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The Economic Costs of Alcohol and Drug Abuse in the United States - 1992
Appendix D. Health Disorder Codes

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Social Welfare Expenditures in the U.S., 1992

Table D.1: Social Welfare Expenditures in the U.S., 1992 (billions of dollars)
Program Total Recipients
(millions1)		 Total Expenditures Transfer Payments Administrative and Direct Service Costs
SOCIAL INSURANCE PROGRAMS
Disability Insurance (OASDI) 3.52 32.0 31.17 .83
Unemployment Insurance 3.23 39.5 35.99 3.51
Railroad Temporary Disability Insurance .0084 .0403 .0263 .014
State Temporary Disability Insurance   3.22 3.08 .14
Veterans Pensions and Compensations 2.675 17.30 16.38 .92
Workers Compensation n/a 37.36 35.38 1.98
Total, Social Insurance   126.2 119.0 7.19
PUBLIC AID
Cash Aid Programs
Supplemental Security Income (SSI) 4.026 22.20 20.66 1.54
Aid to Families with Dependent Children (AFDC) 4.777 22.20 20.83 1.37
Public Assistance n/a 132.74 124.11 8.63
Low Income Heat and Energy Assistance Program 6.28 2.23 2.09 .14
Total, Cash Aid Programs   179.37    
Non-Cash Aid Programs
Food Stamps 25.49 16.25 15.29 .96
Woman, Infants and Children (WIC) 1.2210 2.57 2.42 .15
Public Housing 4.4811 12.5 (1993) 11.76 .74
Total, Non-Cash Programs   31.32    
Total, Public Aid   210.69 197.21 13.48
DIRECT HUMAN SERVICES
Child Welfare
Title IV-B NA .27 .18 .09
Title IV-E (Foster Care) .22212 2.21 1.19 1.02
Title IV-E (Adoption Assistance) .06613 .22 .16 .06
Head Start .62114 2.23 0 2.23
Vocational Rehabilitation .95015 2.13 0 2.13
Special Education 4.3 2.63 0 2.63
Total, Direct Human Services   9.66 1.52 8.14
Total for Programs Analyzed in This Study   336.89 317.73 19.19

Sources: U.S. Bureau of the Census (1994); Committee on Ways and Means (1994); U.S. Dept. of Health and Human Services (1993a). 
1Recipient and expenditure data from 1992 unless otherwise noted.
2Monthly average December 1992.
3Average weekly 1992.
4Weekly average for 1990.
5As of September 30, 1992.
6Monthly average number disabled, December 1992.
7Average monthly, head of household.
8Households for FY 1992.
9Average annual for FY 1992.
10Heads of household.
11Households in March 1993 receiving means-tested benefits.
12Average monthly.
13Average monthly.
14Average annual, 1992.
15Includes active cases accepted for rehab. services during year, plus active cases on hand at beginning of 1992.

A Summary of Studies on Social Welfare and Substance Abuse
Table D.2: A Summary of Studies on Social Welfare and Substance Abuse
Study Welfare Program Measure Value
Substance Abuse and Women on Welfare* Aid to Families with Dependent Children (AFDC) Alcohol abuse is defined as drinking five or more drinks in one sitting, two or more times a month.

Drug use is defined as having used illicit drugs in the past year.		 1.3 million (28 percent) AFDC recipients abuse or are addicted to drugs and alcohol.

Alcohol: 12 percent met abuse criteria in last month.

Drugs: 23 percent used illicit drugs in last year.
Patterns of Substance Use and Program Participation ** AFDC; Food Stamps Alcohol: five or more drinks three or more times in the past 30 days;

Drugs: past month or past year use		 Alcohol: AFDC - 8.7 percent;

Food Stamps - 10.4 percent;

Drugs:

Past month - AFDC - 10.5 percent, Food Stamps - 10.1 percent;

Past year - AFDC - 21.6

Food Stamps - 19.5
Patterns of Substance Use and Substance-Related Impairment Among Participants in the AFDC Program ** AFDC "Significant impairment" would include dependency on alcohol and drunk at least weekly or dependent on an illicit drug other than marijuana and used an illicit drug at least monthly or heroin once in the last year. 4.9 percent of female AFDC recipients are estimated to have significant functional impairment related to substance abuse.
Alcohol and Drug Problems among Diverse Health and Social Service Populations *** Representative sample of welfare recipients (mostly in AFDC and General Assistance) in a No. California County Problem drinking is defined as meeting two of the three following criteria: drinking five or more drinks on an occasion at least once per month; demonstrating one or more dependency symptoms; or experiencing one or more social consequences.

Drug use measures unprescribed use during past year.		 Problem Drinkers: 24 percent

Illicit Drug user: 58 percent

Multiple Drug User: 21 percent
Social Security: Major Changes Needed for Disability Benefits for Addicts **** Disability Insurance; Supplemental Security Income Addiction is defined as medical evidence consisting of symptoms, signs, and laboratory findings that determine that beneficiary cannot work and whose physical or mental impairment is expected to last for at least 12 months or result in death. 4.8 percent of the adult SSI population are diagnosed with addiction, of which 2.6 percent of the Drug Addict & Alcoholic (DA&A) recipients;

2.8 percent of the DI population are diagnosed with addiction. No breakdown of cases by alcoholic or drug addict is provided.
SSI Payments to Drug Addicts and Alcoholics: Continued Dependence ***** Supplemental Security Income Addiction is defined as medical evidence consisting of symptoms, signs, and laboratory findings that determine that beneficiary cannot work and whose physical or mental impairment is expected to last for at least 12 months or result in death. 80,332 (2.0 percent) DA&A cases in the SSI program are diagnosed with addiction. This number does not include primary and secondary diagnoses that are not in DA&A. For those with a primary diagnosis, 67 percent of cases are alcoholics and 33 percent are drug addicts.

*Center on Addiction and Substance Abuse (1994).
**U.S. Department of Health and Human Services (DHHS; 1994b).
***Weisner and Schmidt (1993).
****United States General Accounting Office (1994).
*****DHHS (1994d).

Alcohol- and Drug-Related Social Welfare Expenditures, 1992
Table D.3: Alcohol- and Drug-Related Social Welfare Expenditures, 1992(billions of dollars)
Program Total Expend- itures1 Total Admin. and Direct Service Costs2 Percent Attrib-
uted to AOD3		 Benefit Costs Attributed to Alcohol and Drugs Administrative and Direct Service Costs Attributed to Alcohol and Drugs
Total Alcohol
(67%)4		 Drugs
(33%)		 Total Alcohol
(67%)		 Drug
(33%)
SOCIAL INSURANCE PROGRAMS
Disability Insurance (OASDI) 32.00 .83 (2.6%) 1.7 .53 .35 .18 .0140 .0095 .0045
Unemployment Insurance 39.5 3.51 (8.9%) 1.7 .61 .41 .20 .0597 .0400 .0197
Railroad Temporary Disability Insurance .0403 .014 (35%) 1.7 .0045 .0030 .0015 .00024 .00016 .00008
State Temporary Disability Insurance 3.22 .14 (4.3%) 1.7 .052 .035 .017 .0024 .0016 .0008
Veterans Pensions and Compensations 17.30 .92 (5.3%) 1.7 .28 .19 .09 .0156 .0104 .0052
Workers Compensation 37.36 1.98 (5.3%) 1.7 .60 .40 .20 .0377 .0226 .0111
Total, Social Insurance Programs 126.20 7.394 1.7 2.077 1.388 .689 .130 .084 .041
PUBLIC AID
Cash Benefits
Aid to Families with Dependent Children (AFDC) 22.2 1.37 (6.2%) 5.2 1.08 .73 .35 .1189 .0477 .0235
Supplemental Security Income 22.2 1.54 (6.9%) 3.0 .62 .42 .20 .0462 .0310 .0152
Public Assistance 132.74 8.63 (6.5%) 4.1 5.09 3.41 1.68 .3538 .2371 .1167
Low Income Heat and Energy Assistance Program 2.23 .16 (6.5%) 4.1 .085 .057 .028 .0062 .0041 .0021
Non-Cash Benefits
Food Stamps 16.25 .96 (5.9%) 5.2 .79 .53 .26 .0499 .0334 .0165
Woman, Infants and Children (WIC) 2.57 .15 (5.9%) 4.1 .099 .066 .033 .0062 .0041 .0021

 

 
Public Housing 12.5 (93) .74 (5.9%) 4.1 .48 .32 .16 .0303 .0203 .0100
Total, Public Aid 179.37 13.54 4.1 8.244 5.533 2.711 .6115 .3777 .186
DIRECT HUMAN SERVICES
Child Welfare
Title IV-B .274 .099 (36%) 3.3 .0072 .0048 .0024 .0041 .0027 .0014
Title IV-E (Foster Care) 2.21 1.02 (46%) 3.3 .0488 .0327 .0161 .0418 .0280 .0138
Title IV-E (Adoption Assist.) .22 .058 (26%) 3.3 .0066 .0044 .0022 .0024 .0016 .0008
Head Start 2.23 2.23 (100%) 3.3 0 0 0 .0736 0.493 .0243
Vocational Rehabilitation 2.13 2.13 (100%) 3.3 0 0 0 .0703 .0471 .0232
Special Education 2.63 2.63 (100%) 3.3 0 0 0 .0868 .0581 .0287
Total, Direct Human Services 9.66 8.167   .063 .042 .021 .279 .187 .092
Total 346.55 29.101   10.383 6.963 3.420 1.020 .649 .320

1All data are from 1992 unless otherwise noted.
2Head Start, Vocational Rehabilitation, and Special Education programs make no transfer payments.
3Percentages are calculated using available data sources (e.g., data from the DI program are applied to other social insurance programs). Data from AFDC and SSI are averaged and applied to public aid programs; averages of all available data sources are applied to direct human service programs.
4The breakdown between alcohol and drug users is based on administrative records kept by the SSI program. The breakdown is based on a primary diagnosis of either alcohol or drug dependence.