Mortality and Morbidity Attributable to Use of Addictive Substances in the United States

Abstract

Addiction to tobacco, alcohol, and other drugs inflicts a substantial toll on Americans, measurable in terms of deaths and illnesses, social costs, and economic costs. With approximately 60 million smokers, 14 million dependent on alcohol, and 14 million users of illicit drugs, more than one fourth of Americans over age 15 has a physiological dependence on at least one addictive substance. As a result, nearly 590,000 deaths--about a quarter of all deaths in the United States--are caused by addictive substances: 105,000 from alcohol abuse, 446,000 from tobacco use, and 39,000 from addictive drugs in 1995. The magnitude of addiction's impact on morbidity is also great, causing approximately 40 million illnesses and injuries each year. The economic burden of addiction is estimated at greater than $400 billion every year, including health care costs, lost worker productivity, and crime. Less quantifiable, but equally important, are the social costs to families and communities of addiction. Children of substance-abusing parents are more likely as adults to become plagued by addiction and its related problems. Passive exposure to tobacco smoke affects nonsmokers; drug and alcohol abuse are risk factors for crime and incarceration, family violence, fatal and permanently disabling accidents, birth defects, and divorce. Combined, the effects of tobacco, alcohol, and drugs inflict a greater toll on the health and well-being of Americans than any other single preventable factor.

Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital

“…9 Furthermore, even at ages younger than 70, adults in safety-net care settings have a concentration of risk factors for HAD, including minority race status, baseline functional impairment, low socioeconomic status, substance use, and homelessness. [10][11][12][13][14][15][16] Understanding the prevalence of and the risk factors for HAD in persons as young as 55 is important, as hospitals could target areas of high prevalence for interventions to reduce functional decline in older adults, thus benefitting a greater number of people at risk. 1,[17][18][19] In order to understand the prevalence of HAD in a safety-net setting, we describe HAD in a cohort of racially and ethnically diverse adults aged 55 and older who were hospitalized at an urban safety-net facility.…”

The genetics of addictions: uncovering the genes

“…As well as causing ~590,000 deaths per year in the United States, addictive drugs also cause injury or illness to almost 40 million individuals 3 . On a population basis, alcoholism alone subtracts an average of 4.2 DISABILITY ADJUSTED LIFE YEARS (DALYs) per person, tobacco subtracts 4.1 DALYs and illicit drugs subtract 0.8 DALYs.…”

Untitled

“…For example, the collective effects of tobacco, alcohol, and drugs exact greater consequences on the welfare of the American people than any other single preventable factor (Mulvihill, 2005). The total costs ascribable to addiction are approximated at more than $400 billion every year, including health care costs, low worker productivity, and crime (McGinnis & Foege, 1999).…”

“…Though a causal relationship is difficult to establish, there is a substantial research base supporting a relationship between parental substance abuse and ensuing problems in offspring. These children are considered to be "at-risk" for many developmental problems including substance abuse, psychiatric problems, social-skill deficits, and educational attrition (Claydon, 1987;Potter-Efron, 1987;Kinney 1991;McGinnis & Foege, 1999).…”