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Preliminary Estimates of Costs of Substance Abuse in CA and Savings from Prevention. Ted R Miller, PhD Principal Research Scientist Pacific Institute for Research & Evaluation 240-441-2890 (cell) miller@pire.org. Why Study Costs? Single Compact Metric. Problem size & risk assessment
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Preliminary Estimates of Costs of Substance Abuse in CA and Savings from Prevention Ted R Miller, PhD Principal Research Scientist Pacific Institute for Research & Evaluation 240-441-2890 (cell) miller@pire.org
Why Study Costs?Single Compact Metric • Problem size & risk assessment • Priority setting & resource allocation • Performance comparison • Program evaluation • Advocacy
These Figures Are Based on Perpetrator Substance Use40% of Medically Treated Assault Victims Also Are BAC-PositiveVictimization Is 7-10 Times As Likely When Someone Is Alcohol-Positive As When (S)he Is Sober
Priority-setting: BCRs for School-Based Programs (T=tobacco, V=Violence, C=Cocaine)
Benefits of Prevention Are Reductions in the Costs of Substance Abuse & its Associated Harms
Performance Comparison: Costs of Underage Drinking per Youth Ages 14-20
Evaluation: 21 Minimum Drinking Age • Reduces % of youth who drink & binge • Raises age of initiation which lowers the risk of alcoholism in adulthood • Reduces youth DWI deaths by 19% • Reduces alcohol-involved youth suicides by 27%
You are the Governor of CA • 37 M residents • 233K deaths in 2010 • Can I convince you to continue my $2 M program to prevent alcohol-related injuries
We did a thorough evaluation. The results are highly significant statistically. Our program reduced deaths and hospital admissions due to alcohol-related injury by
Our program prevented 50 deaths and 400 hospital admissions last year.
Our $2 M program saved CA taxpayers $70 M in medical payments and work losses last year. That’s $1900 per CA resident.
Really Big Business 1,372,000 underage customers in CA in 2009 Annual alcohol sales per kid who drank illegally = $2,445
Underage Drinkers Are Great Customers Daily Drinks Per Drinker in CA
Booze Consumed When BAC Will Be > .08
The alcohol industry denies it markets to kids • But the signs are everywhere • Are alcopops for the martini crowd or the beer bellies? • What age group do Budweiser frogs& clever dogs target?
“They might as well rename it "Hello, Creepy," because that's exactly how you'll feel purchasing Hello Kitty wine, from the moment you ask the sales clerk where to find it, right through to the cash register ring-up, where they encircle the neck of your bottle with a pendant suitable for a six-year-old. A pleasant cherry-berry scent, carbonation on my tongue, a bit of sweet-ness, a lingering floral aftertaste reminiscent of bubble bath” www.seriouseats.com
Nationally, $23.8 Billion of Booze Was Consumed by Underage Customers in 2009
A Devastating Tidal Wave of Alcohol-Related Harm Results • 408 deaths in CA in 2010 • 7500 injured in DWI crashes • 115 K violent crimes • 180 K property crimes • 115 K teens having risky sex • 2800 teen pregnancies • 1100 kids in alcohol treatment
Divide by a Sensible Exposure Measure • $4960 Per Underage Customer • $1810 Per Youth Ages 14-20 • $3.05 Per Illegal Drink in CA
The Costs are for Events Caused by Alcohol • 90% of alcohol-involved crashes • 75% of alcohol-involved violence • 54% of alcohol-involved property crime • 50% of alcohol-involved risky sex (one eighth of all risky sex)
Usage Example: Oregon • Had consumption data by county • Paid to get costs by county • Worked with coalitions to understand the problems & plan solutions • Press releases: costs by county, how to solve • Pushed county & state legislatures re costs • Changed laws & enforcement
Intervention Harm Reduction Treatment Prevention
Prevention Typology Universal/ Environ- mental Selective/ Educational Indicated/ Behavioral