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IV. POUCY IMPUCATIONS 



At least one in five dollars that Medicaid spends on hospital care is related to substance abuse. 

 This finding of the CASA study, combined with its identification of over 70 medical conditions 

 attributable in whole or in part to substance abuse, has profound implications for substance abuse 

 prevention and treatment under the Medicaid program. Moreover, given the pervasiveness of 

 smoking, and alcohol and drug abuse through all segments of American society, the implications 

 go beyond Medicaid to the entire health care system in this country. 



Investing in Research 



We need to increase our support for research that will tell us what works in prevention and 

 treatment, for whom, and at what cost. Through the Federal Agency for Health Care Policy and 

 Research and the National Institutes of Health, we are currently investing a considerable amount 

 of money in evaluating and identifying more cost-effective treatment approaches for a variety 

 of medical problems. Given the tremendous cost of substance abuse and its impact on such a 

 wide range of medical problems, greater investment in evaluating substance abuse treatment may 

 yield even greater benefits in reducing morbidity and costs. 



In addition, with respect to basic research into the causes of diseases, the Federal government 

 invests almost $10 billion studying diseases such as AIDS, cancer and cardiovascular diseases. 

 Yet, it spends only 5 % of that amount on research into what causes substance addiction and 

 abuse, a major risk factor for these and many other ailments. 



Finally, while a considerable body of qjidemiologic research already exists identifying the 



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