This report from the Open Society Institute discusses how addiction treatment reduces health care costs.   

From the Open Society Institute:

Addiction is a pervasive yet treatable chronic health condition.  Often it occurs alongside other chronic diseases.  If untreated, the addicted person's medical care becomes more costly due to secondary health conditions.  When treated, addiction leads to better health care outcomes. 

This paper demonstrates how addiction treatment will contribute to containing costs in reforming America's health system.  Studies show that addiction treatment significantly reduces emergency room, inpatient and total health care costs. 

While the overall cost savings have not been documented, there are clear signs of the potential for savings.  For example:

• One out of every 14 hospital stays - 2.3 million stays - was related to substance disorders in 2004, a federal study found.
• Total medical costs were reduced 26 percent among one group of patients that received addiction treatment.
• A group of at-risk alcohol users who received brief counseling recorded 20 percent fewer emergency department visits and 37 percent fewer days of hospitalization.

Full Report: http://www.soros.org/initiatives/treatmentgap/articles_publications/publications/paper1_20090714/paper1_20090714.pdf 

This report, based on the National Survey of Drug Use and Health (NSDUH), found that, in 2007, 8.2 percent of adolescents (an estimated 2.0 million youths aged 12 to 17) experienced at least one major depressive episode (MDE) in the past year, and about two fifths (38.9 percent) of those received treatment for depression in the past year. Among adolescents with past year MDE, those with no health insurance coverage were much less likely than those with Medicaid/Children's Health Insurance Program or private health insurance to have received treatment (17.2 vs. 42.9 and 40.6 percent, respectively). 

Download the report from SAMHSA's OAS here: http://www.oas.samhsa.gov/2k9/youthDepression/MDEandTXTforADOL.pdf 

This report presents results from survey by the Center for Studying Health System Change that examines medical and health burdens of chronic conditions, including depression. The report notes that, in 2007, 30 percent of people with chronic conditions lived in families with trouble paying their medical bills, up from 21 percent in 2003.  In addition, the report notes that while rising health care costs affect uninsured individuals more adversely than those with insurance, uninsured individuals with chronic illnesses are increasingly affected. 

Tu, H. T. and Cohen, G. R. (2009). Financial and health burdens of chronic conditions grow. Tracking Report, (24), 1-6.

Download the full report at the Center for Health System Change: http://www.hschange.com/CONTENT/1049/1049.pdf

The SAMHSA Report examines the need for and receipt of alcohol and illicit drug use treatment among young adults in 2007. 

From the report:

“Substance use disorders are preventable and treatable yet we continue as a Nation to allow the lives of 1 in 5 young people and their families be torn apart by substance abuse,” said SAMHSA Acting Administrator, Eric Broderick, D.D.S., M.P.H. 

The report reveals substantial differences among young adults receiving specialized treatment in terms of their medical health insurance coverage. Young adults covered by Medicaid/Children’s Health Insurance Program (CHIP) were more than three times as likely to receive treatment for alcohol or illicit drug use in a specialty facility as were their counterparts with private insurance (13.2 percent versus 4.0 percent).  Young adults without insurance or with other forms of insurance also received treatment at higher levels than those with private insurance (10.6 percent and 8.7 percent respectively).
 
Young Adult’s Need for and Receipt of Alcohol and Illicit Drug Use Treatment: 2007 is based on 2007 data drawn from the National Survey on Drug Use and Health (NSDUH), involving responses from 22,187 persons aged 18 to 25.

Download the full report from SAMHSA here: http://oas.samhsa.gov/2k9/157/YoungAdultsDrugTxTHTML.pdf 

This study of Expenditures on Clients Receiving Treatment for Both Mental Illness and Substance-Use Disorders was funded by the Substance Abuse and Mental Health Administration to address the gap in information on the cost of treating clients with these co-occurring disorders in the public sector. Although the data are from 1997, they were a rare source for studying expenditures across multiple States and multiple State agencies involved in treatment of people with M/SU conditions. The study analyzed treatment expenditures per public client in three States—Delaware, Oklahoma, and Washington State—after linking client data in each State across three public programs—mental health, substance abuse, and Medicaid agencies. Client data linked across multiple agencies were essential to understand fully the treatment of clients with such co-occurring disorders.

The study estimated expenditures on clients with co-occurring M/SU conditions and compared those with expenditures on clients with a single type of disorder—mental illness (MI only) and substance-use disorders only (SUD only). "Clients with co-occurring disorders" were defined in this study to include patients who were either receiving both MI and SUD services or had both types of diagnosis recorded by a mental health or substance abuse treatment program during 1997.

The numbers reported are estimates of expenditures made for three States with mental health and substance abuse (MH/SA) treatment services through three types of State programs—mental health (MH), substance abuse (SA), and Medicaid agencies. The expenditure estimates did not capture the spending on treatment of MI and/or SUD that may have occurred outside these programs in other State government departments (e.g., corrections, education, or child welfare) or other public or private systems or entities.

The authors highlight the following key findings regarding co-occurring conditions in this setting: substantial prevalence, higher total costs, spending greater than the sum of two treatments, use of most costly services, higher use of medications for severe mental illness (SMI), different client characteristics, primary responsibility with MH/SA agencies, highest level of spending on outpatient but not inpatient, comparable spending levels with clients with MI alone, and higher spending for youth versus adults. 

Download the full report (PDF): Expenditures on Clients Receiving Treatment for Both Mental Illness and Substance-Use Disorders Results from an Integrated Data Base of Mental Health Substance Abuse and Medicaid Agencies.pdf (738.21 kb)

This 2004 report examines mental health and substance abuse service utilization among individuals served by multiple public agencies in Delaware, Oklahoma and Washington. 

From the abstract:

This study examines the extent to which populations with MH and/or SA conditions utilize treatment services through Medicaid and State MH/SA Agencies. Data are from the SAMHSA Integrated Database, a multi-year file for three states combining Medicaid and State MH/SA Agency administrative data into a uniform database. Although populations with co-occurring conditions and those served by both Medicaid and State MH/SA Agencies have substantial contact with the public treatment system, a majority of the MH/SA populations examined here utilize few services over brief periods of time. Utilization is most limited among individuals with MH-only conditions and those served exclusively by Medicaid. While a lack of data on clinical outcomes prevents us from drawing conclusions about the effectiveness of MH/SA services, results of this analysis do indicate that public programs in the states examined here do not provide services that are primarily utilized on a frequent or chronic basis.

Download the full report (PDF): Mental Health and Substance Abuse Treatment Utilization Among Individuals Served by Multiple Public Agencies.pdf (231.15 kb)