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  • Writer's pictureKevin Phillips

The Hidden Costs of Substance Use: A Trillion-Dollar Problem

Substance Use Disorder (SUD) is more than just a personal struggle—it's a significant public health concern with staggering economic implications. When we factor in the costs associated with tobacco and alcohol use, the numbers become truly overwhelming.


Let's break it down:

  1. Tobacco: In 2018, cigarette smoking cost the United States over $600 billion.

  2. Alcohol: As of 2010, alcohol use burdened the U.S. healthcare system with $240 billion in costs.


Adjusting for inflation, the combined public health cost of tobacco and alcohol use today approaches a staggering $1 trillion annually. To put this in perspective, it costs the average American taxpayer $6,666 each year.


Note: These figures don't include the costs associated with illegal substances, which are harder to quantify but would undoubtedly inflate the total even further.


A New Approach at ARS


At ARS, we've recently adopted a holistic approach to substance use treatment. When patients enter our residential treatment facilities, we now support them in quitting smoking alongside addressing their use of other substances. But why this shift in strategy?


The Smoking-Relapse Connection


Beyond the well-known health risks, smoking significantly impacts recovery from other substance use disorders:

  1. High prevalence: Up to 75% of adults with SUDs have a history of cigarette smoking.

  2. Difficulty quitting: 57% of individuals seeking treatment for alcohol or drugs reported that cigarettes would be harder to quit than their primary problem substance.

  3. Increased relapse risk: Smokers have about twice the odds of relapsing to drug use compared to non-smokers.


Integrating Treatment for Better Outcomes


Addressing tobacco use alongside other SUDs improves overall treatment outcomes. This integrated approach allows patients to explore the nature of cravings and urges, developing crucial skills to manage them effectively.


The Power of Craving Management


Tobacco cravings provide a unique opportunity to practice essential recovery skills. A smoker typically experiences cravings that last only 3-5 minutes. Learning to resist these frequent, short-lived urges builds resilience applicable to managing cravings for other substances.


Debunking the Stress-Relief Myth


Many substance users, including smokers, claim their habit helps relieve stress. However, research shows that smokers are generally more stressed than non-smokers. The perceived relief is actually the alleviation of withdrawal symptoms, creating a vicious cycle of dependency.


By quitting smoking during treatment, patients learn alternative stress management techniques. These skills are transferable, helping them resist the urge to reach for any substance when faced with stress.


Medication-Assisted Treatment (MAT): A Comprehensive Approach


To support our patients' recovery, we offer evidence-based medication-assisted treatment (MAT) when appropriate. This includes:

  1. For Opioid Use Disorder: Methadone, buprenorphine, and naltrexone

  2. For Tobacco Use Disorder: Nicotine replacement therapy (patches or gum)


While MAT for opioid use may require long-term use, tobacco cessation medications are typically used for shorter periods, usually 3-6 months.


Our goal at ARS is clear: By the time our patients complete treatment, they are free from alcohol, drugs, and tobacco, equipped with the skills to maintain long-term recovery.

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