The Most Dangerous of All Drug

The Most Dangerous of All Drugs

By Mark Bedillion 1995

We always hear about the war on drugs. The war on drugs will never be won. Why? Because the most dangerous of all drugs, alcohol is not being addressed. Alcohol has killed and destroyed more people than any other problem known to man. Alcohol is a gateway drug. A gateway drug is one that opens the door to other drugs. Yet we are kept in the dark as to the fatal effects of alcohol. I would estimate that 95% of all persons who are incarcerated are there due to alcohol or some other drug related offense. Many people are misdiagnosed with mental illness, when if fact alcohol is causing the bizarre behaviors.

Alcohol is a very subtle drug. The person with an alcohol problem is usually the last to know. How dangerous is a chemical that does not allow the user to even see they are behaving irrationally? Alcohol will tell you that you have no problem.

There is an old Chinese proverb:

"The man takes a drink; The drink takes a drink; The drink takes the man."

Alcohol has destroyed many men and women and children. As a matter of fact, alcohol has destroyed many families. The State sells alcohol then arrests the person for the behavior produced while using it. For example, let's say a person is charged with drunk driving. The person bought and used the alcohol legally. All of a sudden, the person is now in jail, charged with a crime. There was no warning label on the bottle of alcohol about the dangers of operating a vehicle when drinking. Who is to tell the teenager that experimenting with alcohol could cost him/her their lives, not to mention the lives of others? This is a deadly game. All without a warning. What a paradox. Extremely profitable from both sides, however. What is wrong with this picture?

People rarely start off using marijuana, cocaine, heroine, amphetamines, or any other drug. The first drug most people consume is alcohol. Alcohol is legal, socially acceptable, and easily accessible. Once people begin using alcohol, their inhibitions and abilities are dramatically lessened. Alcohol impairs all the senses and is responsible for extremely poor decision making.

Let's count some of the costs of alcohol consumption:

1. Violence (assault, murder, rape, incest, etc.).
2. Other sexual offenses (adultery, prostitution, pornography, etc.).
3. Automobile accidents and deaths.
4. Suicide.
5. Depression.
6. Lost work.
7. Poor work performance.
8. Building more jails and institutions.
9. Mental institution admissions.
10. Homelessness.
11. Broken families.

What is the relationship between prevention and health care cost containment? Twenty-five to forty percent of all Americans in general hospital beds are there for treatment of complications of alcoholism.

There is probably no problem more critical to the future of America than that of health care cost containment. A very large part of the national health care bill is for alcohol and other drug-related medical expenses. For example, as you read this, twenty-five to forty percent of all Americans in general hospital beds are there for treatment of complications of alcoholism.[1] We have only recently had the studies to show how great a part of the Nation's health care cost bill ATOD problems really are.

These costs can be thought of in the following categories:

• Cost of alcoholism or other drug addiction treatment: This would include detoxification, psychotherapy, counseling, methadone maintenance, therapeutic communities, smoking cessation (including nicotine patches), and the like.
• Cost of the other direct health consequences to the users of alcohol, tobacco, and other drugs: Alcohol use affects virtually every organ of the body, including the skin. It increases risk of liver disease, cancer, and a variety of other diseases. Tobacco, and its relationship to cancer and heart disease, produces costs to treat these diseases. And, illicit drug use causes a variety of health complications, including overdoses. Ten percent of all infant deaths are attributed to maternal cigarette smoking.
• Cost of medical treatment for non-using third parties: These costs range from the treatment of drug-exposed infants to the treatment of disease caused by passive smoking; from the trauma treatment of alcohol-related injuries to the mental health treatment of the families and loved ones of Americans with alcohol, tobacco, or other drug problems. Between twenty and thirty percent of low birth weight deliveries are caused by maternal cigarette smoking,[2] and about ten percent of all infant deaths are attributed to the same cause.[3]

There has been no comprehensive study of all of these costs performed to date, and such an analysis is beyond the scope of this article. As a result, there can be no single reliable estimate of each of these three cost areas, much less the total. The best we can do is examine some of the cost elements. The size of these elements we will explore is so large that it only gives us a hint of the dimension of the incredible proportion of our national cost of health care caused by use and abuse of alcohol, tobacco, and other drugs.

Intensive care units in American hospitals offer much of the best that the art and science of medicine has to offer. The cost is very great -- up to $3,000 per patient per day, somewhat less than $50 billion per year nationally.[4] How much of this cost is caused by alcohol, tobacco, or other drugs? Johns Hopkins Hospital conducted a study to find out.[5] The results:

• 28 percent of all the admissions are alcohol, tobacco, and other drug-related (9 percent alcohol, 14 percent tobacco, 5 percent other drugs).
• The ATOD-related admissions were much more severe than the other 72 percent of admissions, requiring 4.2 days in ICU versus 2.8 days.
• The cost per ATOD admission averaged $9,610, 63 percent greater than the average cost for other ICU admissions.
• Fully 39 percent of all the costs of the ICU went to treat ATOD-related diseases.

Now, Johns Hopkins Hospital may not be typical. Replication of the study is needed in other parts of the country. But previous researchers have clearly demonstrated the higher cost of intensive care of ATOD-related disease.[6]

ATOD-related intensive care unit costs exceed $19 billion annually. If the Johns Hopkins' experience is extrapolated to the Nation as a whole, ATOD-related ICU costs alone would account for over $19 billion annually. Allowing for the more expensive cost structure of Johns Hopkins compared to the average hospital, and the fact that it may have a slightly larger proportion of ATOD-related admission, we can be conservative and take half that figure, and estimate that ATOD-related costs for ICU admissions are approximately $10 billion. That's more than the entire Nation spends annually for all home health care and almost as much as much as we spend for the construction of all the medical facilities in the United States.[7]

An indicator of how profound, yet subtle, the effect of alcoholism and other drugs can be on our health cost is revealed by another study conducted in Harrisburg, Pennsylvania.[8] The study examined the health care costs of children of alcoholics (COA's) in comparison to children who did not live with this parental problem. Some of the results included:

• 24 percent increase in inpatient hospital admissions.
• A 29 percent greater average stay in hospital.
• COA hospital utilization rates were 62 percent greater than for non-COA's.
• Average hospital costs were 36 percent greater than for other children.

Hospital costs are higher for children of alcoholics. It is likely that a similar pattern would exist for the children of illicit drug addicts as well. There are billions of dollars being used to pay for the increased health costs of the children of the over 10 million alcoholics and illicit drug addicts across the nation. And there are the additional costs of treating the children of smokers whose respiratory diseases are caused or aggravated by the passive effects of the smoking of their parents.

Note the above cost elements are in the multi-billion dollar range. There are dozens of cost elements that are smaller, such as the annual cost of Fetal Alcohol Syndrome (FAS), which is only about $2 billion a year. [9]

Footnotes

[1] American Medical Association, Factors Contributing to the Health Care

Cost Problem, March 1993.

[2] Public Health Service, Healthy People 2000: National Health Promotion

and Disease

Prevention Objectives, 1991.

[3] Ibid.

[4]T. Raffin et al., Intensive Care: Facing the Critical Choices, W. C.

Freeman &Co., 1989.

[5]W. Andrew Baldwin et al., "Substance Abuse-Related Admissions to Adult

Intensive Care," CHEST, Vol. 103, January 1993, pp. 21-25.

[6]For example, C. L. Taylor et al., "Prospective Study of Alcohol-Related

Admissions in an Inner City Hospital," Lancet, 2:265-268, 1986.

R. D. Moore et al., "Prevalence Detection and Treatment of Alcoholism in

Hospitalized Patients,

JAMA, 261:403-407, 1989.

C. A. Soderstrom and R. A. Crowley, "A National Alcohol &Trauma Center

Survey," Arch Surg,

122:1067-1071, 1987.

[7] The 1990 costs were $6.9 billion for home health care and $10.4 billion

for construction of medical facilities. U.S. Health Care Financing

Administration, Health Care Financing Review, Fall 1991.

[8] Children of Alcoholics Foundation, Children of Alcoholics in the

Medical System: Hidden

Problems, Hidden Costs, 1990.

[9] Dorothy P. Rice, et al., The Economic Costs of Alcohol and Drug Abuse

and Mental Illness: 1985, Institute for Health and Aging, University of

California, 1990. The cost was $1.6 billion. With medical inflation the cost

is now about $2 billion.

source: http://www.12steps.org/12stephelp/shortreads/ALCOHOL.htm