On May 26, the U.S. Department of Justice’s (DOJ) National Drug Intelligence Center (NDIC) released this report, estimating that illegal drug use had an economic impact of $193 billion in 2007.  The authors examined the economic impact of illegal drug use on crime, health, and productivity, attributing the primary cost of illegal drug use to lost productivity, at $120.3 billion.  The authors determined that crime and health costs of illegal drug use totaled $61.4 billion and $11.4 billion, respectively.  NDIC also employed an alternate model, under which lost productivity due to incarceration and homicide were treated as crime costs.  Under that model, crime costs totaled $113.3 billion and productivity costs were estimated at $68.4 billion, though the overall total was unchanged.

From the report:

The National Drug Intelligence Center (NDIC) prepares an annual National Drug Threat Assessment (NDTA) that provides federal policymakers and senior officials with a comprehensive appraisal of the danger that trafficking and use of illicit drugs pose to the security of our nation. To expand the scope of its NDTA, and to provide the Office of National Drug Control Policy (ONDCP) and other federal officials with a broad and deep understanding of the full burden that illicit drug use places on our country, NDIC has prepared this assessment— The Economic Impact of Illicit Drug Use on American Society. The assessment is conducted within a Cost of Illness (COI) framework that has guided work of this kind for several decades. As such, it monetizes the consequences of illicit drug use, thereby allowing its impact to be gauged relative to other social problems.

Full Report: The Economic Impact of Illicit Drug Use on American Society (PDF | 4.76 MB)

U.S. Department of Justics. (2011). The economic impact of illicit drug use on American society.

On March 30, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) released Leading Change: A Plan for SAMHSA’s Roles and Actions 2011-2014.  Developed using stakeholder input, the report outlines SAMHSA’s goals, priorities, and action steps for reducing the impact of substance abuse and mental illness.  The report explains how SAMHSA will focus its resources going forward, particularly while implementing the national health care reform law and the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA).  SAMHSA’s report outlines eight strategic initiatives: prevention of substance abuse and mental illness; trauma and justice; military families; recovery support; health reform; health information technology; data, outcomes, and quality; and public awareness and support.

From the report:

Recognizing the need to balance these opportunities and challenges, SAMHSA has identified eight Strategic Initiatives to focus its limited resources on areas of urgency and opportunity. The Initiatives will enable SAMHSA to respond to national, State, Territorial, Tribal, and local trends and support implementation of the Affordable Care Act and the Mental Health Parity and Addictions Equity Act. People are at the core of SAMHSA’s mission, and these Initiatives will guide SAMHSA’s work through 2014 to help people with mental and substance use disorders and their families build strong and supportive communities, prevent costly and painful behavioral health problems, and promote better health for all Americans.

Full report: Leading Change: A Plan for SAMHSA’s Roles and Actions 2011–2014 (PDF | 1.11MB)

SAMHSA.  (2011).  Leading change: a plan for SAMHSA's roles and actions 2011-2014. 

This report published in Psychiatric Services reviewed the recently implemented reimbursement policies for screening and brief intervention for substance misuse by Medicaid, finding that though many states allow the reimbursement of this service, current policy is not sufficient at promoting high utiltization.

Fussell, H. E., Rieckmann, T.R., and Quick M.B. Medicaid reimbursement for screening and brief intervention for substance misuse.  Psychiatric Services, 62: 306-309. doi: 10.1176/appi.ps.62.3.306. http://psychservices.psychiatryonline.org/cgi/content/abstract/62/3/306

Authors: Holly E. Fussell, Traci R. Rieckmann, and Mary Beth Quick

This report published in Psychiatric Services analyzed spending on mental health and substance use disorder treatment in the Department of Veterans Affairs, finding that from 2000 to 2006 costs decreased each year. However, in 2007, the agency experienced a large increase in spending.

Wagner, T. H., Sinnott, P. and Siroka, A. M.  Mental health and substance use disorder spending in the Department of Veterans Affairs. Psychiatric Services, 62:389-395. doi: 10.1176/appi.ps.62.4.389. http://psychservices.psychiatryonline.org/cgi/content/abstract/62/4/389

Authors: Todd H. Wagner, Patricia Sinnott, and Andrew M. Siroka

On March 15, the Medicaid and CHIP Payment and Access Commission (MACPAC) presented its first annual Report to the Congress on Medicaid and CHIP.  The report found that Medicaid covered 68 million individuals in FY2010, with state and federal spending totaling $406 billion, or 8.1 percent of federal outlays.  In addition, MACPAC determined that the Children’s Health Insurance Program (CHIP) covered 8 million children in FY2010 at a total cost of $11 billion.  Finally, the report also notes that the  Substance Abuse and Mental Health Services Administration (SAMHSA) determined that Medicaid financed 25 percent of behavioral health treatment in 2003.

From the report:

Medicaid and the State Children’s Health Insurance Program (CHIP) are sources of health care coverage for 76 million people, almost one quarter of the population. Medicaid finances health care and related services for more than 30 million low-income children, more than 10 million low-income persons with disabilities, and 6 million low- income seniors with Medicare. CHIP finances health coverage for 8 million uninsured children in families with moderate incomes above Medicaid eligibility levels.

This is the first report of the Medicaid and CHIP Payment and Access Commission (MACPAC) to the Congress. The purpose of this initial report is to contribute to a better understanding of the Medicaid and CHIP programs, their roles in the U.S. health care system, and the key policy and data issues to be addressed. This first report also sets out an analytic framework that serves as the foundation for the Commission’s future work with respect to access and payment. Also included in the Report is a compilation of Medicaid and CHIP program information, including state-specific information about program enrollment, spending, eligibility levels, Medicaid benefits covered, and the federal medical assistance percentage (FMAP). This section of the Report, called MACStats, will be a standing supplement in all Commission reports to the Congress.

Full Report: MACPAC: Report to the Congress on Medicaid and CHIP 

Medicaid and CHIP Payment and Access Commission. (2011). Report to the Congress on Medicaid and CHIP.

Psychiatric Services has published a study examining the impact of the 2001 implementation of substance abuse parity in the Federal Employee Health Benefit Program (FEHBP). Examining health plan spending and treatment utilization, the study reviewed data from six FEHBP health plans between 1999 and 2002. Comparing FEHBP plans with similar plans not offering substance abuse treatment at parity, the authors found that parity did not significantly impact substance abuse treatment utilization. However, the study found that individuals receiving substance abuse treatment in plans with parity incurred an average of $101.09 less in out-of-pocket expenses than did similar individuals in non-parity plans. The authors conclude that parity successfully lowered individuals’ costs without increasing plan costs.

Azzone, V., et. al. (2011). Effect of insurance parity on substance abuse treatment. Psychiatric Services,  62:129-134. doi: 10.1176/appi.ps.62.2.129. http://psychservices.psychiatryonline.org/cgi/content/abstract/62/2/129 

Authors: Azzone, V., Frank, R., Normand, S. T., and Burnam, A.