Developing and Implementing an Integrated Approach

Substance use disorders have a huge economic impact on society through health care expenditures, lost earnings, and expenses associated with crime and unintentional injuries. According to recent research, alcohol and other drug problems cost more than $484 billion each year (Belenko et al., 2005). The heaviest economic burden of these disorders falls on states and localities, with the majority of state and local spending being directed to the justice system.

Our state systems are spending too much money dealing with the problems related to alcohol and other drugs, while not delivering evidence-based practices to improve public health and public safety (Friedmann et al., 2007). Research shows that evidence-based practices reduce substance use, reduce crime, reduce incarceration, improve health, and increase employment (Belenko et al., 2005). The National Criminal Justice Treatment Practices survey conducted by NIDA’s CJ-DATS project revealed that across the states existing services provided by correctional agencies and their affiliate drug treatment agencies have little impact on public safety and changing offender behavior unless there is a greater commitment to provide substance abuse services and correctional programs that are focused on meeting the needs of offenders (Taxman et al., 2007a, 252).

State Spending on Problems Associated with Alcohol and Other Drugs

State Agencies, operating independently, spend a large percentage of their budgets dealing with alcohol and other drugs and related problems. Despite the initial economic burden, there are positive impacts realized from the prevention and treatment funded by state agencies.

State Agency *Percent of State Agency Budgets Spent on Alcohol and Drug Related Problems Positive Impact of Prevention and Treatment
Child Welfare 70% Children whose families receive appropriate drug and alcohol treatment are less likely to remain in foster care.
Criminal Justice 77% Re-arrest rates dropped from 75% to 27% when inmates received addiction treatment.
Juvenile Justice 66% Adolescent re-arrest rates decrease from 64.5% to 35.5% after one year of residential treatment.
Health 25% Families receiving addiction treatment spent $363 less a month on regular medical care than untreated families.
Mental Health 51% When mental health and substance use disorders are treated collaboratively, patients have better outcomes.
Welfare 16%-37% After completing treatment, there is a 19% increase in employment and an 11% decrease in the number of clients who receive welfare.

Integrated Treatment is Effective

A study in California compared the effects of (1) license suspension, (2) incarceration, and (3) alcohol treatment on DUI recidivism among individuals who had already received one, two or three convictions for impaired driving. Results indicated that alcohol treatment in combination with license suspension produced the best outcomes for reducing DUI recidivism among all DUI offenders, regardless of how many times they had been convicted previously (Hon, 2004).

Collaboration between the justice and medical systems can save money while decreasing substance use and associated health and legal problems. Because individuals with substance use disorders often have numerous compounding issues such as mental and physical health problems, dysfunctional families, lack of parenting skills, educational challenges, and vocational needs, it is imperative to include systems beyond the traditional fields of law and medicine in an integrated approach to address these multi-faceted problems (NIDA, 2006).

Council of the State Governments Justice Center

More information on these resources can be found at the end of this section