Home Page of the DPNA Website Learn about the Drug Prevention Network of the Americas, its history, principles, members, supporters, and board Looking for information about drug prevention?  Check out our web page links, books, presentations, position papers, and brochures Want to connect with national, regional or international drug prevention sites?  Visit our extensive Links section. Keep up with the latest drug prevention news and events. Ready to become a part of the Drug Prevention Network of the Americas?  Sign up on line.



WWW DPNA News and Updates
Drug Research
Opinions
Drug Effects
Drug Information
Drug Trends
Best Practices
Drug Legalization
Drug Policy
Books and Guides
Brochures
Courses
Presentations
Funding Sources


The Most Expensive Addictions

Forbes, October 3, 2006

Addictions are all the rage. Life experts popping up everywhere from group-speaking engagements to The Oprah Winfrey Show are extolling the dangers of overdoing activities from shopping and watching television to surfing the Web, drinking coffee and even daydreaming. Some even include excess complaining on the list.

"Everyone has some sort of [addiction], whether it's constantly checking your finances or just biting your nails," says Judith Miller, an author and speaker on the subject. "The problem is doing these things beyond their intended use, and they dominate your life."

Worrisome? Perhaps. But despite the hype, the overall economic effects of "soft addictions" pale in comparison with traditional "hard addictions" like drug abuse and alcoholism. While common sense says that those who spend work hours popping out to the store for a new pair of shoes or surfing the Web for personal use probably cost employers something in lost productivity, there's no definitive proof that employee "downtime" is any more prevalent than it was a generation ago, when telephone and watercooler banter was in.

To be sure, there's plenty of anecdotal evidence to suggest that people can flirt with financial distress when overindulging in their favorite hobbies or escapes. Miller says the average person she's met on her speaking and research travels spends $15,000 a year on his or her soft addictions, and that no one has ever spent less than $3,000.

But there's precious little scientific quantification going on here to enable economists to determine how much these problems really cost. Take sex addiction. It's good for headlines whenever it gets discussed, and it's considered a serious malady by the medical profession, but no formal cost studies exist.

Treatment-Center.net, an online service that compiles lists of treatment facilities around the country, estimated that the percentage of U.S. men addicted to pornography has grown to 20%, from 6%, in the last ten years. That sounds plausible--the Internet's been growing at an explosive rate during that time. But how much does this cost the economy? No one can say.

"We don't have government funds to carve out as much data for things like sex addictions, exercise and others," says John Fitzgerald of the Center for Addiction Management.

Some companies, such as New York-based tech advisory firm Basex and outplacement firm Challenger, Gray and Christmas have tried to quantify the productivity costs of employees distracted by online activity, such as fantasy sports. But the methodology, which is simply to multiply average employee wages by an estimated number of minutes per day online, essentially treats people as robots who would normally spend every moment in full concentration mode. That's never been the case. Why not look into how much productivity is supposedly lost by bathroom breaks or endless meetings?

The biggest problem, from an economic perspective, is that despite all these ills attacking the labor force, government stats show the average worker is twice as productive today as he or she was 40 years ago, thanks to technology, meaning that an occasionally distracted employee is a small price for a business to pay for so much more output.

Meanwhile, studies compiled by various government health agencies show that the five most-chronicled "hard" addictions--alcohol, drugs, tobacco, gambling and eating disorders--are what society truly pays for. Those maladies cost taxpayers and businesses $590 billion annually, primarily in lost productivity and government-assisted medical treatment. That's about 5% of the national debt. And it doesn't count the sometimes bankrupting amounts of money those people personally spend on drugs, liquor, cigarettes or at the craps tables. Economically, those purchases are treated as pure transfer payments, no different than any other form of shopping.

The Substance Abuse and Mental Health Services Administration estimates that a combined $276 billion was spent or lost in 2005 on health care, lost productivity, premature death, auto accidents and crime relating to drug and alcohol abuse. Approximately three-quarters of that money came from public sources, SAMHSA found.

About $18 billion of the tab went for treatment, even though less than 15% of the estimated 22 million Americans who engage in substance abuse actually seek it.

"Many don't recognize they have a problem. Plus, there's the stigma," says Dr. Jack Stein, a SAMHSA director. He favors early intervention, including questioning of hospital patients by medical professionals who are qualified to detect an alcohol or drug problem.

Fitzgerald believes that standard inpatient treatment for a set period of time, or until an addict is "cured," is ineffective. He's found that with his patients, brief periodic follow-up visits make a big difference in keeping them sober.

"The real issue is keeping people connected with their treatment after their main rehab; it should be more about long-term management." he says.

Cigarette smoking, despite a shift in public attitudes over the years that's raised its social stigma, costs taxpayers $157 billion annually in medical expenses and lost productivity, according to the Center for Disease Control and Prevention.

There are some outward signs that more people are kicking the habit. The 378 billion cigarettes officially sold in the U.S. last year, according to the Treasury Department, represent a 21% drop from 1998, the year a group of state attorneys general secured a landmark settlement against the tobacco industry. The lawyers were quick to take credit for the sales decline in a statement earlier this year, claiming that by "focusing attention on the conduct of tobacco companies and the dangers of cigarette smoking," they compelled more people to quit.

But given that the Surgeon General's warning on smoking came in 1964, it's doubtful that many people needed a reminder of cigarettes' health risks 34 years later. More likely, the sky-high taxes imposed by federal, state and local governments sent a good chunk of the business underground.

Meanwhile, eating disorders carry a $107 billion price tag, according to the National Institute of Health. The estimated 39 million workdays lost to obesity-related problems cost businesses about $4 billion annually in lost productivity. And to think, some people criticized Wal-Mart Stores (nyse: WMT - news - people ) for considering a policy of hiring healthy people.

Physical addictions aren't the only serious problems. Compulsive gambling, defined by the American Psychological Association as a mental health disorder of impulse control, accounts for $40 billion in annual losses from counseling, productivity declines and social services, according to an estimate by the National Gambling Impact Study Commission, a body created by Congress to study the problem.

Cutting down on shopping or television may make sense for plenty of people, but it's probably not a life-or-death decision. And neither your boss nor your fellow taxpayers are likely to care--at least not until there's research out there that shows they should.