DRUGS TAKE BIG BITE OF STATE BUDGET

Study on substance-abuse aftermath doesn't surprise local health officials.

Missouri spends almost 13 percent of its budget dealing with the aftermath
of drug, alcohol and cigarette abuse, a private study revealed Monday.

The state spent about $1.4 billion dealing with substance abuse in 1998,
more than the state spent on Medicaid, higher education or transportation,
according to the study released by the National Center on Addiction and
Substance Abuse at Columbia University.

The three-year, state-by-state study, titled "Shoveling Up: The Impact of
Substance Abuse on State Budgets," put New York at the top in percentage of
funds — 18 percent of its budget — spent to "shovel up the wreckage" of
abuse. South Carolina had the lowest percentage — less than 7 percent.
Missouri ranked ninth in percentage of funds, and was 23rd in per capita
spending at about $254 per person.

The study showed that only about 2 percent of the amount Missouri spent was
for prevention and treatment programs. The figure was especially
frustrating — if not surprising — to local health officials.

"It's something we've been harping on in the behavioral health community
for a long time," said Paul Thomlinson, vice president for research and
quality assurance at the Burrell Behavioral Health center in Springfield.

Springfield-Greene County Director Harold Bengsch said the state total was
in line with the amount spent nationally on prevention.

"Everyone talks prevention," he said. "No one's funding it."

Thomlinson said that placing more emphasis on prevention and treatment
would not only benefit people with drug addictions, but could save the
state money as well.

"Prevention works. Treatment works," he said. "There are some programs that
have been shown to be less than sterling, but on the whole that's money
well spent."

Of the funds used to deal with substance abuse, state justice systems spent
the most — $30.7 billion nationally — on prisons, juvenile justice and
court costs.

"Treatment isn't cheap, but relatively it is, compared to what it costs to
keep someone in prison all those years," Thomlinson said.

Bengsch said there are two main reasons why so little emphasis is placed on
prevention.

"The acuteness of the problem is so great it calls for vast amounts of
expenditures to address the problem, leaving little left over for
prevention," he said. The second reason, he said, was that prevention
programs often take several years to show tangible results — something many
aren't willing to wait for.

"We are a nation that desires quick fixes," he said.

Still, Bengsch said that a tobacco tax California earmarked 10 years ago
for anti-smoking campaigns was beginning to pay dividends in lowered health
costs.

Bengsch said it's a problem that has no easy answers.

"It's a domino problem," he said. "One domino flips another one, and that
one may flip two, and it gets to the point that it permeates society. It's
just changing shapes from one community to another, but the cause is
basically the same."

The Associated Press contributed to this article.