In 1992 the National Criminal Justice Reference Service (NCJRS) conducted a research program and determined that the cost of alcohol abuse and alcoholism was over $148 billion. These costs were calculated from the following: premature death, impaired productivity, institutionalized populations, incarceration, crime careers, and victims of alcohol-related crime.Ceoec
Another document published in 2004, again by the NCJRS estimated that those costs have increased by 40%. So that number is close to $207 billion. (And that was 10 years ago.)
However what is most interesting to me as a layperson is that none of these costs include alcohol related/influenced diseases such as, liver disease, cardiovascular disease, cancers, diabetes, and a host of others.
The cost of diabetes in the US in 2012 was more than $245 billion. (American Diabetes Association). Another study by the CDC estimates that 18% of diabetes treatment is alcohol-related. So you could add that number to the 207 billion above.
I suppose I could go on and do significant amount of research. There is a ton of research which relates the consumption of alcohol to various cancers:
• head and neck cancer, particularly oral cavity, pharynx (the throat)
• esophageal cancer,
• liver cancer,
• breast cancer
• colorectal cancer
One of the studies I read said that they were over 310,000 alcohol related cancer deaths each year. Nevermind the cost of a death how long were these individuals treated for their cancer and what was that cost? Then – there was also a whole section of research that has been done on the relationship of alcoholism and cardiovascular disease. This gets brutal.
Now I want to look at treatment costs.
I read a report by the Substance Abuse and Mental Health Services Administration (SAMHA) that said that the cost per admission of an alcoholic to a long-term residential alcohol treatment program was $3840 per admission. The cost for outpatient treatment was $7415 per admission. (I found it interesting that the cost of long-term residential alcohol and drug treatment programs was 40% lower than outpatient.)
The National Survey on Drug Use and Health estimates that 4 million people receive treatment for alcohol and drug addiction each year. (The same study said that 23.6 million people are drugs and/or alcohol dependent. (So only a fraction of the 23.6 million people – 4 million seek out treatment.)
Now – of the 4 million – 934,000 of them received inpatient treatment at a rehab facility. Two other studies estimated the effectiveness of AA, outpatient treatment, or counseling/therapy only about 20%. That means that only about 20% of those seeking help remain sober for more than a year.
That has with the rubber meets the road – the National Survey on Drug Use and Health organization says that when individuals seek long-term residential alcohol or drug treatment – three months to a year that number doubles to 40%.
Okay – I am not going to do the math here. But if you calculate the health-related costs of untreated and treated alcoholism. Including the alcohol related diseases above; IE diabetes, cancers, cardiovascular, digestive and colon related healthcare. It is not a rocket science to see that it is a huge cost effective benefit to provide long-term residential alcohol/drug rehabilitation.
There is a whole other cost that is not mentioned in this blog article I wrote: that is the emotional cost of family and friends. I wonder how many days of work I missed by family members and/or friends who are trying to help and addicted person. I wonder how many hours of ineffective work are done on the job while family members and friends are worried sick, wondering if the person they love is dead or alive. Having been around the halls of AA, and been a patient at alcohol and drug rehabilitation programs, I know this is not an exaggeration. Obviously as a recovering person I have strong feelings about the positive physical, mental, emotional benefits to both those afflicted with addiction, and those affected by addiction.
Obviously I am a proponent of long-term residential alcohol treatment, and/or long-term residential drug treatment centers.
Never Say Die…Just Die.inFOLIO Research Group
I was hoping that if I told a piece of my alcohol/drugging history and treatment it might make a difference to someone reading it on the Internet.
I grew up in a lower middle-class town outside Boston. As a teenager everyone around me drank. Everyone around me smoked pot. That was my drug of choice over alcohol. Maybe because I smoked marijuana I hung around with friends that also began to do other drugs. We had a blast.
I liked alcohol, marijuana, cocaine and methamphetamine. I consistently use marijuana every day for 20 years. In my late teens and 20s I began to go on cocaine or methamphetamine binges. I would disappear for a couple of days. When I came back I look like hell. But no one really said anything, none of my friends thought this was weird.
So this drug use continued into my 30s. In my late 30s began to see a problem. I was “disappearing” more frequently and more often. I started to swear off the alcohol, or swear off the meth, or swear off the cocaine and methamphetamine. I don’t remember any of those commitments to stop using lasting more than a month. Most of them lasted less than 24 hours.
I had a good job, I have bought a house and both of those things have evaporated. Now my friends were telling me I had a problem or they were avoiding me completely.I went to make first detox at 36 years old. I needed to get off alcohol and cocaine. I left a detox saying I was cured. The counselors at the detox wanted me to go to a 28 day program. I would hear nothing of it. I had things to do, people to see, and places to go. About six months later I returned to a different detox. Again I left with the same excuses. I avoided long-term treatment.
To make a long story short this went on for several years. I don’t know how many detoxes I went to, I just know it was a lot. Finally, I had some legal trouble and to avoid going to jail I entered into a four-month residential alcohol rehabilitation program. I remember when I went in there I was so beat up. I was so tired. All the chasing, all the drama, all the lying, all the hiding really was a nightmare. Somewhere around the second month of hanging around with all these sober guys in this alcohol rehab I started feeling really good. By the end of the fourth month I felt like I had really mastered being sober. This lasted about a year and a half.
Three or four years later than another few detoxes – but no long-term residential alcohol/ treatment programs I was worse than ever.
I could go on for some time, sharing about what I saw my family go through. I remember my parents sobbing so many times. I remember my father raging at me for what he said “you put your mother through”. He said I was evil.
So I want to fast forward a bit. Today I can look back at all those detoxes and efforts to stay clean and I see that I was committed to maintaining my “right to drink and drug”. No matter how painful it was for those around me, no matter how much I lost, the matter how ashamed that was a myself, the instant relief the drugs and alcohol gave me always won the internal mind contest.
I don’t even remember choosing to go to a long-term alcohol rehab. But I ended up in one. I was there for nine months. Here’s the difference in what I did. I worked the 12 steps with a counselor in the program who I used to call “Nazi Bill”. Of course I never said that to his face. But he was so strict about working the steps. When I did my fourth step think I wrote a couple hundred pages. I came to learn about the causes and effects of why I drank and drugged.
There were plenty of AA meetings in the area. It was a town full of alcoholics. There was a bar or a liquor store on every corner and almost an equal number of AA meetings each week. Nazi Bill insisted that I become involved with people in the program. Eventually I began to feel at the center of the pack and not on the outside. Eventually I could process those darker moments (feelings and situations that I didn’t want to be in) and I had this sense of space inside me, and I could make a decision. I had the power of choice.
I did what I did with all those early detoxes. I hate that line in AA “I had to drink every drink I did to get here.” I get it. But I can’t help but wonder what would’ve happened if I had surrendered sooner? What would’ve happened if I had done what was suggested and gone into long-term alcohol treatment sooner?
So all I can say to someone who is reading this and can identify with my past is that instead of taking six – nine – 12 months of my life to do treatment. I lost a decade being resistant. Go to it. Surrender.
In the forward to the second edition of the Big Book of Alcoholics Anonymous it says “of the alcoholics who came to AA in really tried 50% got sober at once and remained that way; 25% sobered up after some relapses, and among the remainder, those who stayed on with AA showed improvement.”trevordiy.wordpress.com
Those numbers are in sharp contrast to the effectiveness of Alcoholics Anonymous today. Most studies report that approximately 20% of those who come to Alcoholics Anonymous remain sober. The other 80% disappear or die.
There are a number of men who are still around from the 40s and 50s, when Alcoholics Anonymous was really new. When you talk to them they say that the forward to the second edition is accurate. I remember one guy saying “look! First of all there weren’t a ton of people at the meetings. It wasn’t hard to calculate who got sober, who didn’t, who died.”
So if the numbers of the early recovery are accurate what happened?
There are these AA two guys, Joe and Charlie – who are as old as dirt. They actually had a friendship with Bill Wilson and some of the other original 100. So Joe and Charlie have a program that they do around the country. I guess you could call it the “Joe and Charlie Show”.
Over the course of a long weekend they take men and women who are in AA through the 12 steps as they understand them. Joe and Charlie are so popular that there are a series of CDs that capture the entire weekend.
I have listened to these CDs several times. These guys are hilarious. The recordings are lots of fun to listen to. There is my plug for the Joe and Charlie recordings.
At one point, in the early recordings, one of them, either Joe or Charlie (I forget) addresses the whole effectiveness discussion regarding Alcoholics Anonymous then, an Alcoholics Anonymous now. I want to summarize what I heard:
• When you came into AA someone from the group was assigned/or assigned themselves to the newcomer.
• Everyone read books back then. Even in the late 50s books were the primary vehicle of communication of ideas. Great emphasis was placed on language and definition of words. People knew what words meant when they said them. New members read the Big Book. It was required reading.
• That person that was assigned to you – from the very beginning, this guide (today they call them sponsors) walked you through the steps. He told you about the history of AA, Bill story, the Oxford group, the first 100 members, etc.
• They took the 2nd, and 3rd step really seriously. In other words there was no debate about God. The direct relationship of your sobriety to your higher power, the God of your understanding, was very clearly defined. It was often spoken about from the podium and in the living rooms and kitchens of those early members.
• In the 50s and 60s, if you didn’t have a car someone would always pick you up. Old-timers speak from the podium and share the guy who always showed up even when he didn’t want to go a meeting – His sponsor would be outside his house, beeping his horn, ready to pick him up and bring him to a meeting. There was no argument. If you wanted to stay sober you just fell into line.
• The 4th step happened right away. Maybe a month or two later – but it was considered a key step to sobriety. The 4th step began immediately after you took the 3rd step.
• Joe and Charlie make it very clear that the Big Book is not a novel. It contains “precise directions” in how to stay sober. They point out the Big Book says “we immediately began this step (ie; the 4th step)after we sincerely took our third step – turning our lives and will over to the care of God as we understood Him.
• When you come into AA today, if you don’t tell anyone that you are new, most of the time you will be overlooked.
• It is extremely rare that someone in the halls will immediately make themselves your sponsor. In fact, it is expected that you will approach someone and ask them to be a sponsor. That is definitely NOT how it was in the 40s, 50s and 60s.
• For many people the Big Book serves as a “coffee coaster/drink coaster”.
• The Big Book is not the focus of recovery.
• The formula for sobriety is expressed quite often as“go to meetings, ask God for help in the morning, thank Him if you stayed sober, call your sponsor -and don’t drink!” (Joe and Charlie laugh and say how stupid this sounds to them. They say back in the 50s and 60s the message was “surrender they were powerless, turn your life over to God, clean house, develop your relationship with God, and help others.”)
• Joe and Charlie stress the speed at which society runs today. The idea of volunteering or “service work” is a novelty. So serving others in AA is a novelty.
• If you need to get picked up for AA meetings you had better get a phone list.
• Sometimes the steps 1 through 3 are as far as many newcomers go for months, and sometimes years – or their whole lives.
• Most newcomers have no idea what step 3 really means.
• For many people step 4 never happens.
• For many people a relationship with God is never established. Sometimes at a meeting the word God or Higher Power is rarely mentioned.
Joe and Charlie also stress that in the mid-70s psychological therapy became very popular. People would go to group counseling. They would go to CODA groups. These same people would come into the halls of AA and bring in these external therapeutic/foreign concepts and language. The simplicity of the 12 step program became diluted in one sense, and made very complicated in another.
John Charlie don’t talk about “how it should be, or it is a shame that this is happened”. They simply stress over and over how they got sober and why the program works. They leave it to the listener to decide how to attempt to construct, or reconstruct his or her program.
I guess that they shared this story in an effort to defend AA. When you look on the Internet there are endless number of entries that describe the “failure of AA”. Maybe the failure of these numbers of people getting sober has less to do with the actual AA program in the“precise directions” and more to do with who we have become as a society.
I can tell you one thing for certain – as a society, and as individuals we love to place the blame for failure outside ourselves. If there is one thing that I got from doing my 4th step –
I am accountable for everything that happens to me in some way or form.