Series Continues: The cost of Oklahomans' addictions
Addiction costs Oklahoma and its residents an estimated $7.2 billion a year. That’s more than the state government’s budget of $6.7 billion. That’s enough to build 900 miles of highway. Enough to create 190,000 salaried jobs, with benefits. Enough to erect nine skyscrapers like Oklahoma City’s new Devon tower. That’s roughly $1,900 for every man, woman and child in the state. It’s not just a matter of money, either.
The abuse of street and prescription drugs, alcohol, tobacco and other addictive substances exacts a terrible toll on people. “The bottom line is, we’re witnessing this crisis, this silent cancer that is just growing.” said Darrell Weaver, director of the Oklahoma Bureau of Narcotics and Dangerous Drugs Control. The problem is spreading through every stratum of society: poor, middle-class, wealthy; rural, urban and suburban. The direct and indirect costs are enormous. Incarceration chews up tax dollars; business productivity plummets; families crumble; crime festers. Government, churches and private ventures offer a variety of treatment and recovery programs, but evidence indicates they are inadequate and overloaded. Addiction touches just about everyone in some way: a friend or family member struggling with substance abuse, a crime tied to drug use, a workplace accident caused by an addled employee.
Last year the Centers for Disease Control and Prevention said Oklahoma had the nation’s highest percentage of adolescents and adults who abused prescription drugs over a 12-month period—about 8 percent, or nearly 240,000 people. Part of the problem, Weaver said, is a complacent public. “It seems like they’ve grown immune to the drug issues,” Weaver said. “They think that they’ve heard it so much, is it really even out there? The scary part is, it’s probably affecting more lives in our state than at any time ever in history. Ever.” The Cost of Complacency The $7.2 billion cost estimate was calculated by the National Association of State Alcohol and Drug Abuse Directors, which tracks substance abuse trends. Direct costs account for an estimated $1.8 billion a year—spending on hospital care, doctors, police and prisons, for example.
Indirect costs account for another $5.4 billion in diminished productivity, work and goods never produced, people who die or fall ill. “In the oil fields of Oklahoma, if you’ve got oil workers who miss work because they’re drunk or on meth, they still pump the oil, but they have to hire more people,” said Rick Harwood, the association’s research director. “Maybe they overstaff because they know that one out of 20 is going to be absent on a given day. That’s a cost that somebody has to pay, one way or another, and usually those increases in costs are passed on.”
A year-long study by an Oklahoma task force of lawmakers and state leaders reached similar conclusions. Its 2005 report said Oklahoma pays more than $3 billion annually in direct costs related to untreated and under-treated people with addictions and mental illness. Indirect human costs added $5 billion to the toll. The group estimated that 200,000 Oklahoma workers dealing with depression and addiction were costing employers $600 million annually in additional medical expenses alone. "If you think about vibrant communities and a good economy, we have to have healthy and engaged brains ready to work," said Terri White, commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services. In 2010, parental neglect accounted for 88 percent of the 18,000 children removed from their homes by the courts and Oklahoma Department of Human Services. "Untreated addition is a major part of that, and it could've been prevented if those parents had received treatment," White said.
One of the keys to confronting Oklahoma’s addiction crisis is dealing with teenage drinking, she said. The part of a person's brain that handles critical thinking and decision-making is the prefrontal cortex. It typically does not become fully developed until a person reaches the age of 20 to 25. Alcohol impairs its development. "Significant alcohol use can actually permanently damage or stunt the growth or our prefrontal cortex," White said. "One of the most dangerous things that happens is underage drinking." Certain risk factors are found frequently among people struggling with addiction. Research shows that family history and genetics account for about 60 percent of the risk of addiction. The age at which a person starts using substances increases it—the younger, the riskier.
Joey’s Wasted Years
Joey Dawson, 36, of Hobart, had his first drink at 13. Hobart, in southwest Oklahoma, was like many small towns — there wasn’t much to do, and it seemed like everybody drank, Dawson said. Dawson had family members who had tried meth. He had seen them struggle, had seen them change; he knew the dangers. But at the age of 23, at a party, he decided to give it a shot. “From the day that I tried it, I didn’t stop until I got in trouble,” Dawson said. After about a year, Dawson started manufacturing meth. By 2002, he had meth-related charges pending in Kiowa County.
When he got in trouble four months later in Cordell, he knew he was probably going to prison. He spent 11 months in the county jail. His girlfriend gave birth to his son while he was there. That was a game-changer for Dawson. “After he was born, I realized it wasn’t about me any more,” Dawson said. “I think if they had let me out right then, I would have been fine.” Dawson was convicted on charges of manufacturing meth and possessing of a controlled dangerous substance with intent to distribute. He got two 10-year sentences that ran concurrently. He spent four years in prison at the Bill Johnson Correctional Center in Alva, matching almost day for day for the four years he was addicted to meth.
Dawson got into a treatment program at the prison. Between the program and his son, he was ready for a change. “If you’re not ready to quit, rehab isn’t going to work,” Dawson said. “If you’re not ready to quit, prison isn’t going to work. I hate to say it, but you can get drugs in prison just as readily as you can out on the streets.” Once Dawson got out, he told every old “friend” he had that he had become a snitch. It was a good way to ensure he wouldn’t repeat his past. Dawson now works for an oil and gas drilling company, is married and has custody of his 9-year-old son. Users Behind Bars Like Dawson, the majority of people headed to prison are nonviolent offenders. An analysis of nonviolent prison admissions from 2005 to 2010 showed that 44 percent involved drug-related offenses, mainly possession.
Not all offenders are as lucky as Dawson. In 2010, for example, 885 female offenders who left prison had been assessed as needing substance abuse treatment. About 72 percent of them, or 633 offenders, had not received it. A recent corrections department study determined that offenders who completed an approved substance abuse treatment program reduced their chances of returning to prison by 20 percent compared to offenders who did not complete the program. For every $100 that Oklahoma spends on substance abuse and addiction, only about $2 goes to prevention, treatment and research, while $97 goes to cover other direct costs such as incarceration, according to a study by the National Center on Addiction and Substance Abuse at Columbia University. “And the horror is that it doesn’t have to be that way because we know more effective ways to make use of the tax dollar,” said Susan Foster, vice president and director of policy at the center. “We just haven’t done it — policy hasn’t caught up with science.”
Waiting for Help
On any given day, 600 to 900 Oklahomans are on a waiting list for a bed in a publicly funded residential substance abuse center. About 160,000 Oklahomans need treatment for drug and alcohol addiction, according to the state mental health department. An estimated 20,000 teenagers are in need of drug and alcohol treatment. Alcohol abuse is far more common than drug addiction. For every seven people who need treatment for alcohol, only one needs help for drugs. But only a few get state-funded help. To qualify, a person must have no other means to pay and no other sources of help. That excludes anyone with private insurance, unless it’s a child whose private insurance company won't cover the costs. "In our system, we have enough resources to serve about one-third of the Oklahomans who financially qualify for our services and need help," said White, the mental health commissioner. "So on any given day, two-thirds of Oklahomans who need help, and qualify, can't get it."
Rhonda McGough faces this challenge every day as a drug and alcohol counselor in Idabel, a town of about 7,000 in southeast Oklahoma. “You have to try to look outside the box to get your clients access to resources readily available in their towns,” said McGough, who works for the Kiamichi Council on Alcoholism & Other Drug Abuse. The lengthy week wait for an inpatient bed sometimes is a deal-breaker. “A lot can happen in three to four months,” McGough said. “A person who comes in today and says, ‘I’m ready to do this’ may not be saying that two weeks from now.”
Ginnie Graham of the the Tulsa World, Andrew Knittle of the Oklahoman and Ron Jackson of Oklahoma Watch contributed to this report.