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The Economic Costs of Alcohol and Drug Abuse in the United States - 1992

Table of Contents

Chapter 1: Executive Summary

1.1  Overview

1.2  Health Care Expenditures

1.3  Premature Death

1.4  Impaired Productivity

1.5  Motor Vehicle Crashes

1.6  Crime

1.7  Social Welfare

1.8  Who Bears the Costs of Alcohol and Drug Abuse?

1.9  Comparison With Prior Studies

1.10 Updated Estimates for 1995

Chapter 2: Introduction

2.1  Purpose of This Report

2.2  Background

2.2.1  Alcohol and Drug Abuse and Dependence in 1992
2.2.2  Trends in Alcohol and Drug Use Before and Since 1992
2.2.3  The Need To Reestimate Costs

2.3  Scope of This Study

2.4  Overview of the Report

Chapter 3: Analytical Principles in Estimating the Costs of Alcohol and Drug Abuse

3.1  Synopsis

3.2  A Short History of Cost-of-Illness Studies

3.2.1  Prior Studies on Alcohol and Drug Abuse
3.2.2  The Guidelines and the Opportunity Cost Principle

3.3  The Framework for Cost-of-Illness Studies

3.3.1  Adverse Outcomes Associated With Alcohol and Drug Abuse
3.3.2  Causality
3.3.3  Cost or Valuation Techniques

3.4  Sources and Limitations of Data

3.5  Conclusion

Chapter 4: Health Care Costs

4.1  Synopsis

4.2  Specialty Treatment for Alcohol and Other Drugs

4.2.1  Alcohol and Drug Abuse Treatment
4.2.2  Prevention
4.2.3  Support for Specialty Alcohol and Drug Services

4.3  Medical Consequences

4.3.1  Hospital Costs
4.3.2  Veterans Affairs and Other Federal Hospitals
4.3.3  Outpatient Medical Care
4.3.4  Nursing Homes
4.3.5  Pharmaceuticals
4.3.6  Other Health Professionals

4.4  Special Disease Groups

4.4.1  Fetal Alcohol Syndrome
4.4.2  Drug-Exposed Infants, Boarder Babies, and Abandoned Infants
4.4.3  Tuberculosis
4.4.4  Human Immunodeficiency Virus Infection
4.4.5  Hepatitis B and Hepatitis C Infection
4.4.6  Psychiatric Comorbidity
4.4.7  Medical Consequences of Violent Crime

4.5  Health Insurance Administration for Comorbid Health Conditions

Chapter 5: Productivity Losses

5.1  Synopsis

5.2  Mortality

5.2.1  Synopsis
5.2.2  Methodology for Estimating Deaths
5.2.3  Mortality Costs

5.3  The Impact of Alcohol and Drug Abuse Morbidity on Productivity

5.3.1  Synopsis
5.3.2  Introduction
5.3.3  Previous Studies
5.3.4  Data Source
5.3.5  The Prevalence of Alcohol, Drug, and Mental Disorders
5.3.6  Analyses
5.3.7  Productivity Losses Due to Alcohol and Drug Disorders
5.3.8  Discussion

5.4  Lost Earnings While Institutionalized and Hospitalized

5.5  Lost Earnings Among Fetal Alcohol Syndrome Victims

5.6  Crime-Related Productivity Losses

Chapter 6: Other Impacts On Society

6.1  Synopsis

6.2  Crime and the Criminal Justice System

6.2.1  Synopsis
6.2.2  Trends in Crime and Alcohol and Drug Use
6.2.3  Relationship Between Alcohol and Drug Use and Crime
6.2.4  Criminal Justice System and Victim Costs Attributed to Alcohol and Drug Abuse (Excluding Health- and Productivity-Related Costs)

6.3  Social Welfare Costs

6.3.1  Synopsis
6.3.2  The U.S. Social Welfare System
6.3.3  Methodology
6.3.4  Alcohol and Drug Abuse and Social Welfare: Prevalence and Costs
6.3.5  Conclusion

6.4  Motor Vehicle Crashes

6.5  Fire Damage and Control

Chapter 7: Analysis and Discussion

7.1  Who Bears the Costs of Alcohol and Drug Abuse?

7.1.1  The Burden on Employers
7.1.2  The Burden on Households and Families
7.1.3  Health Care Expenditures
7.1.4  Mortality - Lifetime Earnings
7.1.5  Morbidity - Lost Earnings
7.1.6  Crime-Related Costs
7.1.7  Social Welfare Administration
7.1.8  Motor Vehicle Crashes and Fire Destruction
7.1.9  Victims of Crime
7.1.10 Incarceration and Crime Career Losses - Lost Legitimate Earnings
7.1.11 Summary

7.2  Comparison with Previous Studies

7.2.1   Five Major Studies on Alcohol and Drug Costs
7.2.2  Comparison With Rice et al. (1990)

7.3  Updated Estimates for 1995

7.4  Topics for Future Study

Index of Appendices

Appendix A. Health Disorder Codes

Appendix B. Supplemental Tables For Productivity Effects

Appendix C. Supplemental Tables For Costs Related To Crime

Appendix D. Supplemental Tables For Social Welfare Costs


List of Tables

List of Figures

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