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NIDA. (1998, September 1). The Economic Costs of Alcohol and Drug Abuse in the United States - 1992. Retrieved from

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Chapter 4: Health Care Costs


Treatment and prevention of alcohol and drug abuse problems and related health conditions are estimated to have cost almost $28.8 billion in 1992, of which about $18.8 billion was for alcohol problems and $9.9 billion was for drug abuse problems. Included in these estimates are the cost of specialty treatment, prevention, and support services for alcohol and drug abusers, as well as health care costs for treatment of the medical consequences of alcohol and drug abuse. Treatment of medical consequences includes inpatient and outpatient medical care, pharmaceuticals, and other services provided to persons suffering from conditions such as HIV/AIDS, infant drug or alcohol exposure, liver cirrhosis, and trauma. Findings from this analysis of health care costs are summarized in table 4.1 and include the following:

  • Treatment and prevention of alcohol and drug abuse disorders cost about $9.0 billion, and training, research, and insurance administration for treatment and prevention services cost another $1.0 billion.
  • Treatment of the medical consequences of alcohol and drug abuse cost about $18.8 billion.
  • Medical consequences of alcohol and drug abuse resulted in costs of $6.3 billion for hospitalizations and $4.9 billion for other health care services (e.g., ambulatory care and medications).
  • Special disease groups cost about $6.5 billion, including about $3.7 billion for drug abuse-related HIV/AIDS cases, $462 million for hepatitis, and $407 million for drug-exposed newborns.

Estimates reported in this study are greater than would have been expected given inflation from the previous estimate by Rice et al. (1990) for 1985 of $8.9 billion. Most of the differences can be attributed to (1) application of specific causal factors to estimate alcohol-related hospital days and other health care utilization and (2) inclusion of drug-related cases of HIV/AIDS, hepatitis, and drug-exposed newborns.

Table 4.1: Health Care Costs of Alcohol and Drug Abuse, 1992
Table 4.1: Health Care Costs of Alcohol and Drug Abuse, 1992 (millions of dollars)
Cost Total Drugs
Specialty Services and Support
Alcohol or drug abuse treatment $7,176 $4,046 $3,130
Alcohol or drug abuse prevention $1,814 $1,088 $726
Training $122 $73 $49
Research $536 $184 $352
Insurance administration $325 $182 $143
Total, Specialty Services and Support $9,973 $5,573 $4,400
Medical Consequences
Health Providers:
Hospitalization, non-Federal $5,846 $5,328 $518
Hospitalization, Federal $495 $451 $44
Outpatient medical $1,749 $1,749 0
Nursing homes $623 $623 0
Pharmaceuticals $1,581 $1,581 0
Other health professionals $935 $935 0
Special Disease Groups:
Fetal alcohol syndrome $1,944 $1,944 0
Drug-exposed infants, etc. $407 0 $407
Tuberculosis $30 0 $30
HIV/AIDS $3,700 0 $3,700
Hepatitis $462 0 $462
Violent crime $105 0 $105
Health Insurance Administration $901 $636 $265
Total, Medical Consequences $18,778 $13,247 $5,531
Total $28,751 $18,820 $9,931

Source: Analysis by The Lewin Group.
Note: Components may not sum to totals because of rounding.