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April 1991, Vol. 114, No. 4
Marc E. Kronson
T here are currently about 13 million substance abusers in the United States,1 and it is estimated that substance abuse cost the U. S. economy $229 billion in 1990.2 (Substance abuse is defined as the use of illicit substances or misuse of controlled substances, alcohol, or other psychoactive drugs.)
Recent data clearly suggest a major problem facing American employers. More and more dollars are spent on employee substance abuse treatment costs while work time is lost and productivity is reduced because of an employee's incapacity induced by substance abuse. To help counter this trend, employers have been adding benefits to their medical care plans to treat the acute effects of substance abuse and to assist individuals in altering their behavior.
According to data from the Bureau of Labor Statistics' Employee Benefits Survey, participation in plans providing substance abuse coverage has grown dramatically since 1983, the first year for which data are available. In that year, a little more than one-half of all participants had coverage for some form of alcohol abuse care. By 1989, approximately 97 percent were covered for alcohol abuse services. Similarly, 43 percent of health care plan enrollees had drug abuse coverage in 1983; in 1989, the figure had risen to 96 percent. (See chart 1.)3
Benefits provided for this type of care are, however, less comprehensive than those for other illnesses. Plans typically impose limits on the duration or cost of coverage, beyond those applicable to other illnesses. For example, a plan may impose a 30-day per year limit on inpatient substance abuse treatment or restrict expenses for all substance abuse care to $10,000 per lifetime.
This excerpt is from an article published in the April 1991 issue of the Monthly Labor Review. The full text of the article is available in Adobe Acrobat's Portable Document Format (PDF). See How to view a PDF file for more information.
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1 National Household Survey on Drug Abuse , 1990.
2 Substance Abuse Issues (Marsh and McLennan Cos., Winter 1990).
3 The relatively large increase in the incidence of substance abuse benefits between 1988 and 1989 is due not only to the greater extent of such benefits in health insurance plans, but also to improvements made in the survey's methods for tabulating detoxification benefits. Private industry data are not available for 1987, because the survey examined only State and local government benefit plans in that year. the extent of substance abuse coverage and details of plan provisions among government employees in 1987 was similar to the private industry data.
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