Addiction: Who Suffers? Who Pays?

1. INFLUENCE - April 30, 2008 Addiction: Who Suffers? Who Pays? Helene M.CrossPresident/CEOFairbanks

2. Women and Addiction • 4.4 million (17%) U.S. women over the age of 59 are addicted to nicotine • 1.8 million (7%) abuse alcohol • 2.8 million (11%) abuse prescription drug

3. Women and Addiction • Women over the age of 59 are more likely to be hospitalized for health problems related to substance abuse than for heart attacks. • The substance abuse health issues and accidents these women suffer from will result in $100 billion a year in 10 years.

4. U.S. Data • One in four people between the ages of 15-54 have a substance abuse problem. • Since 1999,the deaths attributable to alcohol and drugs has grown steadily in the U.S., over dose mortality has grown 60%.

5. U.S. Data • One in four children live in a home where alcohol is abused. • In 2003, an estimated 34 million people, aged 12+ used an illegal drug during the past year.

6. Medicare/Medicaid • Medicare hospital admissions of women over the age of 59 for ailments or injuries caused by substance abuse is 3x the rate of admissions for non-substance abuse related heart attacks. • Medicaid admissions of women over the age of 59 is more than 4x the rate of admissions.

7. College Students • 38% of college students abuse or are dependent on alcohol. • 44% of college students reported binge drinking at least 2x a month. 1/3 are women. • Binge drinkers experience a higher percentage of alcohol-related problems such as disciplinary problems, violence, irresponsible sexual activity, personal injury and academic performance.

8. Indiana Data • In 2004, 27% of 12-20 year olds used alcohol. • In 2004, 1 in 10 Hoosiers used Marijuana. • 30% of Marion County 8th Graders used Marijuana. • In 2001, 47% of homicides were related to alcohol

9. Indiana Data • Alcohol abuse is the most significant substance abuse problem in Indiana. • Indiana’s estimated rate of abuse exceeds that of the nation for prescription pain relievers, especially in 12-25 year olds.

10. What are the Costs? • Every person in the US pays approximately $1000 per year for unnecessary health care, extra law enforcement, auto crashes, crime and lost productivity resulting from untreated addiction.

11. What are the Costs? • Alcohol are Drugs are leading factors in: • 40% of Homelessness • 38% of Child Abuse & Neglect • 50% of Domestic Violence Disputes • 50% of Auto Accidents • 62% of Aggravated Assaults

12. Do you see RED?

13. Symptoms • Depression • Memory Loss • Irritability • Upset Stomach • Trouble Sleeping • Change in Friends • Drop in Grades • Poor Hygiene • Never Having any Money • Changes in Eating or Sleeping Habits

14. A Hidden Disease • Substance abuse and addiction is hidden in the shame, embarrassment and denial of those who struggle with it. • Physicians fail to identify substance abuse or addiction, some simply ignore it because they don’t believe anything can be done.

15. A Hidden Disease • Addiction is hidden in the diseases and injuries it spawns. • Including : Cancer, heart attacks, diabetes, hypertension, strokes, pneumonia, kidney failure, asthma, bronchitis and hip fractures.

16. Related Costs • In 1998, of the $10 billion in acute care hospital charges resulting from substance abuse and addiction in women over the age of 59, 98% ($9.8 billion) was spent to treat the illnesses and injuries that are the consequence of abuse and addiction. • Only 2% is spent to treat substance abuse and addiction.

17. Undiscovered - Untreated • Less than one percent of doctorsidentified a classic profile of an alcoholic woman as having an alcohol problem.

18. Undiscovered - Untreated • Few caregivers, families and friends spot the symptoms of substance abuse and addiction; fewer know what to do when they spot these symptoms. • Physicians survey revealed that less than 1% look for substance abuse and addiction.

19. Undiscovered - Untreated • When physicians identify a woman as a substance abuser, 1 in 5 report that managed care organizations or insurance companies have refused to cover the cost of referrals for counseling or treatment. • Some caregivers and family are deaf to the sounds of trouble, or they don’t realize that there is treatment.

20. Living with the Wolf

21. Consequences of Not Treating • School failure • Infant mortality or low birth weight • Child abuse • Other health issues or death

22. Consequences of Not Treating • Abuse and depression are also related. • At any age, alcoholic females are twice as likely as non-alcoholic females to be depressed and almost four times as likely than male alcoholics to be depressed.

23. Can we Eliminate Addiction?

24. No, We Can’t!!! • Addiction cannot be eliminated. • Addiction is a Chronic Disease

25. Prevention & Treatment is the Answer • For millions of people the problem of substance abuse and addiction can be prevented and treated.

26. What can we prevent and when do we treat? • Two groups of people • Thosewho abuse alcohol and illegal drugs • Those who have the biological and genetic predisposition to addiction.

27. Alcohol & Drug Abuse • Educate the abusers: • Overdrinkingcan result in an accident. • Illegal drug possession can result in arrest and conviction. • Both can cause brain injury and other health issues, including addiction.

28. Alcoholism & Drug Addiction • The second group, an estimated 1 in 20 people have a genetic link to the disease. • They have a chronic brain disease. • Other chronic diseases include diabetes, hypertension and asthma.

29. Symptoms of Alcoholism • Primary symptoms of alcoholism: • Craving • Loss of Control • Physical dependence • Tolerance

30. What can be done for some one who is alcohol or drug dependent?

31. Treatment and Recovery Management • Professional medical help and treatment. • Detoxification, inpatient and outpatient rehabilitation, medication, and counseling. • Tools for recovery management. • 12-Step program and other supports.

32. Often Treatment Doesn’t Occur • 23 million Americans drug or alcohol dependent in 2006, only 2.5 million (11%) received treatment. • 1.8 millionwomen 59+ who needed treatment for alcoholism, less than 11,000 received it. • Only 25% of students who were alcohol abusers, and 6% of students who were alcohol dependent, got treatment while in college.

33. Often Treatment Doesn’t Occur • Some of the factors why individuals don’t get treatment: • They don’t know that alcohol and drug dependence is a brain disease • Lack of knowledge about treatment • Cost/insufficient insurance coverage • Low investment in treatment with government dollars

34. Close the Treatment Gap • Yet, for every dollar invested in addictions treatment, the taxpayer saves $7.46 in societal costs (including the cost of incarceration.) • Substance abuse treatment cuts drug use in half, reduces criminal activity up to 80%, and reduces arrests up to 64%. • The cost of treatment is 15 times less than the cost of incarcerating a person for a drug-related crime.

35. Take action promoting intervention, prevention and treatment.

36. Sources • Under the Rug: Substance Abuse and the Mature Woman, June 1998 the National Center and Addiction and Substance Abuse at Columbia University (CASA) • Substance Abuse and Mental health Service Administration (SAMHSA) www.samhsa.gov • Alcohol abuse and Dependency among US College Students, Journal of Studies on Alcohol (2002) • Controlling Cocaine Supply VX. Demand Program, RAND Drug Policy Research Center (1994). • Cost Effectiveness and Cost Benefit Analysis of Substance Abuse Treatments, IRETA 2003 • PLNDP and Join Together: A Physician’s Guide on How to Advocate for More Effective national and State Drug Policies. (January 2002) • 2006 National Survey on Drug Use and Health • The Consumption and Consequences of Alcohol, Tobacco, and Drugs in Indiana; A State Epidemiological Profile 2007 • A Community at Risk, Drug Free Marion County, 4th Edition