prevention of Alcohol Problems.” Addictive Behaviors, 25(6), 929-942.

Karoly, L. A., et al. (1998). Investing in Our Children: What We Know and Don’t Know about the Costs and Benefits of Early Childhood Interventions. Rand Corporation, Santa Monica, CA.

Pentz, M. A. (1995). Costs, Benefits, and Cost Effectiveness of Comprehensive Drug Abuse Prevention. In W. Bukoski and R. Evans (eds.), Cost-benefit/Cost-effectiveness Research of Drug Abuse Prevention: Implications for Programming and Policy, Research Monograph Series, No. 176., 111-129. National Institute on Drug Abuse, Rockville, MD.

Rice, D. P. (1999). Economic Costs of Substance Abuse, 1995. Proceedings of the Association of American Physicians, 111(2), 109-118.

Schweinhart, L. J., Barnes, H. V., and Weikart, D. P. (1993). Significant Benefits: The High/Scope Perry Preschool Study Through Age 27. High/Scope Educational Research Foundation, Ypsilanti, MI.

Swisher, J. D. (2001). The Costs, Cost-Effectiveness, and Cost-benefit of School and Community Counseling Services. In D. Locke, J. Meyer, and E. Herr (eds.), Handbook of Counseling, Sage, N. Y.

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