203 



Charts 



Chart 5 breaks out the substance abuse costs in terms of the four categories of costs. 

 The largest share -- 71 percent - of substance abuse costs are for treatment of diseases and 

 conditions where substance abuse is a major risk factor. Direct treatment of substance abuse 

 disorders, such as detox units, accounted for only 19 percent of substance abuse-related 

 Medicaid costs. i 



Chart 6 



Chart 6 details the direct treatment costs for substance abuse in general hospitals. These costs 

 break down fairly evenly between alcohol and drugs. This chart does not include the 

 approximately $240 million for substance abuse treatment in psychiatric facilities. The direct 

 treatment costs in general hospitals are often not for any therapeutic treatment but, rather, for 

 short-term treatment of immediate symptoms (e.g. , stabilizing or detoxifying the patient). Costs 

 in psychiatric hospitals include more long-term therapies such as psychotherapy and drug 

 rehabilitation. 



Charts 7-8 



TTie next two charts portray in some detail the impact of substance abuse as a major risk factor 

 in a variety of diseases. For 1991 , 3.9 million hospital days costing Medicaid close to $3 billion 

 dollars were due to diseases or trauma where substance abuse was a major attributable risk 

 factor. These charts portray the pervasive impact substance abuse has on all aspects of health 

 care. Babies bom with complications due to the mother's abuse of substances during pregnancy 

 are the major contributor to these costs and account for 32 % of all Medicaid hospital days. 

 Cardiovascular diseases (15.7%) and respiratory diseases (15.7%) are the second and third 

 leading diseases where substance abuse is a major risk factor. The Appendix shows the specific 

 attributable risks of the various substances to diseases identified through the review of the 

 epidemiologic literature. 



