Drug Abuse and Addiction: One of America's Most Challenging Public Health Problems

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Drug Abuse is Costly

Drug abuse is a major public health problem that impacts society on multiple levels. Directly or indirectly, every community is affected by drug abuse and addiction, as is every family. Drugs take a tremendous toll on our society at many levels.

Approximate Costs of Substance Abuse in the U.S.Approximate Costs of Substance Abuse in the U.S. graph Sources: Rice, 19991;ONDCP, 20012; Harwood, 20003
Substance Abuse Costs Our Nation More than $484 Billion per Year

The Costs of Drug Abuse are as Substantial as that of other Chronic Conditions:

  • Diabetes costs society $131.7 billion annually4
  • Cancer costs society $171.6 billion annually5

This includes health care expenditures, lost earnings, and costs associated with crime and accidents. This is an enormous burden that affects all of society - those who abuse these substances, and those who don't.

Drug Abuse is a Major Public Health Problem

Americans Perceive Drug Abuse as a Major Public Health Problem

Americans' Views of the Seriousness of Health Problems (Top Ten of Thirty-Six Problems)Americans' Views of the Seriousness of Health Problems graph Source: Harvard School of Public Health et al., 20004

Many of America's top medical problems can be directly linked to drug abuse:

  • Cancer: Tobacco contributes to 11-30% of cancer deaths.7
  • Heart Disease: Researchers have found a connection between the abuse of tobacco, cocaine, MDMA (ecstasy), amphetamines, and steroids and the development of cardiovascular diseases. Tobacco is responsible for approximately 30% of all heart disease deaths each year.8
  • HIV/AIDS: Approximately one-third of AIDS cases reported in 2000 (11,635) and most cases of hepatitis C (approximately 25,000 in 2001) in the United States are associated with injection drug use.9&10
  • Approximately half of pediatric AIDS cases (4,700 reported through 2002) result from injection drug use or sex with injection drug users by the child's mother.11

Many of America's top social problems also relate to or impact drug abuse:

Photo of car crash
  • Drugged Driving: The National Highway Traffic Safety Administration estimates that drugs are used by approximately 10 to 22 percent of drivers involved in crashes, often in combination with alcohol.12
  • Violence: At least half of the individuals arrested for major crimes including homicide, theft, and assault were under the influence of illicit drugs around the time of their arrest.13
  • Stress: Exposure to stress is one of the most powerful triggers of substance abuse in vulnerable individuals and of relapse in former addicts.
  • Child Abuse: At least two-thirds of patients in drug abuse treatment centers say they were physically or sexually abused as children.14

Drug Abuse is a Major Public Health Problem

Addiction Affects EveryoneAddiction Affects Everyone - Pictures of different people

Drug abuse impacts the individual, family, and community.
Everybody knows someone who is affected by drug abuse.


  • Adolescence: This is a time period of high vulnerability to drug abuse and other risk taking behaviors.
  • Mental Illness: People with mental illness are particularly at risk for problems related to substance abuse.
  • Consequences of Substance Abuse: These can include illness, injuries, and death. Each year approximately 40 million debilitating illnesses or injuries occur among Americans as the result of their use of tobacco, alcohol, or another addictive drug.7&15
  • Deaths: In 2000, approximately 460,000 deaths were attributable to illicit drug abuse and smoking.16

Addiction Affects Everyone

Addiction Affects Everyone - woman and baby

Families can be destroyed by drug abuse:

  • Prenatal:
    • Smoking: Infants born to women who smoke during pregnancy have a lower average birth weight and may be at increased risk for attention deficit hyperactivity disorder, conduct disorders, and childhood obesity.17, 18 & 19
    • Cocaine: Babies born to mothers who abuse cocaine during pregnancy can be born prematurely and have low birth weights. There may be as many as 45,000 cocaine-exposed babies per year.20
  • Child Abuse: Approximately 50% to 80% of all child abuse and neglect cases substantiated by child protective services involve some degree of substance abuse by the child’s parents.21

Drug Abuse Affects Us All

Drug Abuse Affect Us All - homeless person


  • Homelessness: 31% of America's homeless suffer from drug abuse or alcoholism.22
  • Crime: As many as 60% of adults in Federal prisons are there for drug-related crimes.23
  • Education: Children with prenatal cocaine exposure are more likely (1.5 times) to need special education services in school. Special education costs for this population are estimated at $23 million per year. 24
  • The Workplace: In 1997, illicit drug users were more likely than others to have missed 2 or more days of work in the past month and to have worked for three or more employers in the past year.25