Abstract
One in four Americans has a substance abuse problem during his or her lifetime, with alcohol abuse being the most common. Between 12 and 18 million Americans need treatment for alcohol abuse or dependence (Brandeis University, 1993; Substance Abuse and Mental Health Services Administration (SAMHSA, 1999a). Alcohol use and abuse among adults has been stable in the past decade (SAMHSA, 1999a), but the annual cost to U.S. society in lost productivity, healthcare, crime, accidents, and workplace violence exceeds $165 billion a year (Rouse, 1998). Among illicit drugs, marijuana and cocaine are the most popular, but use of designer drugs and heroin is rising, especially among young adults. Due partly to purer, more powerful drugs, emergency room episodes involving drugs have risen over the past decade (Rouse, 1998). The estimated annual cost to U.S. society of drug abuse, excluding alcohol, is $110.4 billion (Rouse, 1998). Only 10% of alcoholics and 9% of drug addicts receive treatment in any given year (Grant, 1997). For its victims, the costs of substance abuse in human suffering are incalculable.
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