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The economic costs of drug and alcohol abuse in the United States are estimated to exceed $275 billion a year, including lost productivity, medical expenses, crime, and other costs (Stein, 2001). About 3 million individuals entered addiction treatment services last year but more than 23 million adults and adolescents are in need of addiction treatment leaving more than 20 million needing but not receiving treatment (SAMHSA, 2008).

In 2003, the United States spent an estimated $21 billion (U.S. dollars) on treatment for alcohol and drug disorders, a total of 1.3 percent of all health care expenditures (Mark et al., 2007, 2008). Public payers now account for 77% of all spending to address drug and alcohol disorders. Consequently, policymakers want to learn more about the costs and benefits of treatment to justify the use of billions of public monies used yearly for this purpose. During the last five years, with support from SAPRP and other sources both public and private, new studies have begun to examine and evaluate the benefits and cost-effectiveness of investing in treatment.