The Economic Costs of
Drug Abuse in Alaska,
2016 Update

Prepared for:

Alaska Mental Health Trust Authority

March 2017

 The Economic Costs of
Drug Abuse in Alaska,
2016 Update

Prepared for:

Alaska Mental Health Trust Authority

Prepared by:

McDowell Group Anchorage Office
1400 W. Benson Blvd., Suite 510
Anchorage, Alaska 99503
McDowell Group Juneau Office
9360 Glacier Highway, Suite 201
Juneau, Alaska 99801
Website: www.mcdowellgroup.net

March 2017

 Table of Contents
Executive Summary ....................................................................................................................... 1
Introduction and Methodology ................................................................................................... 6
Introduction ................................................................................................................................................................... 6
Report Organization ................................................................................................................................................... 6
Methodology, Definitions, and Data Sources ................................................................................................... 6
Chapter 1: Drug Consumption in Alaska .............................................................................................................................. 6
Chapter 2: Productivity Losses ................................................................................................................................................. 7
Chapter 3: Vehicle Traffic Collisions .....................................................................................................................................10
Chapter 4: Criminal Justice and Protective Services ......................................................................................................10
Chapter 5: Health Care ..............................................................................................................................................................12
Chapter 6: Public Assistance and Social Services............................................................................................................15

Abbreviations .............................................................................................................................................................. 17
Chapter 1: Drug Consumption and Prevalence in Alaska ....................................................... 19
Summary ....................................................................................................................................................................... 19
Co-Occurrence of Mental Health and Substance Abuse .............................................................................................19

Illicit Drug/Drug Abuse Consumption in Alaska ............................................................................................ 20
Marijuana ........................................................................................................................................................................................21
Other Illicit Drugs ........................................................................................................................................................................23
Cocaine ............................................................................................................................................................................................24
Nonmedical Use of Pain Relievers ........................................................................................................................................24
Drug Dependence or Abuse ...................................................................................................................................................25
Drug Dependence Only ............................................................................................................................................................26

Co-Occurring Disorders .......................................................................................................................................... 26
Co-Occurring Disorders in the U.S. ......................................................................................................................................27
Co-Occurring Disorders in Alaska .........................................................................................................................................29

Chapter 2: Productivity Losses ................................................................................................... 31
Summary ....................................................................................................................................................................... 31
Lost Productivity Due to Mortality ...................................................................................................................... 32
Estimated Productivity Losses for Primary (Underlying) Cause of Death .............................................................32
Estimated Productivity Losses for Contributing (Not Primary) Cause of Death .................................................34
Estimated Value of Potential Years of Life Lost (PYLL) .................................................................................................35

Lost Productivity Due to Incarceration .............................................................................................................. 35
Losses Due to Diminished Productivity ............................................................................................................. 36
Lost Productivity Due to Drug Treatments ...................................................................................................... 37
Lost Productivity Due to Drug Abuse Related Medical Conditions........................................................ 38
Chapter 3: Vehicle Traffic Collisions .......................................................................................... 39
Summary ....................................................................................................................................................................... 39
Impaired Traffic Collisions ...................................................................................................................................... 39
Chapter 4: Criminal Justice and Protective Services ............................................................... 42
Summary ....................................................................................................................................................................... 42
Criminal Justice ........................................................................................................................................................... 42
Offenses and Arrests ..................................................................................................................................................................42
Criminal Justice System Costs ................................................................................................................................................43
Crime Victimization.....................................................................................................................................................................44

Protective Services .................................................................................................................................................... 45
Child Protective Services ..........................................................................................................................................................45
Title 47 Protective Custody ......................................................................................................................................................46

 Chapter 5: Health Care................................................................................................................ 47
Summary ....................................................................................................................................................................... 47
Medical Costs .............................................................................................................................................................. 47
Inpatient ..........................................................................................................................................................................................47
Emergency Department (ED) Costs ......................................................................................................................................48

Costs of Treating Drug Dependence or Addiction ....................................................................................... 51
Prescription Drugs ..................................................................................................................................................... 52
Legal Use.........................................................................................................................................................................................52
Illegal Use .......................................................................................................................................................................................52

HIV and AIDS Costs................................................................................................................................................... 53
Hepatitis B and C Drug Treatment Costs.......................................................................................................... 53
Hepatitis B ......................................................................................................................................................................................54
Hepatitis C ......................................................................................................................................................................................54

Chapter 6: Public Assistance and Social Services ..................................................................... 55
Summary ....................................................................................................................................................................... 55
Social Welfare Funding............................................................................................................................................ 55
Federal .............................................................................................................................................................................................55
State ..................................................................................................................................................................................................56

Chapter 7: Drug Abuse Impacts on the State General Fund Budget ..................................... 57
Summary ....................................................................................................................................................................... 57
Healthcare Related Costs........................................................................................................................................ 57
Prevention Grants ........................................................................................................................................................................57

Social Welfare Related Costs ................................................................................................................................. 58
Criminal Justice/Corrections Related Costs ..................................................................................................... 58
References .................................................................................................................................... 61
Appendix: Mortality .................................................................................................................... 63

List of Tables
Table 1. Estimated Annual Drug-related Economic Costs to Alaska, 2015 ........................................................................... 2
Table 2. Estimated Annual Drug-related Productivity Losses, Alaska, 2015 ......................................................................... 3
Table 3. Estimated Annual Impairment-caused Traffic Collision Costs, Alaska, 2011 ....................................................... 4
Table 4. Summary of Estimated Annual Drug-related Criminal Justice and Protective Services Costs, Alaska, 2015
............................................................................................................................................................................................................. 5
Table 5. Summary of Estimated Annual Drug-related Health Care Costs, Alaska, 2015 .................................................. 5
Table 6. Estimated Annual Drug-related Social Welfare Costs, Alaska, 2015 ....................................................................... 5
Table 7. Drug-related Diagnosis and Corresponding ICD-9 Code .........................................................................................13
Table 8. Drug Prevalence Estimates, Alaska and U.S., Ages 12+, 2013-2014 .....................................................................20
Table 9. Drug Prevalence Estimates with Alaska Model-Based Population Estimates, Ages 12+, 2013-2014......21
Table 10. Illicit Drug Use in the Past Month Prevalence Estimates, by Age Group, Alaska and U.S. Comparisons,
2013-2014 .....................................................................................................................................................................................21
Table 11. Marijuana Use in the Past Year Prevalence Estimates, by Age Group, Alaska and U.S. Comparisons,
2013-2014 .....................................................................................................................................................................................22
Table 12. Marijuana Use in the Past Month Prevalence Estimates, by Age Group, Alaska and U.S. Comparisons,
2013-2014 .....................................................................................................................................................................................22
Table 13. Illicit Drug Use in the Past Month Other than Marijuana Prevalence Estimates, by Age Group, Alaska
and U.S. Comparisons, 2013-2014 ......................................................................................................................................23
Table 14. Cocaine Use in the Past Year Prevalence Estimates, by Age Group, Alaska and U.S. Comparisons, 20132014.................................................................................................................................................................................................24
Table 15. Nonmedical Use of Pain Relievers in the Past Year Prevalence Estimates, by Age Group, Alaska and
U.S. Comparisons, 2013-2014 ...............................................................................................................................................24
Table 16. Illicit Drug Dependence or Abuse in the Past Year Prevalence Estimates, by Age Group, Alaska and U.S.
Comparisons, 2013-2014 ........................................................................................................................................................25

 Table 17. Illicit Drug Dependence in the Past Year Prevalence Estimates, by Age Group, Alaska and U.S.
Comparisons, 2013-2014 ........................................................................................................................................................26
Table 18. Alaska Drug-Related Deaths, 2010-2014 ......................................................................................................................32
Table 19. Estimated Productivity Loss in Alaska, Primary Cause Drug-Attributable Mortality, by Age and Gender,
Annual Average Deaths 2010-2014, $2014 .....................................................................................................................33
Table 31. Estimated PYLL (Potential Years of Life Lost) Due to Drug-attributable Causes in Alaska, 2010-2014 35
Table 21. Incarcerations Attributed to Drug Abuse by Offense in Alaska, 2014 ...............................................................36
Table 22. Cost of Lost Productivity by Gender in Alaska, 2014 ................................................................................................36
Table 23. Alaska Labor Force Earnings Losses, Workers with a History of Drug Dependence, by Gender, 2014 37
Table 24. Alaska Labor Force Earnings Losses, Workers with a History of Drug Dependence or Abuse, by Gender,
2014.................................................................................................................................................................................................37
Table 40. Number of 24-Hour Detoxification and Residential Bed Days and Estimated Lost Earnings from Drugrelated Admissions, SFY 2015 ...............................................................................................................................................38
Table 26. Number of Clients Who Received 24-Hour Detoxification or Residential Treatment Services, Number
of Bed Days for Those Clients, and Estimated Lost Earnings, Attributable to Drugs, by Client Income
Range, SFY 2015 .........................................................................................................................................................................38
Table 27. Total Length of Stay for Inpatient and ED Treatment of Diseases and Conditions Attributable to Drug
Abuse, and Subsequent Lost Potential Earnings, SFY 2015 ......................................................................................38
Table 28. Unit Costs of Impaired (Alcohol and/or Drugs) Traffic Collisions in Alaska, 2011 ........................................40
Table 44. Number of Impairment-caused Traffic Collisions and Cost of Collisions in Alaska, 2011 .........................41
Table 30. Summary of Criminal Justice Costs Attributable to Drug Abuse in Alaska, 2014 .........................................42
Table 31. Offenses and/or Arrests Attributable to Drug Abuse in Alaska, 2014 ...............................................................43
Table 32. Criminal Justice System Costs Attributable to Drug Abuse by Offense in Alaska, 2014 ............................43
Table 33. Victimizations Attributable to Drug Abuse in Alaska, 2014 ...................................................................................44
Table 34. Crime Victim Tangible Costs Attributable to Drug Abuse in Alaska, 2014 ......................................................44
Table 35. Crime Victim Intangible Costs Attributable to Drug Abuse in Alaska, 2014 ...................................................45
Table 36. Summary of OCS Expenditures Attributable to Drugs, SFY 2015 ........................................................................45
Table 37. Summary of Alaska Medical Charges Attributable to Drug Abuse, 2012 and 2015$ ..................................47
Table 38. Summary of Alaska Inpatient Hospital Admissions, Length of Stay, and Total Charges Attributable to
Drug Abuse, 2012 and Adjusted 2015$ ............................................................................................................................47
Table 39. Summary of Alaska ED Visits, Length of Stay, and Total Charges Attributable to Drug Abuse, Alaska,
2012 and Adjusted 2015$ ......................................................................................................................................................48
Table 40. Inpatient Hospital Admissions, Length of Stay, and Charges, HFDR Total and Attributable to Drugs,
Alaska, 2012 .................................................................................................................................................................................49
Table 41. Inpatient Hospital Admissions, Length of Stay, and Charges, Total and Attributable to Drugs, Alaska,
2012.................................................................................................................................................................................................49
Table 42. Emergency Department Visits, Length of Stay, and Charges, Total and Attributable to Drug Abuse,
Alaska, 2012 .................................................................................................................................................................................50
Table 43. ED Visits, Length of Stay, and Charges, Total and Attributable to Drug Abuse, Alaska, 2012 .................50
Table 44. Percent of Admissions for Drug Only and Both Alcohol and Drug Treatment, by Treatment Setting,
SFY 2015 ........................................................................................................................................................................................51
Table 45. Number of Enrollments for Drug Treatment, by Service Type, SFY 2015 ........................................................51
Table 46. Bed Days at Drug Abuse Treatment, by Treatment Setting, SFY 2015 ..............................................................51
Table 47. DBH Grants and Medicaid Funding for Drug Abuse Treatment, by Service Type, SFY 2015 ...................52
Table 48. Alaska Cases of HIV/AIDS and Estimated Medical Costs, 2015 ............................................................................53
Table 49. Hepatitis C Cases and Estimated Drug Treatment Costs, 2015 ............................................................................54
Table 50. Federal Social Welfare Spending in Alaska Attributable to Alcohol and Drug Abuse, FFY 2014............55
Table 51. State Social Welfare Program Spending Attributable to Drug Abuse, Alaska, SFY 2015 ...........................56
Table 52. State of Alaska DBH Prevention Grant Funding for the Prevention of Drug Abuse, SFY 2015 ...............57
Table 53. Undesignated General Fund Portion of DBH Prevention Grant Funding, (‘000$) FY 2015 .......................58
Table 54. Undesignated General Fund Portion of State of Alaska Social Welfare Program Spending Attributable
to Drug Abuse, SFY 2015 ........................................................................................................................................................58
Table 55. Summary of Criminal Justice Costs Attributed to Drug Abuse in Alaska, 2014 .............................................59
Table 56. National Justice System Expenditures by Type of Government, ..........................................................................59
Table 57. State of Alaska Justice System Budgets, SFY 2015 ....................................................................................................60
Table 58. ICD-10 Codes and Drug Attributable Fractions (DAFs) by Cause of Death, Gender, and Age Group ..63
Table 59. Alaska Drug-Related Deaths, by Cause, 2010-2014..................................................................................................64
Table 60. Estimated Potential Years of Life Lost (PYLL) Due to Causes of Death Attributable to Drugs in Alaska,
2010-2014 .....................................................................................................................................................................................64

 List of Figures
Figure 1. Drug Consumption Patterns Prevalence Estimate Percentages, Alaska and U.S., Age 12+, 2013-2014 2
Figure 2. Estimated Economic Costs of Drug Abuse, by Category, 2015 ............................................................................... 3
Figure 3. Drug Consumption Patterns Prevalence Estimate Percentages, Alaska and U.S., Age 12+, 2013-2014
...........................................................................................................................................................................................................20
Figure 4. Illicit Drug Use in the Past Month Prevalence Estimates, by Age Group, Alaska and U.S. Comparisons,
2013-2014 .....................................................................................................................................................................................21
Figure 5. Marijuana Use in the Past Year Prevalence Estimates, by Age Group, Alaska and U.S. Comparisons,
2013-2014 .....................................................................................................................................................................................22
Figure 6. Marijuana Use in the Past Month Prevalence Estimates, by Age Group, Alaska and U.S. Comparisons,
2013-2014 .....................................................................................................................................................................................23
Figure 7. Illicit Drug Use in the Past Month Other than Marijuana Prevalence Estimates, by Age Group, Alaska
and U.S. Comparisons, 2013-2014 ......................................................................................................................................23
Figure 8. Cocaine Use in the Past Year Prevalence Estimates, by Age Group, Alaska and U.S. Comparisons, 20132014.................................................................................................................................................................................................24
Figure 9. Nonmedical Use of Pain Relievers in the Past Year Prevalence Estimates, by Age Group, Alaska and U.S.
Comparisons, 2013-2014 ........................................................................................................................................................25
Figure 10. Illicit Drug Dependence or Abuse in the Past Year Prevalence Estimates, by Age Group, Alaska and
U.S. Comparisons, 2013-2014 ...............................................................................................................................................25
Figure 11. Illicit Drug Dependence in the Past Year Prevalence Estimates, by Age Group, Alaska and U.S.
Comparisons, 2013-2014 ........................................................................................................................................................26
Figure 12. Past Year Co-Occurring Mental Health and Substance Use Disorders, Adults Age 18+, 2014 .............27
Figure 13. Percentage of Adults (18+ Years) with Mental Illness in the Past Year, by Past Year Drug Only or Both
Alcohol and Drug Dependence or Abuse, 2014 ............................................................................................................28
Figure 14. Percentage of Adults (18+ Years) with Drug Only or Both Alcohol and Drug Dependence or Abuse in
the Past Year, by Past Year Mental Illness, 2014 ...........................................................................................................28
Figure 15. Percentage of Substance Abuse or Dependence in the Past Year Who Received Mental Health
Treatment/Counseling and/or Illicit Drug or Alcohol Treatment in the Past Year, Age 18+, 2014 ..........29
Figure 16. Alaska Adult Past Year Mental Health Prevalence Among Persons Needing Treatment for Illicit Drug
or Alcohol Use, 2013 ................................................................................................................................................................30
Figure 17. Total Number of Alaska Adults Served with Support from State Medicaid and Behavioral Health Funds
by Diagnosis, FY2013 ...............................................................................................................................................................30
Figure 18. Estimated Productivity Loss in Alaska, Primary Cause Drug-Attributable Mortality, by Age Group and
Gender, Annual Average Deaths 2010-2014, $2014 ....................................................................................................34
Figure 19. Estimated Productivity Loss in Alaska, Primary Cause Drug-Attributable Mortality, by Age Group and
Gender, Annual Average Deaths 2010-2014, $2014 ....................................................................................................34
Figure 20. Impairment-caused (Alcohol and/or Drug) Traffic Collisions, by Type, in Alaska, 2011 ...........................40

 Executive Summary
The economic costs of drug abuse in Alaska total billions of dollars each year. Costs to society include increased
health care costs, increased criminal justice system costs, lost or reduced workplace productivity, greater
spending on public assistance and social services, and a range of other impacts. This study measures these and
other tangible economic costs associated with drug abuse.
The misuse of drugs also has a wide range of intangible costs, in terms of diminished quality of life, pain and
suffering of crime victims and others, and a spectrum of additional qualitative costs. While several measures of
these types of costs are described in this report, calculating the full extent of intangible human costs resulting
from drug abuse is beyond the scope of this study.
The Alaska Mental Health Trust Authority contracted with McDowell Group to update its series of prior studies
on the economic costs of drug abuse in Alaska. A variety of methodologies, data sources, and modeling
assumptions were required for this analysis. While some trend analysis may be possible for specific measures
of economic impact, the quality of data and modeling techniques have improved in recent years. As a result,
caution is warranted in making detailed comparison between this study and previous efforts to quantify the
economic costs of drug abuse in Alaska.

Illicit Drug Use
In 2013-2014, approximately 77,000 Alaskans (13 percent of those 12 or older) had used illicit drugs in the past
month, including 69,000 who consumed marijuana and 20,000 who used other illicit drugs (such as cocaine).
Further, 26,000 Alaskans (4 percent of those 12 or older) used pain relievers for non-medical purposes in the
previous year. Two percent of all Alaskans 12 or older (13,000) were dependent on illicit drugs. One in five
Alaskans age 12 and older consumed marijuana in the previous year.
Marijuana consumption was the only drug use in Alaska that was statistically different from the country in 20132014. Twelve percent of Alaskans used marijuana in the past month compared to 8 percent nationally, and 20
percent of Alaskans used marijuana in the past year compared to 13 percent nationwide.

(See figure next page.)

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 1

 Figure 1. Drug Consumption Patterns Prevalence Estimate Percentages, Alaska and U.S.,
Age 12+, 2013-2014
Alaska

U.S.

19.6%
13.2%
9.8%

12.9%

11.9%
8.0%

Current Illicit
Past
Drug Use
Marijuana
Use

3.5%
3.3%

4.4%
4.1%

1.5%
1.7%

3.2%

2.6%

2.2%1.9%

Current Current Drug Past Cocaine
Past
Illicit Drug Illicit Drug
Marijuana Use Other
Use
Nonmedical Dependence Dependence
Use
than
Pain Reliever or Abuse
Past Year
Marijuana
Use
Past Year

Source: National Survey of Drug Use and Health, SAMHSA.

Economic Costs of Drug Abuse in Alaska
In 2015, the estimated cost of drug abuse to the Alaska economy totaled just under $1.22 billion. These costs
are borne by state and local governments, employers, and residents of Alaska.
Productivity losses are the largest component of these annual economic costs (45 percent or $542 million).
Table 1. Estimated Annual Drug-related Economic Costs to Alaska, 2015
Productivity Loss

Drug-related
Costs
$542 million

Traffic Collisions

$396 million

33

Criminal Justice and Protective Services

$136 million

11

Health Care

$134 million

11

$7 million

1

Cost Category

Public Assistance and Social Services
Total

$1,215 million

% of
Total
45%

100%

Note: Due to rounding, some columns may not sum to the total.
Source: McDowell Group calculations.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 2

 Figure 2. Estimated Economic Costs of Drug Abuse, by Category, 2015
Drug-related Costs
($1.22 billion)
Public Assistance
Health Care and Social Services
Criminal $134 million
$7 million
Justice and
11%
1%
Protective
Services
$136 million
11%

Traffic
Collisions
$396 million
33%

Productivity
Loss
$542 million
45%

Source: McDowell Group calculations.

Categories of Economic Costs
PRODUCTIVITY LOSSES
Drug abuse results in lost productivity when it prevents people from being employed or performing household
services such as child care. Lost productivity occurs because of premature death, reduced efficiency through
physical and/or mental impairment, employee absenteeism, incarceration for criminal offenses, and medical
treatment or hospitalization.
In 2015, drug abuse resulted in $542 million in lost productivity in Alaska.
Table 2. Estimated Annual Drug-related Productivity Losses, Alaska, 2015
Productivity Category
Premature death (primary diagnosis)

Drug-related Costs

% of Total

$391.4 million

72%

Incarceration

$29.7 million

5

Diminished productivity

$119.3 million

22

$1.4 million

0.3

Drug abuse treatment
Medical conditions
Total

$0.6 million
$542.4 million

0.1
100%

Due to rounding, some columns may not sum to total.
Source: McDowell Group calculations.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 3

 TRAFFIC COLLISIONS
Substance abuse plays a major role in vehicle traffic collisions in Alaska. In 2011 (most recent available data),
1,680 people were involved in 704 impairment-related collisions in Alaska. Of these, 32 people died, 299 had
major injuries, and 63 had minor injuries. Of the 704 impairment-related collisions, 54 percent had property
damage only. Direct costs of impairment-related traffic collisions were $172.5 million. However, there was
another $818.0 million in costs for lost life and reduced quality of life, resulting in total traffic crash costs related
to substance abuse of approximately $990.5 million. Approximately 40 percent of the traffic collisions (or $396.2
million in costs) were related to drug abuse.
Table 3. Estimated Annual Impairment-caused Traffic Collision Costs, Alaska, 2011
Cost Category

Impairment-Caused
Traffic Collision Costs

% of Total, Excluding
Quality-Adjusted Life
Years
22.3%

% of Total, Including
Quality-Adjusted Life
Years
3.9%

Medical

$38.5 million

Emergency services

$0.02 million

0.1

0.02

Market productivity

$81.4 million

47.2

8.2

Household productivity

$22.6 million

13.1

2.3

Insurance administration

$9.3 million

5.4

0.9

Workplace costs

$1.6 million

1.0

0.2

Legal costs

$12.8 million

7.4

1.3

Congestion costs

$1.3 million

0.8

0.1

Property damage

$4.9 million

2.8

0.5

Direct Costs

$172.5 million

100.0%

Quality-adjusted life years

$818.0 million

-

82.6

Total, including quality-adjusted
life years
Estimated portion attributed to
drugs (40 percent of total)

$990.5 million

100.0%

$396.2 million

Note: Due to rounding, some columns may not sum to total.
Source: McDowell Group calculations.

CRIMINAL JUSTICE AND PROTECTIVE SERVICES
A significant number of crimes can be directly attributed to drug abuse, for example driving under the influence,
sale of illegal drugs, and many cases of assault, theft, and other violent and nonviolent crimes. The cost of these
crimes includes criminal justice system costs (police protection and law enforcement, legal and adjudication,
and incarceration), and the costs to crime victims (both tangible and intangible). Additionally, a portion of child
protective services are associated with drug abuse.
In 2014, there were 9,572 arrests/offenses and 12,237 crime victims attributed to drug abuse in Alaska. These
arrests/offenses represented 27 percent of all offenses in Alaska, and affected 29 percent of all crime victims.
The estimated cost of drug abuse to the criminal justice system, including tangible costs (such as medical care
costs, lost earnings, and property loss/damage to victims and Child Protective Services in Alaska) was $136.4
million. Victim intangible costs (such as pain and suffering, decreased quality of life, and psychological distress),
added another $175.4 million for a total of just under $311.8 million.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 4

 Table 4. Summary of Estimated Annual Drug-related Criminal Justice
and Protective Services Costs, Alaska, 2015
Criminal justice system

Drug-related
Costs
$73.4 million

% of
Total
54%

Crime victim tangible costs

$28.5 million

21

Cost Category

Child protective services

$34.5 million

25

Total

$136.4 million

100%

Crime victim intangible costs

$175.4 million

Total, incl. intangible costs

$311.8 million

Source: McDowell Group calculations.

HEALTH CARE
A wide variety of health care costs are associated with drug abuse, including hospitalization from injuries and
illness, residential and outpatient treatments costs, and the cost of treating human immunodeficiency virus (HIV)
and acquired immunodeficiency syndrome (AIDS), and hepatitis C. Annual drug-abuse-related health care costs
totaled $133.7 million in 2015.
Table 5. Summary of Estimated Annual Drug-related Health Care Costs, Alaska, 2015
Drug
Related Costs
$14.6 million

Cost Category
Medical inpatient

% of Total
11%

Medical ED

$3.1 million

2

Alcohol/Drug treatment

$23.5 million

18

HIV/AIDS

$2.5 million

2

Hepatitis C

$90.1 million

67

Total

$133.7 million

100.0%

Note: Due to rounding, some columns may not total.
Source: McDowell Group calculations.

PUBLIC ASSISTANCE AND SOCIAL SERVICES
Drug abuse can result in greater demand for public and social services. For example, problems with drugs can
reduce personal income due to mental and physical impairment or inability to hold a job. Drug abuse may also
lead to disability. Some or all these conditions may qualify individuals for publicly funded social programs like
food stamps, public assistance, and vocational rehabilitation. Based on prevalence rates, federal and state social
welfare costs paid to support people impacted by drug abuse totaled $7.3 million annually.
Table 6. Estimated Annual Drug-related Social Welfare Costs, Alaska, 2015
Cost Category

Drug Related Costs

% of Total

$4.7 million

64%

Federal social welfare
State social welfare

$2.6 million

Total

$7.3 million

36
100.0%

Source: McDowell Group calculations.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 5

 Introduction and Methodology
Introduction
The Alaska Mental Health Trust Authority contracted with McDowell Group to update prior studies on the
economic costs of drug abuse in Alaska. Drug abuse impacts Alaska’s economy in a variety of ways. It can lead
to greater health risks and death, impaired physical and mental abilities, crime and incarceration, greater reliance
on public assistance, and several other adverse effects. This study addresses tangible economic costs of drug
abuse, such as lost earnings among the affected population and costs of government programs. Quality of life
and other qualitative impacts of drug abuse, while substantial, are not included in this report.

Report Organization
This report contains:
•

Chapter 1: Drug Consumption in Alaska, including state comparisons and co-occurrence of drug abuse
disorders and mental illness.

•

Chapter 2: Productivity Losses, including productivity loses due to death, diminished productivity,
incarcerations, and impatient treatment or hospitalization as a result of drug abuse.

•

Chapter 3: Traffic Collisions, including number of, and estimated costs due to, substance abuse-related
traffic collisions

•

Chapter 4: Criminal Justice and Protective Services, including law enforcement, legal and adjudication,
incarceration, and victimization costs.

•

Chapter 5: Health Care, including hospital, residential and outpatient drug treatment, AIDS and HIV,
and Hepatitis B and C costs.

•

Chapter 6: Public Assistance and Social Services, including public assistance in the form of cash, food
stamps, child care assistance, or other social services provided by the state and federal government.

•

Chapter 7: Implications for Drug Abuse Impacts on the State General Fund Budget, including healthcare, criminal justice, corrections, and other related costs.

•

References

Methodology, Definitions, and Data Sources
A variety of methodologies, data sources, and modeling techniques were required for this analysis. Methods
and sources relevant to each chapter of the study are described below.

Chapter 1: Drug Consumption in Alaska
Data were analyzed from one primary source:
1.

National Survey of Drug Use and Health (NSDUH): This dataset includes national and state-level
data on drug use and mental health within the U.S., including prevalence estimates, trends in illicit drug
consumption, levels of consumption, demographic characteristics of illicit drug consumers, and national

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 6

 and state consumption comparisons. For an adequate sample, Alaska results were pooled from surveys
conducted in 2013 and 2014. Some definitions used in NSDUH analysis include:
a.

Illicit Drugs ― Marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin,
or prescription-type drugs (i.e., pain relievers, tranquilizers, stimulants, or sedatives) that were
nonmedical.

b. Nonmedical Use ― Use of prescription-type drugs that were not prescribed for the
respondent or were used only for the experience or feeling they caused. Nonmedical use of
prescription-type drugs does not include over-the-counter drugs. Nonmedical use of
stimulants and of any prescription-type drug includes methamphetamine use.
c.

Drug Dependence or Abuse ― Based on criteria in the Diagnostic and Statistical Manual of

Mental Disorders (DSM-IV), including such symptoms as withdrawal, tolerance, use in
dangerous situations, trouble with the law, and interference with major obligations at work,
school, or home during the past year. 1
To obtain data on those with co-occurring disorders, McDowell Group compiled data from the U.S. Department
of Health and Human Services’ Substance Abuse and Mental Health Services Administration’s (SAMHSA) annual
National Survey on Drug Use and Health (NSDUH). This report includes national data on substance abuse and
mental illness in the U.S. as well as estimates of the rate of co-occurrence of mental health issues [any mental
health illness (AMI), serious mental health illness (SMI), and major depressive episodes (MDE)] and substance
use disorders among adults age 18+ in the United States. A special request was made to SAMHSA for Alaska’s
NSDUH data from April 2014, which provided some Alaska-specific counts on co-occurrence.
Additionally, in 2016, a report titled “Alaska Behavioral Health Systems Assessment Final Report” was prepared
for the Alaska Mental Health Trust Authority. The purpose of the report was to analyze the “behavioral health
system in Alaska and the barriers and opportunities to meeting the behavioral health needs of Alaskans” with
the goal to “describe the system, assess the need for services and capacity to meet the need, develop a
framework for regular monitoring of the system, and identify barriers, opportunities, and recommendations for
system improvement.”

Chapter 2: Productivity Losses
Several methods were used to estimate the economic impact of different causes of productivity loss.
MORTALITY CAUSES
A special data request for death counts was made to the DHSS, Division of Public Health, Health Analytics &
Vital Records (formerly the Bureau of Vital Statistics (BVS)). Due to small numbers for some causes, a multi-year
period (2010-2014) was used to estimate the number of deaths statewide. BVS provided two datasets: 1) counts
where drug-related causes of death were the underlying (primary) cause of death; and 2) counts where a 100
percent attributable alcohol or drug-related cause of death was listed as any reason other than the primary
cause for the death in the record. These two different death counts demonstrate the various degrees of drug
abuse impacts; they were not combined as there is overlap in the counts.

For details, see American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC:
Author.

1

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McDowell Group, Inc.  Page 7

 Drug-Attributable Fractions
Drug-attributable fractions (DAF) were gathered from three sources: (1) the CDC’s Vital Statistics section; (2) the
article “Substance-attributable morbidity and mortality changes to Canada's epidemiological profile:

Measurable differences over a ten-year period” by Jayadeep Patra and Benjamin Taylor, et al. and published in
the Canadian Journal of Public Health; and (3) “The Costs of Alcohol and Drug Abuse in Maine” by Anne L.
Rogers, Marcella H. Sorg, et al. prepared for the Maine Office of Substance Abuse and Mental Health Services
Department of Health and Human Services (with DAFs pulled from the National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA) “The Economic Costs of Alcohol and Drug Abuse in the United States

1992”). NIDA compiled the diagnoses and conditions attributable to drug abuse. For each diagnosis and
condition, the study reported the percent of cases attributable to drug abuse. The percentages are called DAFs.
The DAFs and ICD-10 codes used in this report may be found in the appendix. DAFs are based on national data.

Potential Years of Life Lost Due to Death from Drugs
BVS provided the potential years of life lost (PYLL) for each death using the ICD-10 codes by age and gender.
These calculations assume a 75-year lifespan. Using the appropriate DAFs for each cause of death, an estimate
of the number of PYLL attributable to drugs was calculated. No economic costs were applied to these
calculations because the complex modeling required was outside the scope of this analysis.
INCARCERATION CAUSES
The primary method for estimating lost productivity due to incarceration involved applying potential earnings
to the number of inmates absent from the workforce due to drug-abuse-related incarcerations. Statewide
incarceration counts by gender and offense were gathered from the Alaska Department of Corrections (DOC)’s

Alaska Offender Profile, 2014 ― an annual report that examines the total inmate population by offense category
and calendar year.
Drug attributable rates were drawn from the U.S. Department of Justice’s National Drug Intelligence Center
(NDIC) report, The Economic Impact of Illicit Drug use on American Society 2011. Drug-related offenses were
fully attributed to drugs. For other offenses, the NDIC’s drug-attributable rates were based on the Bureau of
Justice Statistics’ (BJS) Survey of Inmates in Local Jails, Survey of Inmates in State Correctional Facilities, and the

Survey of Inmates in Federal Correctional Facilities.
DIMINISHED PRODUCTIVITY CAUSES
To estimate economic productivity losses by gender, the NDIC report, “The Economic Impact of Illicit Drug Use

on American Society 2011” was used: a 17 percent decrease attributable to drug use in productivity for males
and an 18 percent decrease for females. Other sources include DOLWD’s population estimates, ACS’s estimates
for median individual annual average earnings by gender, and SAMHSA’s 2013-2014 Alaska NSDUH incidence
estimates for past year drug dependence and drug dependence or abuse.
This report provides two different estimates of impaired productivity losses for drug use. The first is for
individuals who reported drug dependence in the past year. The second is for individuals who reported either
drug dependence or abuse in the past year. The estimates should not be added together as there is overlap.
Definitions of abuse or dependence or abuse were taken from DSM-IV.
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 HOSPITALIZATION AND TREATMENT CAUSES
To estimate lost earnings, the total length of stay for drug-attributable inpatient hospital and emergency
department (ED) visits was multiplied by the statewide average daily work-place earnings.
A study commissioned in 1998 by the National Institute of Drug Abuse, The Economic Costs of Alcohol and

Drug Abuse in the United States – 1992, compiled the diagnoses and conditions attributable to drug abuse. For
each diagnosis and condition, the study reported the percent of cases attributable to drug abuse. The
percentages are called drug-attributable fractions. This report draws from that compilation.
The total length of stay for drug-attributable inpatient and ED visits was obtained through the Alaska Hospital
Facilities Data Reporting Program (HFRP), which collects discharge data from inpatient, ED, and other outpatient
facilities throughout the state. The most recent data available was from 2012. Without more recent data, this
2012 data serves as a proxy for 2015 hospital information. Additionally, Department of Health and Social
Services (DHSS) estimates that approximately 70 percent of the state’s hospital facilities reported to HFRP in
2012. Admissions and length of stay were adjusted by this factor to arrive at an estimate for the entire state.
Drug-attributable fractions from the 1998 study were applied to Alaska HFRP totals to determine the length of
stay attributable to drug abuse. Length of stay was measured in days for both inpatient admissions and ED
visits. To estimate days of lost work, it was assumed that a visit to the ED consumed an entire day. If an ED visit
occurred over the course of multiple days – a patient was admitted to the ED on one day and discharged on a
different day – all days are considered lost-work days.
The Alaska Department of Labor and Workforce Development (DOLWD) publishes annual average wage data
for Alaska workers. The 2015 annual average wage of $50,150 was converted to average earnings per work day
of $192 (based on 261 work days per year).
Income-related data, including employment status and annual household income ranges, was provided by DBH
for clients in 24-hour detoxification and residential treatment services. DBH also provided the total number of
bed days at 24-hour detoxification and at residential services in 2015.
The number of bed days were separated into those associated with drug treatment based on the proportions
of admissions associated with drugs only, and both alcohol and drugs.
It was assumed that patients under age 18 were in school rather than in the labor force and, therefore, did not
forfeit direct earnings while admitted. Annual incomes were converted to earnings per day (based on 261 work
days per year) using the midpoint of each income range provided in the data. Total incomes were reduced by
a factor of .746, the average proportion of total personal income attributable to personal earnings (wages and
salaries) for Alaskans in 2015 per the Bureau of Economic Analysis.
The total number of bed days was distributed according to the proportions of clients in each income range.
Then, the number of bed days associated with each income range was multiplied by earnings per day of that
range to arrive at an estimate for lost earnings.

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 Chapter 3: Vehicle Traffic Collisions
This chapter examines nine categories of costs incurred from vehicle traffic accidents, plus a quality-adjusted
life-years (QALY) cost. The National Highway Traffic Safety Administration (NHSTA), which estimates the costs,
provides the following definitions for the nine categories:
1.

Medical: The cost of all medical treatment associated with motor vehicle injuries, including treatment
given during ambulance transport. Medical costs include ED and inpatient hospitalization costs, followup visits, physical therapy, rehabilitation, prescriptions, prosthetic devices, and home modifications.

2.

Emergency services: Police and fire department response costs.

3.

Market productivity: The net present value of the lost wages and benefits over the victim’s remaining
life span.

4.

Household productivity: The net present value of lost productive household activity, valued at the
market price for hiring a person to accomplish the same tasks.

5.

Insurance administration: The administrative costs associated with processing insurance claims
resulting from motor vehicle collisions and defense attorney costs.

6.

Workplace costs: The costs of workplace disruption due to the loss or absence of an employee. This
includes the cost of retraining new employees, overtime required to accomplish work of the injured
employee, and the administrative costs of processing personnel changes.

7.

Legal costs: The legal fees and court costs associated with civil litigation resulting from traffic collisions.

8.

Congestion costs: The value of travel delay, added fuel usage, greenhouse gas and criteria pollutants
that result from congestion that results from motor vehicle collisions.

9.

Property damage: The value of vehicles, cargo, roadways, and other items damaged in traffic collisions.

The number of vehicle traffic collisions in Alaska was obtained from DOTPF’s most recent report available, 2011

Crash Data. In addition to reporting all traffic collisions, the report gives the number of impaired (alcohol and/or
drug) collisions. Due to differences in reporting injury levels between NHSTA and DOTPF, NHSTA’s MAIS Level
1 was matched to DOTPF’s “minor injury” category and MAIS Level 5 was matched to DOTPF’s “major injury”
category. Both sources report “fatal” and “property damage only” incidences.
No data were available to separate costs related to drug abuse from those related to alcohol abuse. In the
absence of data, the study team assumed the split of drug- and alcohol-related collusions would be like all
other components of costs measured in this study, which is approximately 40 percent drug-related and 60
percent alcohol-related.

Chapter 4: Criminal Justice and Protective Services
OFFENSES AND ARRESTS
Costs related to the criminal justice system were estimated based on arrest and offense data from the Alaska
Department of Public Safety (DPS) Uniform Crime Reporting document, Crime in Alaska, 2014, and the FBI’s
annual Uniform Crimes Report (UCR). As part of the nationwide Unified Crime Reporting system, DPS reports
known offenses annually. In 2014, law enforcement agencies reporting to DPS had jurisdiction over 99.4 percent
of Alaska’s population. The data show all known offenses regardless of whether an arrest was made. They include
the categories of criminal homicide (murder and manslaughter), rape (rape and attempts to commit rape),
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 aggravated assault, other assault, robbery, burglary, larceny/theft, and auto theft. Data for the remaining
categories of driving while intoxicated, other sex offenses (including prostitution and commercialized vice), and
liquor laws represent are from the FBI’s UCR alone.
Drug attribution rates were gathered from the NDIC report, The Economic Impact of Illicit Drug use on American

Society 2011. Drug-law offenses were attributed in full to drugs. For other offenses, the NDIC’s drug attributable
rates were based on the BJS’s Survey of Inmates in Local Jails, Survey of Inmates in State Correctional Facilities,
and the Survey of Inmates in Federal Correctional Facilities.
CRIMINAL JUSTICE SYSTEM
The primary source used to estimate criminal justice system costs for specified crimes as the 2010 NIH report,

The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program Evaluation.
Costs for the criminal justice system addressed in the NIH report include “local, state, and federal government
funds spent on police protection; legal and adjudication services; and correction programs, including
incarceration.” This study was used to estimate the cost for criminal homicide, rape and other sexual offenses,
assaults, robbery, burglary, larceny-theft, and motor vehicle theft.
CRIME VICTIMIZATION
Bureau of Justice Statistics (BJS) publishes national data on victimization rates per 1,000 people age 12+ or per
1,000 households. These rates are published in the annual National Criminal Victimization Survey (NCVS) report.
The NCVS collects information on nonfatal crimes reported and not reported to police from a nationally
representative sample of U.S. households. The 2014 victimization rates were applied to Alaska’s 2014 population
age 12 and older (published by DOLWD) or to ACS 2010-2014 Five-Year Data count of Alaska households to
find the number of victims for specified crimes for the state.
The 2010 NIH report was also used to estimate tangible costs for crime victim, defined as the cost of “direct
economic losses suffered by crime victims, including medical care costs, lost earnings, and property
loss/damage.” Tangible victim costs were estimated for homicide, assaults, rape/sexual assault, robbery,
burglary, theft, and motor vehicle theft. These were adjusted for inflation and Alaska’s cost-of-living differential.
Data from the 2010 NIH report were also used to estimate intangible costs, which include “indirect losses
suffered by crime victims, including pain and suffering, decreased quality of life, and psychological distress.”
These intangible costs include pain and suffering, and the probability of being killed while a crime is occurring
(corrected risk-of-homicide costs). Intangible victim costs were estimated for homicide, assaults, rape/sexual
assault, robbery, burglary, theft, and motor vehicle theft. The costs were adjusted for inflation and Alaska’s costof-living differential.
To find the number of Alaska crime victims, the BJS’s annual national data on victimization rates were used. The
2014 victimization rates were applied to Alaska’s 2014 population (DOWLD) or to ACS’s 2010-2014 Five-Year
Data of Alaska households count to find the number of victims for specified crimes. Drug attribution rates from
the NDIC were then applied to estimate the number of crime victimizations attributed to drugs in Alaska.

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 PROTECTIVE SYSTEMS
The National Survey of Children and Adolescent Well-Being estimates that 61 percent of infants and 41 percent
of older children in out-of-home care are from families with active alcohol or drug abuse (Wulczyn, Ernst, &
Fisher, 2011). For almost 31 percent of all children placed in foster care in 2012, parental alcohol or drug abuse
was the documented reason for removal and in several states that percentage surpassed 60 percent (National
Data Archive on Child Abuse and Neglect, 2012).
While there are no accurate data available, according to the Alaska Office of Children’s Services (OCS),
approximately 75 percent of its cases may result from or involve alcohol or drug abuse. To estimate the total
costs of child abuse and neglect attributable to alcohol or drug abuse, this percentage was applied to OCS
actual expenditures for State Fiscal Year (SFY) 2015. This estimate assumes the workload for all OCS functions,
not just case work but administrative and support services as well, is proportional to the number of cases
involving alcohol and drug abuse. To separate costs attributable to alcohol from costs attributable to drugs, it
was estimated that alcohol accounts for two-thirds of the total and drugs one-third. This estimate is drawn from
the 1998 National Institute on Drug Abuse study, The Economic Costs of Alcohol and Drug Abuse in the United

States – 1992.
An estimate of the percent of cases related to drug abuse was not available from the Division of Senior and
Disability Services. Therefore, costs for adult protective services are not estimated in this report.

Chapter 5: Health Care
Table 7 below lists the drug-related diagnoses used to estimate inpatient and ED costs. More detailed tables of
ICD-10 codes and attributable fractions used in this health care chapter can found in Tables 40 (inpatient) and
42 (Emergency Department).
INPATIENT COSTS
Alaska Hospital Facilities Data Reporting Program (HFDR) collects discharge data for inpatient, ED, and other
outpatient settings from health care facilities in Alaska. At the time of this report, the HFDR 2012 dataset was
the most recent year of data available.
NIDA’s The Economic Costs of Alcohol and Drug Abuse in the United States – 1992 compiled the diagnoses and
conditions attributable to drug abuse. For each diagnosis and condition, the study reported the percent of cases
attributable to drug abuse (also known as DAFs).
The Alaska HFDR 2012 dataset provided the number of admissions, length of stay, and hospital charges for each
drug attributable diagnosis or condition. DAFs were applied to those totals to determine the amounts
attributable to drug abuse. Charges presented by HFDR represent the amount charged by a facility for services,
not the final amount paid.
In 2012, not all hospital facilities in Alaska reported to the HFDR. DHSS estimates that the HFDR 2012 dataset
represents 70 percent of the state’s total inpatient, ED, and other outpatient hospital visits or admissions. For
inpatient data, the total number of admissions, length of stay, and hospital charges attributable to drug abuse
were divided by 0.7 to estimate statewide totals.
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 EMERGENCY DEPARTMENT COSTS
The methodology for ED data mirrors that for inpatient data. ED visits for the same diagnoses and conditions
used for hospital admissions were pulled from the HFDR 2012 dataset. Totals were adjusted by the 70 percent
to estimate statewide totals.
Table 7. Drug-related Diagnosis and Corresponding ICD-9 Code
Diagnosis

ICD-9 Code

Drug mental disorders and psychoses

292.xx

Drug dependence

304.xx

Non-dependent abuse of drugs

305.2x, 305.3x, 305.4x, 305.5x, 305.6x, 305.7x, 305.8x, 305.9x

Polyneuropathy due to drugs

357.6

Drug dependence complicating pregnancy,
childbirth, or puerperium

648.3x

Drugs affecting fetus or newborn via placenta or
breast

760.72, 760.73, 760.75

Drug withdrawal syndrome in newborn

779.5

Fetal damage due to drugs

655.5x

Poisoning by opiates and related narcotics

965.0x

Poisoning by sedatives and hypnotics

967.xx

Poisoning by CNS muscle tone depressants

968

Poisoning by psychotropic agents

969.xx

Poisoning by CNS stimulants

970.xx

TREATMENT FOR DRUG ABUSE
Data were compiled for costs incurred and number of admissions for four drug use disorder services: 24-hour
detoxification, residential, outpatient (non-opioid), and outpatient-opioid. The analysis includes funding from
two sources: Behavioral Health Treatment and Recovery grants awarded to agencies by the Alaska Division of
Behavioral Health (DBH) and Medicaid payments for services provided by those agencies to Medicaid
beneficiaries. The analysis does not include payments from other sources such as Medicare, Indian/Native
Health Services, other public funding sources, or private insurance. Additionally, the number of bed days are
presented for two service types: 24-hour detoxification and residential treatment.
For agencies receiving treatment and recovery grants, DBH provided SFY 2015 data on the number of statewide
admissions by service type (24-hour detoxification, residential, outpatient (non-opioid), and outpatient-opioid)
and by substance of abuse (drugs only, or alcohol and drugs). DBH also provided the treatment and recovery
grant award amounts and Medicaid payments to grantee agencies by service type. The grant and Medicaid
payment totals did not distinguish the amount for treating alcohol dependence/abuse from the amount for
treating drug dependence/abuse. This allocation was estimated by applying to the grant and Medicaid payment
totals the proportions of enrollment associated with admissions for each substance of abuse (drugs only, or
alcohol and drugs). Enrollments and admissions differ in that a single admission could be associated with
enrollment into multiple service types. For enrollments treating both alcohol and drug dependence/abuse, it
was estimated that half were for alcohol dependence/abuse and half for drug dependence/abuse. These
amounts were added to totals for drug only, respectively.

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 DBH also provided the SFY 2015 number of bed days for 24-hour detoxification and residential treatment. The
number of bed days was not initially separated by substance of abuse. This separation was estimated with the
same methodology used for grant totals and Medicaid payments described above.
HEPATITIS C COSTS
Significant changes to hepatitis C virus (HCV) treatment have occurred in recent years. Due to the complexity
of quantifying the costs to treat HCV, these estimates have some limitations. The number of new HCV cases in
Alaska, available through the state’s Infectious Disease Program, serves as a proxy for the number of patients
treated each year. Data compiled by the CDC in 2013 suggest injection drug use (IDU) as a risk factor for 61.6
percent of new HCV cases 2. This percent was applied to the number of new cases to estimate the number of
2F3F

annual treatments attributable to IDU. It is important to note that years when new cases are reported are not
necessarily the years when HCV was contracted.
Two common HCV medications are Harvoni and Viekira Pak. A 12-week course of the medications has a
wholesale acquisition cost (the price set by manufacturers) of $94,500 and $84,000, respectively. The number of
new cases of HCV in Alaska in 2015 attributable to IDU was multiplied by the average cost of the 12-week
courses of Harvoni and Viekira Pak.
It is important to recognize the estimated costs are limited by the complexity of HCV treatment and a lack of
available data. For one, multiple genotypes of HCVs exist, each requiring unique treatment guidelines and
medication. Multiple medications exist that vary in price by type and length of prescription (6 weeks, 12 weeks,
or 24 weeks). Additionally, pharmaceutical companies negotiate prices with each insurer or pharmacy separately
and sometimes give away medications for low-income patients.
While the State of Alaska Infectious Disease Program tracks new reported cases of HCV, it does not track the
number of patients receiving treatments. Those receiving treatment could be not only new reported cases, but
those cases backlogged in the years prior to the new and more effective treatment methods made recently
available. To obtain the number of actual treatments would require the release of information by all health care
providers in the state that treat HCV. A more representative total for the costs of treating HCV would include
the number of cases treated, the treatment type for each case, and the amount paid for the treatment type.
Unsuccessful attempts were made to obtain this information from pharmaceutical manufacturers and health
care providers. This analysis does not include the high costs associated with liver treatment or transplants.
Theoretically, these costs are included under the impatient and outpatient cost estimates.
HIV AND AIDS COSTS
DHSS’s Division of Public Health’s Epidemiology Section compiles and reports data on infectious disease cases
reported in the state. Since 1982, the state has tracked HIV and AIDS in several ways, including all known cases
in the state and cases first diagnosed in the state of HIV (non-AIDS) and HIV with AIDS. The state also records
methods of transmission.

Surveillance for Viral Hepatitis – United States,
http://www.cdc.gov/hepatitis/statistics/2013surveillance/

2

The Economic Costs of Drug Abuse in Alaska, 2016 Update

2013.

The

Centers

for

Disease

Control

and

Prevention.

McDowell Group, Inc.  Page 14

 For this report, the transmission estimate counts of interest are IDU, and male-to-male sex and IDU. From 1982
to 2015, there were 1,680 total reported cases of HIV and HIV with AIDS. Of these 1,680 cases, 330 were
attributed to IDU, for an Alaska-specific attribution rate of 19.6 percent; this is similar to the national rate
reported in NDIC report, “The Economic Impact of Illicit Drug use on American Society 2011,” of 18.5 percent.
PREVENTION SERVICES
DBH prevention grants target mental health and substance abuse. Some target only mental health or only
substance abuse, while others target both. This study separates out the grants for mental health and reports
only the grants directed towards substance abuse. For grants that target both substance abuse and mental
health, DBH assisted in estimating what proportion went towards substance abuse prevention. The total amount
directed towards substance abuse prevention was then further separated to identify totals for alcohol abuse
prevention and drug abuse prevention. If grant recipient programs used funds to prevent both alcohol and drug
abuse, it is estimated that half went to the prevention of alcohol abuse and half to the prevention of drug abuse,
unless otherwise informed by DBH.
It is important to note that only grants with funding for substance abuse prevention are reported. There are
prevention grants directed solely towards mental health prevention that are not included.

Chapter 6: Public Assistance and Social Services
FEDERAL GOVERNMENT COSTS
This report captures federal funding from federal FY 2014, the most recent available published data, for the
following programs: Old Age, Survivors, and Disabilities Insurance (OASDI); Supplemental Security Income (SSI);
Temporary Assistance for Needy Families (TANF); and Supplemental Nutrition Assistance Program (SNAP).
The NIDA study, The Economic Costs of Alcohol and Drug Abuse in the United States – 1992, compiled the
national prevalence of drug abuse among beneficiaries of different social welfare programs. This study applied
those prevalence rates to the federal funding allocated to Alaska through the programs listed above. The NIDA
study estimated that one-third of total funding attributable was to drug abuse. This report adopts that estimate.
STATE GOVERNMENT COSTS
The State of Alaska Office of Management and Budget published actual expenditures for SFY 2015 for individual
programs operated by the Division of Public Assistance (DPA). Prevalence rates for drug abuse among social
welfare beneficiaries – taken from the 1998 NIDA study – were applied to state funding for welfare programs to
determine the portion attributable to drug abuse.
PREVENTION GRANTS
DBH provided SFY 2015 data on prevention grants, also used under the health care costs section. This report
separated from the total grant values the amounts directed towards substance abuse. For grant recipient
programs that prevent both substance abuse and other mental health issues, DBH assisted in estimating what
proportion went towards substance abuse prevention. The grant value allocated to substance abuse prevention
was then further separated to identify totals for alcohol abuse prevention and drug abuse prevention. If grant

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 recipient programs used funds to prevent both alcohol and drug abuse, this report estimated that half went to
the prevention of drug abuse.
JUSTICE SYSTEM
Justice system governmental finances and employment data were compiled from U.S. Census Bureau
information. The justice data include the expenditures and employment of the federal government, state
governments, and a sample of county, municipal, and township governments. Unless otherwise noted, data for
total governmental expenditures, including justice and non-justice governmental functions, also include the
expenditures of special districts and school districts, which generally do not have justice functions. The 2012
survey sample was selected from the 2007 Census of Local Governments and consists of large units of
government (including all 50 state governments) sampled with certainty and smaller units selected with a
probability proportional to the unit’s expenditure. It was designed to produce data by type of government
estimate with a relative standard error of 3 percent or less for total expenditure and state estimates with a
relative standard error of 5 percent or less on total expenditure, criminal justice, and other government
functions. All other government units were selected into the sample with a probability proportional to their size.

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 Abbreviations
ACS

American Community Survey

AIDS

Acquired Immunodeficiency Syndrome

AMI

Any Mental Health Illness

ART

Antiretroviral Treatment

BJS

Bureau of Justice Statistics

BVS

Bureau of Vital Statistics

CDC

Centers for Disease Control and Prevention

DAF

Drug-attributable Fractions

DBH

Division of Behavioral Health

DHSS

Alaska Department of Health and Social Services

DOC

Alaska Department of Corrections

DOLWD

Alaska Department of Labor and Workforce Development

DOTPF

Alaska Department of Transportation and Public Facilities

DPA

Division of Public Assistance

DPS

Alaska Department of Public Safety

DSDA

Alaska Division of Senior and Disability Services

DSM-IV

Diagnostic and Statistical Manual of Mental Disorders

ED

Emergency Department

ESRI

Environmental Systems Research Institute

GF

General Fund

HFRP

Alaska Hospital Facilities Data Reporting Program

HIV

Human Immunodeficiency Virus

IDU

Injection Drug Use

LTC

Long Term Care

MDE

Major Depressive Episodes

NAMI

National Alliance on Mental Illness

NCVS

National Criminal Victimization Survey

NDIC

National Drug Intelligence Center

NHSTA

National Highway Traffic Safety Administration

NIDA

National Institute on Drug Abuse

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 NIH

National Institute of Health

NSDUH

National Survey of Drug Use and Health

OSC

Office of Children Services

PFAS

Partial FAS

PYLL

Potential Years of Life Lost

QALY

Quality-adjusted Life Years

QCEW

Quarterly Census of Employment and Wages

SAMHSA

Substance Abuse and Mental Health Services Administration

SFY

State Fiscal Year

SMI

Serious Mental Health Illness

SNAP

Supplemental Nutrition Assistance Program

SNF

Skilled Nursing Facility

SSI

Supplemental Security Income

SUD

Substance Use Disorder

TANF

Temporary Assistance for Needy Families

UCR

Uniform Crime Report

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McDowell Group, Inc.  Page 18

 Chapter 1: Drug Consumption and Prevalence
in Alaska
Summary
•

In 2013-2014, approximately 77,000 Alaskans age 12 or older (13 percent) used illicit drugs in the past
month, including 69,000 (12 percent) consuming marijuana and 20,000 (4 percent) using other illicit
drugs (such as cocaine). Approximately 26,000 Alaskans (4 percent) used pain relievers for non-medical
reasons, and 13,000 Alaskans (2.2 percent) were illicit-drug dependent.

•

In 2013-2014, 114,000 Alaskans 12 years or older (20 percent) reported consuming marijuana in the
past year.

•

Marijuana use was considerably higher in Alaska than nationally; with 12 percent saying they consumed
marijuana in the past month compared to 8 percent in the U.S. and 20 percent consuming in the past
year in Alaska compared to 13 percent in the U.S.

•

Other than marijuana, consumption rates for illicit drugs in Alaska were similar to national rates in 20132014.

•

In 2013-2014, young adult Alaskans (age 18-25) had the highest percent of illicit drug use by age group,
with 24 percent saying they had used illicit drugs in the past month. Among that age group:
o

37 percent used marijuana in the past year.

o

21 percent used marijuana in the past month.

o

7 percent used other illicit drugs in the past month (excluding marijuana).

o

4 percent used cocaine in the past year.

o

9 percent used painkillers non-medically.

o

9 percent were drug dependent or abusing drugs (including 7 percent who were just drug
dependent).

Co-Occurrence of Mental Health and Substance Abuse
•

In 2013, there were approximately 62,815 adults in Alaska who needed treatment for a substance use
disorder (SUD).

•

Of those who needed treatment, approximately 37 percent (22,990 people or 3 percent of Alaska’s
population) also have a mental illness.

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 Illicit Drug/Drug Abuse Consumption in Alaska
In 2013-2014, approximately 13.2 percent of Alaskans age 12 or older reported illicit drug use in the past month,
including 11.9 percent consuming marijuana and 3.5 percent using other illicit drugs (such as cocaine). In 20132014, 19.6 percent of Alaskans reported consuming marijuana sometime in the past year. Overall illicit drug use
was higher in Alaska (13.2 percent) than nationally (9.8 percent). Marijuana use was also considerably higher in
Alaska than the national averages of 8 percent consuming in the past month and 12.9 percent consuming in
the past year. There were no statistically significant differences between consumption patterns for other illicit
drugs for Alaska and nationally.
Table 8. Drug Prevalence Estimates, Alaska and U.S., Age 12+, 2013-2014
Drug Indicator, Ages 12+

Percent

Alaska
95% Confidence
Interval
11.5 – 15.2%

United States
95% Confidence
Percent
Interval
9.8%
9.5 – 10.0%

Illicit drug use in past month

13.2%

Marijuana use past year

19.6%

17.5 -21.9%

12.9%

12.6 – 13.2%

Marijuana use past month
Illicit drug use in past month, other than
marijuana
Cocaine use past year

11.9%

10.1 – 13.8%

8.0%

7.7 – 8.2%

3.5%

2.7 – 4.4%

3.3%

3.1 – 3.4%

1.5%

1.1 – 2.2%

1.7%

1.6 – 1.8%

Nonmedical use of pain relievers past year

4.4%

3.6 – 5.4%

4.1%

3.9 – 4.2%

Illicit drug dependence or abuse past year

3.2%

2.6 – 4.0%

2.6%

2.5 – 2.8%

Illicit drug dependence in past year

2.2%

1.7 – 2.8%

1.9%

1.8 – 2.0%

Source: National Survey of Drug Use and Health, SAMHSA.

Figure 3. Drug Consumption Patterns Prevalence Estimate Percentages, Alaska and U.S.,
Age 12+, 2013-2014
Alaska

13.2%
9.8%

U.S.

19.6%
12.9%

Current Illicit
Past
Drug Use
Marijuana
Use

11.9%
8.0%

3.5%
3.3%

1.5%
1.7%

4.4%
4.1%

3.2%

2.6%

2.2%1.9%

Current Current Drug Past Cocaine
Past
Illicit Drug Illicit Drug
Marijuana Use Other
Use
Nonmedical Dependence Dependence
Use
than
Pain Reliever or Abuse
Past Year
Marijuana
Use
Past Year

Source: National Survey of Drug Use and Health, SAMHSA.

Approximately 77,000 Alaskans used illicit drugs in the past month (2013-2014), including 69,000 who
consumed marijuana and 20,000 who used other illicit drugs. Approximately 114,000 Alaskans used marijuana
in the past year (2013-2014). Approximately 26,000 Alaskans used pain relievers for non-medical purposes in
the past year. Approximately 13,000 Alaskans are illicit drug dependent.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 20

 Table 9. Drug Prevalence Estimates with Alaska Model-Based Population Estimates,
Age 12+, 2013-2014
% of
Alaskans
13.2%

95% Confidence
Interval
11.5 – 15.2%

# of
Alaskans
77,000

95% Confidence
Intervals
66,000 – 88,000

Marijuana use past year

19.6%

17.5 -21.9%

114,000

101,000 – 127,000

Marijuana use past year
Illicit drug use in past month, other than
marijuana
Cocaine use past year

11.9%

10.1 – 13.8%

69,000

59,000 – 80,000

3.5%

2.7 – 4.4%

20,000

16,000 – 26,000

1.5%

1.1 – 2.2%

9,000

6,000 – 13,000

Nonmedical use of pain relievers past year

4.4%

3.6 – 5.4%

26,000

21,000 – 31,000

Illicit drug dependence or abuse past year

3.2%

2.6 – 4.0%

19,000

15,000 – 23,000

Illicit drug dependence in past year

2.2%

1.7 – 2.8%

13,000

10,000 – 16,000

Drug Indicator, Ages 12+
Illicit drug use in past month

Source: National Survey of Drug Use and Health, SAMHSA.

The highest percent of illicit drug use (in the past month) by age group occurred among young adults (24.4
percent of all Alaskans age 18-25). Alaskans age 12 or older are more likely to use illicit drugs (13.2 percent)
than nationally (9.8 percent).
Table 10. Illicit Drug Use in the Past Month Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Alaska
95% Confidence
Interval
7.9 – 12.1%

United States
95% Confidence
Percent
Interval
9.1%
8.7 – 9.5%

Age Group

Percent

12-17 years

9.8%

18-25 years

24.4%

21.1 – 28.1%

21.8%

21.2 – 22.4%

12+ years

13.2%

11.5 – 15.2%

9.8%

9.5 – 10.0%

18+ years

13.6%

11.7 – 15.8%

9.8%

9.6 – 10.1%

26+ years

11.6%

9.6 – 13.9%

7.8%

7.5 – 8.1%

Source: National Survey of Drug Use and Health, SAMHSA.

Figure 4. Illicit Drug Use in the Past Month Prevalence Estimates, by Age Group, Alaska and U.S.
Comparisons, 2013-2014
Alaska

24.4%

U.S.

21.8%
13.2%

9.8% 9.1%

12-17 years

18-25 years

9.8%

12+ years

13.6%

9.8%

18+years

11.6%

7.8%

26+ years

Source: National Survey of Drug Use and Health, SAMHSA.

Marijuana
The highest percent of marijuana use (in the past year) by age group occurred with young adults (36.5 percent
of all Alaskans age 18-25). Alaskans age 12 or older are more likely to use marijuana (19.6 percent) than
nationally (12.9 percent).

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 21

 Table 11. Marijuana Use in the Past Year Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Alaska
95% Confidence
Interval
14.7 – 20.2%

United States
95% Confidence
Percent
Interval
13.3%
12.8 – 13.7%

Age Group

Percent

12-17 years

17.3%

18-25 years

36.5%

32.7 –40.4%

31.8%

31.1 – 32.5%

12+ years

19.6%

17.5 -21.9%

12.9%

12.6 – 13.2%

18+ years

19.9%

17.6 – 22.3%

12.9%

12.6 – 13.2%

26+ years

16.7%

14.2 – 19.5%

9.6%

9.3 – 10.0%

Source: National Survey of Drug Use and Health, SAMHSA

Figure 5. Marijuana Use in the Past Year Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Alaska

U.S.

36.5%
31.8%
17.3%

19.9%

19.6%
13.3%

12-17 years

12.9%

18-25 years

12+ years

12.9%

18+years

16.7%
9.6%

26+ years

Source: National Survey of Drug Use and Health, SAMHSA.

The highest percent of marijuana use (in the past month) by age group occurred with young adults (21.3 percent
of all Alaskans age 18-25). Alaskans age 12 or older are more likely to use marijuana (11.9 percent) than
nationally (8.0 percent).
Table 12. Marijuana Use in the Past Month Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Age Group

Percent

Alaska
95% Confidence
Interval
7.4 – 11.3%

United States
95% Confidence
Percent
Interval
7.2%
6.9 – 7.6%

12-17 years

9.2%

18-25 years

21.3%

18.2 – 24.7%

19.3%

18.7 – 19.9%

12+ years

11.9%

10.1 – 13.8%

8.0%

7.7 – 8.2%

18+ years

12.2%

10.3 – 14.3%

8.0%

7.8 – 8.3%

26+ years

10.4%

8.5 – 12.8%

6.1%

5.9 – 6.4%

Source: National Survey of Drug Use and Health, SAMHSA.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 22

 Figure 6. Marijuana Use in the Past Month Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Alaska

U.S.

21.3% 19.3%
11.9%

9.2% 7.2%

12-17 years

18-25 years

8.0%

12+ years

12.2%

8.0%

18+years

10.4%

6.1%

26+ years

Source: National Survey of Drug Use and Health, SAMHSA.

Other Illicit Drugs
The highest percent of other illicit drug use (not including marijuana) in the past month, by age group, occurred
among young adults (7.4 percent of all Alaskans age 18-25).
Table 13. Illicit Drug Use in the Past Month Other than Marijuana Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Age Group

Percent

12-17 years

2.9%

Alaska
95% Confidence
Interval
2.1 – 4.1%

United States
95% Confidence
Percent
Interval
3.3%
3.1 – 3.5%

18-25 years

7.4%

5.7 – 9.6%

6.6%

6.2 – 6.9%

12+ years

3.5%

2.7 – 4.4%

3.3%

3.1 – 3.4%

18+ years

3.6%

2.8 – 4.6%

3.3%

3.1 – 3.5%

26+ years

2.8%

2.0 – 3.95

2.7%

2.6 – 2.9%

Source: National Survey of Drug Use and Health, SAMHSA.

Figure 7. Illicit Drug Use in the Past Month Other than Marijuana Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Alaska

2.9%

3.3%

12-17 years

7.4% 6.6%

18-25 years

U.S.

3.5% 3.3%

3.6% 3.3%

12+ years

18+years

2.8%

2.7%

26+ years

Source: National Survey of Drug Use and Health, SAMHSA.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 23

 Cocaine
The highest percent of cocaine use (in the past year) by age group occurred among young adults (3.8 percent
of all Alaskans age 18-25).
Table 14. Cocaine Use in the Past Year Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Age Group

Percent

12-17 years

0.5%

Alaska
95% Confidence
Interval
0.3 – 0.9%

United States
95% Confidence
Percent
Interval
0.6%
0.5 – 0.7%

18-25 years

3.8%

2.7 – 5.4%

4.5%

4.2– 4.8%

12+ years

1.5%

1.1 – 2.2%

1.7%

1.6 – 1.8%

18+ years

1.7%

1.1 – 2.4%

1.8%

1.7 – 1.9%

26+ years

1.2%

0.8 – 2.0%

1.3%

1.2 – 1.4%

Source: National Survey of Drug Use and Health, SAMHSA.

Figure 8. Cocaine Use in the Past Year Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Alaska
0.5% 0.6%
12-17 years

3.8% 4.5%
18-25 years

1.5%

U.S.
1.7%

12+ years

1.7%

1.8%

18+years

1.2%

1.3%

26+ years

Source: National Survey of Drug Use and Health, SAMHSA.

Nonmedical Use of Pain Relievers
The highest percent of nonmedical use of pain relievers (in the past year) by age group occurred among young
adults (9.0 percent of all Alaskans age 18-25).
Table 15. Nonmedical Use of Pain Relievers in the Past Year Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Alaska
95% Confidence
Interval
3.5 – 5.8%

United States
95% Confidence
Percent
Interval
4.7%
4.4 – 4.9%

Age Group

Percent

12-17 years

4.5%

18-25 years

9.0%

7.2 – 11.2%

8.3%

8.0 – 8.7%

12+ years

4.4%

3.6 – 5.4%

4.1%

3.9 – 4.2%

18+ years

4.4%

3.5 – 5.5%

4.0%

3.8 – 4.2%

26+ years

3.5%

2.7 – 4.7%

3.3%

3.1 – 3.5%

Source: National Survey of Drug Use and Health, SAMHSA.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 24

 Figure 9. Nonmedical Use of Pain Relievers in the Past Year Prevalence Estimates, by Age Group, Alaska
and U.S. Comparisons, 2013-2014
Alaska
4.5%

4.7%

12-17 years

9.0% 8.3%

18-25 years

U.S.

4.4% 4.1%

4.4% 4.0%

12+ years

18+years

3.5%

3.3%

26+ years

Source: National Survey of Drug Use and Health, SAMHSA.

Drug Dependence or Abuse
The highest percent of illicit drug dependence or abuse (in the past year) by age group occurred among young
adults (8.7 percent of all Alaskans age 18-25). 3
5F 5F

Table 16. Illicit Drug Dependence or Abuse in the Past Year Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Age Group

Percent

12-17 years

3.4%

Alaska
95% Confidence
Interval
2.5 – 4.7%

United States
95% Confidence
Percent
Interval
3.5%
3.3 – 3.8%

18-25 years

8.7%

6.9 – 11.0%

7.0%

6.6 – 7.4%

12+ years

3.2%

2.6 – 4.0%

2.6%

2.5 – 2.8%

18+ years

3.2%

2.5 – 4.1%

2.6%

2.4 – 2.7%

26+ years

2.1%

1.5 – 3.0%

1.8%

1.7– 1.9%

Source: National Survey of Drug Use and Health, SAMHSA.

Figure 10. Illicit Drug Dependence or Abuse in the Past Year Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Alaska

3.4%

8.7%
3.5%

12-17 years

U.S.

7.0%

18-25 years

3.2% 2.6%

3.2% 2.6%

2.1% 1.8%

12+ years

18+years

26+ years

Source: National Survey of Drug Use and Health, SAMHSA.

Based on criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), including such symptoms as withdrawal, tolerance,
use in dangerous situations, trouble with the law, and interference with major obligations at work, school, or home during the past year.

3

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 25

 Drug Dependence Only
The highest percent of illicit drug dependence only (in the past year) by age group occurred among young
adults (6.5 percent of all Alaskans age 18-25).
Table 17. Illicit Drug Dependence in the Past Year Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Age Group

Percent

12-17 years

1.9%

Alaska
95% Confidence
Interval
1.3 – 2.7%

United States
95% Confidence
Percent
Interval
1.9%
1.7 – 2.1%

18-25 years

6.5%

4.9 – 8.7%

5.0%

4.7 – 5.3%

12+ years

2.2%

1.7 – 2.8%

1.9%

1.8 – 2.0%

18+ years

2.2%

1.7 – 2.9%

1.3%

1.2 – 1.5%

26+ years

1.4%

1.0 – 2.0%

1.9%

1.8 – 2.0%

Source: National Survey of Drug Use and Health, SAMHSA.

Figure 11. Illicit Drug Dependence in the Past Year Prevalence Estimates, by Age Group,
Alaska and U.S. Comparisons, 2013-2014
Alaska

U.S.

6.5%
5.0%
1.9% 1.9%
12-17 years

18-25 years

2.2% 1.9%

2.2% 1.9%

1.4% 1.3%

12+ years

18+years

26+ years

Source: National Survey of Drug Use and Health, SAMHSA.

Co-Occurring Disorders
While substance use disorders (SUD) have been documented as a problem in Alaska and nationwide, not often
mentioned are individuals with SUDs who also have a mental health issue, defined as a co-occurring disorder.
Research has shown individuals with co-occurring disorders display higher rates of substance dependence or
abuse than the population as a whole. Further, they are likely to receive treatment only for their mental illness
rather than for substance dependence or abuse.
According to the National Alliance on Mental Illness (NAMI), people with co-occurring disorders are far more
prone to violence, medication noncompliance, and failure to respond to treatment. The poor response is
because they are normally undergoing treatment for only one disorder, not both. Further, individuals with cooccurring disorders not only suffer from poorer overall functioning, they also have a significantly greater chance
of relapse to substance use. Finally, people with co-occurring disorders are more likely to live in high-risk
locations such as marginal neighborhoods with high substance usage, and they have a more difficult time
forming social relationships and becoming involved in their communities.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 26

 This means people with co-occurring disorders are highly likely to be homeless. In 2011, SAMHSA estimated 50
percent of homeless persons with serious mental illness (SMI) have a co-occurring SUD. 4
In 2000, DHSS partnered with what was then the Alaska Mental Health Board and the Advisory Board on
Alcoholism and Drug Abuse to identify challenges and barriers in caring for individuals with co-occurring mental
health and substance use disorders. The goals of the project were to improve treatment outcomes, to improve
accessibility of services and quality of care, and to improve efficiency in administration to minimize costs and
facilitate greater use of funds for client services. As part of the program, the project team administered a survey
of substance use disorder and mental health providers. Mental health providers reported up to three-quarters
of their clients experienced co-occurring disorders, compared to 42 percent of substance abuse providers. 5
DHSS’s DBH was a product of this project and continues to work towards integration and improvement of
services.

Co-Occurring Disorders in the U.S.
According to NSDUH data from “Behavioral Health Trends in the United States: Results from the 2014 National

Survey on Drug Use and Health,” in 2014, there were 20.2 million adults (age 18 or older) with a past year SUD,
and an additional 43.6 million adults who had any mental illness (AMI). Among these two groups, there were
7.9 million adults who had both an SUD and AMI (39 percent of the 20.2 million who have an SUD plus 18
percent of the 43.6 million who have AMI). The 7.9 million adults with co-occurring disorders represents 3.3
percent of the total U.S. population, with 2.3 million experiencing the co-occurrence of an SUD and a serious
mental health illness (SMI) (1.0 percent of the total U.S. population).
Figure 12. Past Year Co-Occurring Mental Health and Substance Use Disorders, Adults Age 18+, 2014

Adults with Past Year
Substance Use Disorder

Adults with Past Year Any
Mental Health Illness
SUD and Mental Illness
7.9 million
18%

SUD, No
Mental Illness
12.3 million
61%

SUD and
Mental
Illness
7.9 million
39%

Total adults with past year substance
abuse disorder: 20.2 million

7.9 million

SUD, No Mental Illness
35.6 million
82%

Total adults with past year mental
health illness: 43.6 million

Source: U.S. Department of Health and Human Services, SAMHSA NSDUH, “Behavioral Health Trends in the United States: Results
from the 2014 National Survey on Drug Use and Health” (2015).

4 National Alliance on Mental Illness (NAMI), Dual Diagnosis and Integrated Treatment of Mental Illness and Substance Abuse Disorder,
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=54&ContentID=23049.
5
DHSS, Final Report of the Steering Committee, Substance Abuse/Mental Health Integration Project, http://www.hss.state.ak.us/abada/pdf/itfinal.pdf.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 27

 In 2014, among adults with AMI, only 16 percent had no drug abuse. However, 57 percent were dependent on
or abusing both illicit drugs and alcohol, and 51 percent were dependent on or abusing illicit drugs only. Among
adults with serious mental illness, only 3 percent had no substance dependence or abuse. However, 20 percent
were dependent on or abusing both illicit drugs and alcohol, and 18 percent were dependent or abusing illicit
drugs only.
Figure 13. Percentage of Adults (18+ Years) with Mental Illness in the Past Year,
by Past Year Drug Only or Both Alcohol and Drug Dependence or Abuse, 2014
Any Mental Health Illness

Serious Mental Health Illness

56.5%
50.6%

20.4%

16.2%

17.5%

3.4%
None

Both illicit drugs and alcohol

Illicit drugs only

Source: SAMHSA’s NSDUH, “Results from the 2014 National Survey on Drug Use and Health: Mental Health Detailed

Tables” (2015).

In 2014, among adults with SUDs, 3 percent of those with AMI were dependent on or abusing both illicit drugs
and alcohol, and 7 percent were dependent on or abusing illicit drugs only. For those with past year SMI, 5
percent were dependent on or abusing both illicit drugs and alcohol, and 11 percent were dependent on or
abusing illicit drugs only.
Figure 14. Percentage of Adults (18+ Years) with Drug Only or Both Alcohol and Drug
Dependence or Abuse in the Past Year, by Past Year Mental Illness, 2014
Any Mental Illness

Serious Mental Illness
11.1%
7.2%

4.8%
3.0%

Both illicit drugs and alcohol

Illicit drugs only

Source: SAMHSA’s NSDUH, “Results from the 2014 National Survey on Drug Use and Health: Mental Health Detailed

Tables” (2015).

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 28

 Mental health and substance use co-occurring disorders are not limited to adults. While NSDUH does not
estimate overall mental health among adolescents age 12-17, it does provide estimates of adolescents having
a past year major depressive episode (MDE). MDE is defined as a period of two or more weeks in the past year
when an individual experiences a depressed mood or loss of interest or pleasure in daily activities, with at least
four out of seven qualifying symptoms (i.e. problems with sleep, eating, energy, concentration, and self-worth).
In 2014, there were an estimated 271,000 adolescents in the U.S. who had an SUD and an MDE, approximately
1.1 percent of all U.S. adolescents.
TREATMENT
In 2014, among adults who had substance abuse or dependence in the past year and received some form of
treatment, 46 percent with AMI received mental health or substance treatment, 34 percent with AMI received
mental health treatment only, 4 percent with AMI received substance treatment only, and 9 percent with AMI
received both mental health and substance treatment. Of adults who had a past year substance abuse or
dependence and received some form of treatment, 66 percent of those with SMI received mental health or
substance treatment, 46 percent of those with SMI received mental health treatment only, 3 percent of those
with SMI received substance treatment only, and 17 percent of those with SMI received both mental health and
substance treatment.
Figure 15. Percentage of Substance Abuse or Dependence in the Past Year Who Received
Mental Health Treatment/Counseling and/or Illicit Drug or Alcohol Treatment in the Past Year,
Age 18+, 2014
Any mental illness

Serious mental illness

65.7%
46.4%

46.1%
33.9%
3.5%

Mental health OR
substance treatment

Mental health
treatment only

8.9%

2.6%

Substance treatment
only

17.0%

BOTH mental health
and substance
treatment

Source: SAMHSA’s NSDUH, “Results from the 2014 National Survey on Drug Use and Health: Mental Health

Detailed Tables” (2015).

Co-Occurring Disorders in Alaska
According to the report “Alaska Behavioral Health Systems Assessment Final Report,” in 2013, there were
approximately 62,815 adults in Alaska who needed treatment for an SUD. Of those who needed treatment,
22,990 were estimated to have AMI (37 percent of those needing SUD treatment), approximately 3.1 percent of
the total Alaska population. Of those with AMI and an SUD, 16 percent had SUD and mild mental illness, 10
percent had moderate mental illness and SUD, and 11 percent had SMI and SUD.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 29

 Figure 16. Alaska Adult Past Year Mental Health Prevalence Among Persons Needing Treatment for
Illicit Drug or Alcohol Use, 2013
Mild mental illness
and SUD
10,239
16%
Moderate
mental illness
and SUD
6,281
10%

SUD only
39,762
63%

Serious mental
illness and SUD
6,533
11%

Source: Alaska Mental Health Trust Authority, “Alaska Behavioral
Health Systems Assessment Final Report” (2016).

TREATMENT
According to SAMHSA’s National Survey of Substance Abuse Treatment Services (N-SSATS), in 2013, Alaska had
91 treatment facilities; of which 83 offered treatment services for co-occurring disorders. 6
Per a report produced for the Alaska Mental Health Trust Authority, in SFY 2013, Alaska behavioral health
services served 27,728 unique adult clients with support from State Medicaid and/or behavioral health funds.
There were 14,442 individuals with SUD, 16,641 with SMI, 2,061 with mental illness other than SMI, 3,327 with
co-occurring SMI and SUD, and 363 with co-occurring SUD and mental illness other than SMI. Adults with SUD
or SMI make up 61 percent of the total, and co-occurring disorders comprise 13 percent of the 27,728 Alaska
adults.
Figure 17. Total Number of Alaska Adults Served with Support from State Medicaid and Behavioral
Health Funds by Diagnosis, FY2013
27,728
14,442

16,841

2,061
Total

Substance use Serious mental Mental illness
disorder
illness
(other than
SMI)

3,327

363

Co-occurring
SMI and SUD

Co-occurring
mental illness
(other than
SMI) and SUD

Notes: Alcohol and/or Related Deaths, as defined, with 100 percent alcohol or drug-attributable ICD-10 codes listed in at
least one contributing cause of death, as coded in the International Classification of Diseases, 10th Revision.
Source: Alaska Mental Health Trust Authority, “Alaska Behavioral Health Systems Assessment Final Report” (2016).

6http://www.samhsa.gov/data/sites/default/files/2013_N-SSATS/2013_NSATS_National_Survey_of_Substance_Abuse_

Treatment_Services.pdf

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 30

 Chapter 2: Productivity Losses
Summary
•

From 2010 to 2014, there were 908 deaths in Alaska that had an ICD-10 code potentially linked to drugs.
By applying the attributable fractions, 792 (87 percent) of the deaths were attributable to drug abuse.
Between 2010 and 2014, there was an average of 158 drug-related deaths per year.

•

There are two ways to measure productivity loss due to drug-related deaths: 1) deaths where the
primary (or underlying) causes of death are linked to drugs or 2) deaths where drugs were not linked
to the primary cause but were a subsequent cause with an attributable fraction assigned to that cause
of 100 percent due to drugs (see Tables 58-60 in the appendix for details on which causes are 100
percent attributable). These two measures cannot be combined because there will be overlap between
deaths where both primary and subsequent causes were attributable to drug abuse. However, both
measures are useful as indicators of the productivity loss associated with drug abuse.

•

Productivity loss due to deaths where drugs are the primary cause of death totaled approximately $391
million in Alaska in 2014.
o

An average of 58 women and 100 men died per year from drug abuse.

o

Female deaths attributed to drugs caused a productivity loss of $107.5 million (27 percent of
the total), while male deaths caused the remaining $284.0 million productivity loss.

o

The age group with the highest productivity loss was ages 25-34, followed by 35 to 44 years,
and 45 to 54 years.

•

The estimated cost of lost productivity due to drug abuse-related incarceration in Alaska in 2014 was
about $29.7 million, including $4.4 million for women (15 percent) and $25.4 million for men (85
percent).

•

In 2014, productivity losses due to drug dependence were an estimated $81.4 million.
o

Men had an estimated loss of $48 million (59 percent) while women were estimated to have a
loss of $33 million (41 percent).

•

In 2014, productivity losses due to drug dependence or abuse were approximately $119.3 million.
o

Men had an estimated loss of $70 million (59 percent) and women were estimated to have a
loss of $49 million (41 percent).

•

In SFY 2015, admission to 24-hour detoxification and residential treatment services resulted in an
estimated loss $1 million in potential earnings associated with drug abuse/dependence. These lost
earnings were associated with approximately 42,000 bed days for drug treatment.

•

In SFY 2015, 3,197 lost days of work for medical treatment of diseases and conditions attributable to
drug abuse resulted in an estimated $613,824 in lost earnings.

•

In 2015, in total, drug abuse resulted in $775 million in lost productivity in Alaska.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 31

 Lost Productivity Due to Mortality
One of the largest economic costs to Alaska due to drug abuse results from premature death. Various causes
of death can be attributed to drug abuse either directly or indirectly, such as motor vehicle collisions, diabetes,
or homicide. In all such cases, premature death results in the loss of the person’s potential productivity. Total
lost productivity as a result of death makes up the largest drug abuse-attributable cost to the Alaska economy.
Since each individual has the potential to join the workforce and contribute to the economy, premature death
costs the economy in the form of lost production of goods and services as well as the circulation of earned
wages back into the local economy. While some individuals may not join the workforce, they nevertheless have
the potential to create societal value by performing household services, such as raising children and maintaining
the household.
According to DHSS’ BVS, 908 deaths occurred in Alaska from 2010 to 2014 that included an ICD-10 code that
could be linked to drugs. By applying the attributable fractions, it was estimated 792 of these deaths (87 percent)
were attributable to drugs. There was an annual average of 158 drug-related deaths between 2010 and 2014.
Table 18. Alaska Drug-Related Deaths, 2010-2014
Deaths Caused by
Selected ICD-10
Diagnoses
2010-2014

Estimated Drug Attributable
Deaths
2010-2014

Annual Average Drug
Attributable Deaths
Per Year

Directly attributable (100
percent)

756

756

151

Partially attributable <100
percent

152

36

7

Total

908

792

158

Notes: Due to rounding columns may not add to totals. See the Appendix for ICD-10 codes used and drug attribution rates, along with
estimations by cause of death.
Source: Death counts provided by DHSS’ Division of Public Health Bureau of Vital Statistics’ (BVS) unpublished data and McDowell Group
calculations. Drug attribution rates from CDC’s Vital Statistics; Patra et al. “Substance-attributable morbidity and mortality changes to
Canada's epidemiological profile: Measurable differences over a ten-year period;” and Rogers et. al. “The Costs of Alcohol and Drug Abuse

in Maine.”

Estimated Productivity Losses for Primary (Underlying) Cause of Death
The table below shows the annual average number of drug-attributable deaths by age and gender from 2010
to 2014 where drugs were the primary cause of death. The table includes estimates of the inflation-adjusted
future earnings for each age group and gender and the estimated economic loss by age group and gender. 7
The primary causes of drug-related deaths with the highest annual costs were accidental poisoning by and
exposure to drugs, medicaments, and biological substances (96 deaths per year); suicide by and exposure to
drugs, medicaments, and biological substances (11 deaths per year); and hepatitis C (6 deaths per year). (A full
list of deaths by primary cause and counts are in the appendix.)

7

Please note, the totals in this section may differ slightly than totals in other sections in this chapter due to the removal of deaths where
the age of the person is unknown.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 32

 Total productivity loss due to drug-attributable deaths is estimated at $391.4 million. About 27 percent of the
productivity loss attributed to drugs ($107.5 million) is associated with female deaths. The remaining 73 percent
($284.0 million) is associated with male deaths).
Table 19. Estimated Productivity Loss in Alaska, Primary Cause Drug-Attributable Mortality,
by Age and Gender, Annual Average Deaths 2010-2014, $2014
Annual Ave.
Drug
Attributable
Deaths

Net Present Value
of Future Earnings
(3% Discount
Rate)

Estimated
Loss Due to
Drugs ($)

0-4 years

1.6

$2,240,253

$3,584,405

5-14 years

0.6

$2,641,089

$1,584,653

15-24 years

6.2

$3,056,355

$18,949,401

25-34 years

10.8

$2,847,565

$30,782,178

35-44 years

13.3

$2,185,690

$29,161,476

45-54 years

13.3

$1,343,687

$17,825,352

55-64 years

10.0

$532,092

$5,306,021

65-74 years

2.2

$122,750

$272,996

75-84 years

0.5

$22,338

$11,437

85+ years

0.2

$1,113

$223

Females Total

58

-

$107,478,142

0-4 years

1.8

$3,028,719

$5,451,694

5-14 years

0.6

$3,572,336

$2,143,402

15-24 years

10.6

$4,225,625

$44,791,625

25-34 years

23.3

$4,185,264

$97,374,352

35-44 years

19.3

$3,390,101

$65,537,433

45-54 years

23.3

$2,214,940

$51,581,523

55-64 years

17.2

$960,192

$16,492,258

65-74 years

2.2

$250,985

$547,147

75-84 years

0.9

$48,252

$41,304

85+ years

0.4

$4,054

$1,622

Males Total

100

-

$283,962,359

Overall Total

158

-

$391,440,502

Females

Males

Note: Due to rounding columns may not add to totals. For universal understanding,
the term, “primary” is substituted for the official term, “underlying.”
Source: Death counts provided by DHSS’ BVS’ unpublished data, and McDowell Group
calculations. Drug attribution rates from CDC’s Vital Statistics; Patra et al., and Rogers
et. al. Net present value of future earnings from Wendy Max, Dorothy Rice, Hai-Yen
Sung, Martha Michel, "Valuing Human Life: Estimating the Present Value of Lifetime
Earnings, 2000” (2004). Values have been adjusted for inflation from ADOLWD
Research and Analysis, http://laborstats.alaska.gov/cpi/cpi.htm.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 33

 Figure 18. Estimated Productivity Loss in Alaska, Primary Cause Drug-Attributable Mortality,
by Age Group and Gender, Annual Average Deaths, 2010-2014, $2014
$140,000,000
$120,000,000
$100,000,000
$80,000,000
$60,000,000
$40,000,000
$20,000,000
$0
00-04 05-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
years years years years years years years years years years
Note: The term, “primary” is substituted for the official term, “underlying” because it is more commonly understood.
Source: DHSS’ BVS’ unpublished data, McDowell Group calculations, CDC’s Vital Statistics, Patra et al., Rogers et al.,
Max et al., and DOLWD.

In 2014 dollars, the age group with the largest loss was 25 to 34 years, followed by 35 to 44 years, and 45 to 54
years.
Figure 19. Estimated Productivity Loss in Alaska, Primary Cause Drug-Attributable Mortality,
by Age Group and Gender, Annual Average Deaths, 2010-2014, $2014
Females

Males

$150,000,000
$100,000,000
$50,000,000
$0
00-04 05-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
years years years years years years years years years years
Note: The term, “primary” is substituted for the official term, “underlying” because it is more commonly understood.
Source: DHSS’ BVS’ unpublished data, McDowell Group calculations, CDC’s Vital Statistics, Patra et al., Rogers et al.,
Max et al., and ADOLWD.

Estimated Productivity Losses for Contributing (Not Primary) Cause of Death
Another way to estimate productivity loss is to consider substance abuse-related deaths when the primary cause
of death was not alcohol and/or drug-attributable, but rather a contributing cause and the attributable fraction
assigned to that cause is 100 percent (see Tables 58-60 in the appendix for details on which causes of death are
100 percent attributable).
For the purposes of this study, deaths attributed to drugs was not separated from those attributed to alcohol.
Based on this methodology, the number of substance abuse-attributable deaths between 2010 and 2014 is
1,970, for an annual average of 394 alcohol and/or drug-related deaths per year from 2010-2014.
For all deaths where alcohol and/or drugs were a contributing cause and where the attribution rate assigned to
the cause was 100 percent due to alcohol or drugs, there was an estimated productivity loss of $708.9 million.
The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 34

 Females had an annual average of 152 deaths per year for a productivity loss of $211.5 million (30 percent of
total), while males averaged 242 deaths per year for a productivity loss of $497.4 million (70 percent of total).
The age group with the highest productivity loss was ages 45-54, followed by ages 25-34, and 35-44.

Estimated Value of Potential Years of Life Lost (PYLL)
Yet another way to see the impact of mortality due to drugs is by calculating the potential years of life lost
(PYLL). These estimates are based on an average 75-year lifespan for both males and females, and are based on
a person’s age at the time of their death and how many years they would have been expected to live if drugs
had not been a factor in their deaths.
Using the PYLL method, between 2010 and 2014, there were 618 deaths attributable to drugs for a total of
20,067 PYLL per year. No attempt was made to calculate a monetary value for PYLL.
Table 20. Estimated PYLL (Potential Years of Life Lost) Due to Drug-attributable Causes
in Alaska, 2010-2014
Cause
Directly attributable (100 percent)

Total Number of Drug
Attributable Deaths
557

Partially attributable <100 percent
Total

PYLL Attributable
to Drugs
18,391

Average PYLL
Per Year
3,678

61

1,636

327

618

20,027

4,005

Note: Due to rounding columns may not add to totals.
Source: Death counts provided by DHSS’ BVS’ unpublished data, and McDowell Group calculations. Drug attribution rates from
CDC’s Vital Statistics; Patra et al., and Rogers et. al.

Lost Productivity Due to Incarceration
Alaska also experiences lost productivity from people incarcerated because of drugs. Incarcerated individuals
may commit a crime directly related to drug use, such as driving while intoxicated or selling narcotics. They may
also commit crimes when they are under the influence of a drug or to obtain more drugs. It is assumed
incarcerated adults could otherwise be productive members of the workforce or in households. Therefore, their
absence from society due to incarceration is an economic loss for Alaska.
The table below shows the number of inmates in Alaska by offense category, the percentages of crimes
attributable to drugs, the estimated numbers of inmates attributed to drugs, and the estimated total number
of inmates attributed to drug abuse. In 2014, there were 3,302 inmates incarcerated in Alaska for the specified
offenses. Of those inmates incarcerated 734 were attributed to drugs (22 percent of inmates incarcerated for
these specific offenses).

(See table next page.)

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 35

 Table 21. Incarcerations Attributed to Drug Abuse by Offense in Alaska, 2014
Type of Offense

2014 Alaska Inmates
by offense category 1

Percent
Attributed
to Drugs 2

Estimated Number
Attributed to
Drugs

340

0%

0

Alcohol offenses
Assault

749

6%

48

Burglary

108

34%

36

Drug offenses

433

100%

433

Homicide/murder/
manslaughter

429

7%

31

Larceny-theft

286

39%

112

Motor vehicle theft

49

18%

9

Prostitution

2

12%

0

Robbery

130

28%

36

Sexual offenses

776

4%

29

Total

3,302

734

Alaska Department of Corrections (DOC), “Alaska Offender Profile, 2014” (2015).
http://www.correct.state.ak.us/admin/docs/Final_2014_Profile.pdf
2 U.S. Department of Justice National Drug Intelligence Center (NDIC), “The Economic Impact of Illicit
Drug Use on American Society 2011” (2011).
1

To estimate the cost of lost productivity, the study team obtained median individual annual average earnings
for Alaska’s population 16 or older by gender from the ACS 2010-2014 Five-Year Data. These earnings (adjusted
for inflation to 2014 dollars) were $42,923 (+/-$800) for males and $30,441 (+/-$400) for females. The estimated
cost of lost productivity due to incarceration related to drug abuse in Alaska in 2014 was $29.7 million; $4.4
million from women (15 percent) and $25.4 million from men (85 percent). 8
Table 22. Cost of Lost Productivity by Gender in Alaska, 2014
Estimated Number

Attributed
to Drugs1

Total1

Median
Earnings2

Earnings Lost Due to
Incarceration Due to Drugs

Females incarcerated

143

249

$30,441

$4,353,063

$42,923

Males incarcerated

591

1,483

Total

734

1,732

$25,367,493
$29,720,556

Source: 1 McDowell Group calculations based on DOC and NDIC drug attribution rates. 2 American Community
Survey (ACS) 2010-2014 Five-Year Data.

Losses Due to Diminished Productivity
Drug dependence or abuse can impair an individual's productivity in employment (physical and/or mental
impairment; ability, willingness, or motivation to work or find a job; etc.) and non-employment activities
(household chores, parenting, etc.). These estimates address only workplace earnings. While non-employment
impacts are important, there is no generally accepted method to compute monetary values for household
activities.

8 The large differential between men and women is partly because of men’s higher earnings but mainly because men are a much larger
proportion of the prison population than women.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 36

 Two different estimates of impaired productivity losses in traditional earnings are presented below. The first is
for individuals who reported drug dependence in the past year, while the second is for individuals who reported
drug dependence or abuse in the past year. The estimates cannot be added together as there is overlap.
In 2014, there was an estimated loss of $81.4 million in labor force earnings due to drug dependence. Males
lost an estimated $48.0 million (59 percent) and females an estimated $33.4 million (41 percent).
Table 23. Alaska Labor Force Earnings Losses, Workers with a History of Drug Dependence,
by Gender, 2014
Male

Female

Total

years 1

300,185

278,476

578,661

2013-2014 Annual average percentage of population 12+ years
reporting past year drug dependence 3

2.2%

2.2%

-

2014 Alaska population 15+

2014 Estimated number of Alaskans 15+ years dependent
2010-2014 Median Alaska individual annual average earnings 4
Loss in productivity from drug dependence

2

Estimated productivity loss due to drug dependence

6,574

6,099

12,673

$42,923

$30,441

-

17.0%

18.0%

-

$47,970,262

$33,416,681

$81,386,943

Note: Due to rounding, some columns may not sum to total.
1 Alaska Department of Labor and Workforce Development’s 2014 population estimates.
2
U.S. Department of Justice National Drug Intelligence Center (NDIC), “The Economic Impact of Illicit Drug Use on American Society 2011”
(2011).
3 SAMHSA’s “National Survey on Drug Use and Health, 2013 and 2014 – Alaska” (2014).
4 American Community Survey (ACS) 2010-2014 Five-Year Data.

The loss in productivity for individuals who reported past year drug dependence or abuse was estimated to be
$119.3 million in 2014. Males lost an estimated $70.3 million (59 percent) and females an estimated $49.0 million
(41 percent).
Table 24. Alaska Labor Force Earnings Losses, Workers with a History of Drug Dependence or Abuse,
by Gender, 2014
Male

Female

Total

years 1

300,185

278,476

578,661

2013-2014 Annual average percentage of population 12+ years
reporting past year drug dependence or abuse 3

3.2%

3.2%

-

2014 Estimated number of Alaskans 15+ years dependent or
abusing

9,636

8,939

18,575

$42,923

$30,441

-

17.0%

18.0%

-

$70,312,576

$48,980,614

$119,293,190

2014 Alaska population 15+

2010-2014 Median Alaska individual annual average earnings 4
Loss in productivity from drug dependence

2

Estimated productivity loss due to drug dependence or abuse

Note: Due to rounding, some columns may not sum to total.
1 Alaska Department of Labor and Workforce Development’s 2014 population estimates.
2 NDIC, “The Economic Impact of Illicit Drug Use on American Society 2011” (2011).
3 SAMHSA’s “National Survey on Drug Use and Health, 2013 and 2014 – Alaska” (2014).
4 American Community Survey (ACS) 2010-2014 Five-Year Data.

Lost Productivity Due to Drug Treatments
When individuals are admitted to a medical facility for treatment of drug dependence or abuse, they may lose
time that would otherwise be spent in the workforce. This results in economic loss due to reduced employment,
production, and services. To estimate that loss, this report quantifies potential earnings forfeited by clients
admitted to DBH Treatment and Recovery grantee agencies for 24-hour detoxification or residential services.
The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 37

 In SFY 2015, admission to 24-hour detoxification and residential treatment services resulted in an estimated loss
of potential earnings of $1.4 million associated with drug abuse/dependence. These lost earnings were
associated with 42,376 bed days for drug treatment.
Table 25. Number of 24-Hour Detoxification and Residential Bed Days and
Estimated Lost Earnings from Drug-related Admissions, SFY 2015
Number/$Amount
Number of bed days

42,376

Estimated Lost Earnings

$1,356,861

Source: Total number of bed days estimates calculated from data
provided by the State of Alaska Division of Behavioral Health.

Incomes varied widely for clients receiving services at residential treatment and detoxification facilities. More
than half reported annual incomes of $0 or less than $5,000. Estimates of lost earnings per day ranged from $0
to $143.
Table 26. Number of Clients Who Received 24-Hour Detoxification or Residential Treatment Services,
Number of Bed Days for Those Clients, and Estimated Lost Earnings, Attributable to Drugs,
by Client Income Range, SFY 2015
# of
Clients

% of
Clients

Estimated # of
Drug Bed Days

Estimated
Earnings per Day

Estimated Lost Earnings due to
Drug Abuse

<18 years

110

5.20%

2,215

$0

$0

Income Range
$0-4,999

1,176

55.9

23,685

7

169,697

$5,000-9,999

147

7.0

2,961

21

63,644

$10,000-$19,999

257

12.2

5,176

43

222,509

$20,000-29,999

151

7.2

3,041

72

217,880

$30,000-39,999

70

3.3

1,410

100

141,432

$40,000-49,000

53

2.5

1,067

129

137,606

143

$50,000+
Total

140

6.7

2,820

2,104

100%

42,376

404,092
$1,356,861

Source: Estimates calculated from data provided by the State of Alaska Division of Behavioral Health.

Lost Productivity Due to Drug Abuse Related Medical
Conditions
In SFY 2015, 3,197 lost days of work for medical treatment of diseases and conditions attributable to drug abuse
resulted in an estimated $613,824 in lost earnings (not including drug treatment programs (see above)).
Table 27. Total Length of Stay for Inpatient and ED Treatment of Diseases and Conditions Attributable
to Drug Abuse, and Subsequent Lost Potential Earnings, SFY 2015
Total Inpatient Length of Stay
(days)*
1,866

Total ED Length
of Stay (days)*
1,331

Total Length
of Stay (days)
3,197

Average Earnings
per Day**
$192

Estimated Lost
Potential Earnings
$613,824

Source: *Alaska Hospital Facilities Data Reporting Program (HRFP); **Based on DOLWD wage data.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 38

 Chapter 3: Vehicle Traffic Collisions
Summary
•

In 2011, 704 vehicle traffic collisions in Alaska were attributed to impaired (alcohol and/or drug) drivers,
costing approximately $990.5 million.

•

Impaired traffic collisions represented about 6 percent of all traffic collisions (a total of 12,576 collisions)
in Alaska.

•

Of the impaired collisions, 54 percent involved property damage only, 33 percent resulted in minor
injuries, 9 percent resulted in major injuries, and 4 percent caused a fatality.

•

1,680 persons were involved in the 704 impaired-related collisions; 229 people had minor injuries, 64
had major injuries, and there were 30 fatalities.

•

Of the $990.5 million in estimated costs due to substance abuse-related traffic collisions, approximately
40 percent (or $396.2 million) are related to drug abuse.

Impaired Traffic Collisions
DOTPF maintains records of all traffic collisions in Alaska by injury severity, including impaired (alcohol and/or
drug) collisions. DOTPF data does not distinguish between alcohol and drug-related collisions. National
Highway Traffic Safety Administration (NHSTA) estimates of the average costs per crash were used to develop
the following table of unit costs of impaired traffic collisions in Alaska for 2011. While DOTPF maintains records
of off-road vehicle collisions such as ATVs and snowmachines that occur on roadways, no record is kept of those
incidences that occur off-road.

(See table next page.)

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 39

 Table 28. Unit Costs of Impaired (Alcohol and/or Drugs) Traffic Collisions in Alaska, 2011
Property Damage Only

Minor Injury

Major Injury

Fatal

Medical

$0

$4,425

$578,183

$16,704

Emergency services

$40

$126

$1,209

$1,275

Market productivity

$0

$4,158

$489,605

$1,635,627

Household productivity

$85

$1,330

$138,874

$445,824

Insurance administration

$270

$5,436

$104,769

$40,043

Workplace costs

$88

$482

$15,681

$16,659

Type of Cost

Legal costs

$0

$1,996

$121,803

$150,558

Congestion costs

$1,523

$1,568

$2,162

$8,087

Property damage

$3,455

$7,640

$21,338

$15,852

Quality-adjusted life years (QALYs)
Total

$0

$34,473

$7,028,039

$12,010,805

$5,460

$61,635

$8,501,664

$14,341,436

Source: U.S. Department of Transportation National Highway Traffic Safety Administration (NHSTA) “The Economic and Societal Impact
of Motor Vehicle Crashes, 2010 (Revised)” (2015). http://www-nrd.nhtsa.dot.gov/pubs/812013.pdf.

In 2011, there were 704 impairment-caused traffic collisions reported in Alaska, 6 percent of the 12,576 total
traffic collisions in the state. Of the impaired collisions, those with property damage only totaled 381 (54 percent
of impaired collisions), 229 collisions (33 percent) resulted in minor injuries, 64 (9 percent) resulted in major
injuries, and 30 collisions (4 percent) had a fatality. The figure below shows impaired-related traffic collisions by
injury severity.
Figure 20. Impairment-caused (Alcohol and/or Drug) Traffic Collisions, by Type, in Alaska, 2011

Major Injury
(MAIS 5)
64
9%

Minor Injury
(MAIS 1)
229
33%

Fatal
Collisions
30
4%

Property
Damage
Only
381
54%

Source: Alaska Department of Transportation and Public Facilities (DOTPF), “2011 Alaska Traffic Crashes” (2015).
http://www.dot.alaska.gov/stwdplng/transdata/pub/accidents/2011_AK_CrashData.pdf.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 40

 The table below shows the 704 Alaska impairment-caused collisions by type and by injury, including property
damage only, minor and major injuries, fatalities, and the total cost. Total cost of the impairment-caused
collisions in Alaska in 2011 was $990.5 million. The highest costs resulted from fatal collisions which totaled
$430.2 million.
In all, it is estimated that approximately 40 percent (or $396.2 million) of the impairment-related collisions in
Alaska is related to drug abuse.
Table 29. Number of Impairment-caused Traffic Collisions and Cost of Collisions in Alaska, 2011
Number of Alaska
Impaired Collisions1

Property
Damage Only

Minor Injury

Major Injury

Fatal

Total

381

229

64

30

704

$0

$1,013,364

$37,003,719

$501,131

$38,518,214

$15,082.97

$28,816

$77,366

$38,259

$159,523

Type of Costs 2
Medical
Emergency services
Market productivity

$0

$952,213

$31,334,749

$49,068,804

$81,355,767

Household productivity

$32,321

$304,669

$8,887,945

$13,374,724

$22,599,660

Insurance administration

$102,887

$1,244,903

$6,705,230

$1,201,293

$9,254,314

Workplace costs

$33,398

$110,406

$1,003,586

$499,782

$1,647,172

$0

$457,166

$7,795,412

$4,516,746

$12,769,324

Congestion costs

$580,156

$359,063

$138,354

$242,617

$1,320,189

Property damage

$1,316,528

$1,749,664

$1,365,622

$475,563

$4,907,377

$0

$7,894,209

$449,794,521

$360,324,164

$818,012,894

$2.1 million

$14.1 million

$544.1 million

$430.2 million

$990.5 million

Legal costs

Quality-adjusted life years
(QALYs)
Total
Estimated portion
attributed to drug abuse
(40 percent)

$396.2 million

Note: Due to rounding, some columns may not sum to total.
1 DOTPF, “2011 Alaska Traffic Crashes” (2015). http://www.dot.alaska.gov/stwdplng/transdata/pub/accidents/2011_AK_CrashData.pdf.
2
NHSTA, “The Economic and Societal Impact of Motor Vehicle Crashes, 2010 (Revised)” (2015). http://wwwnrd.nhtsa.dot.gov/pubs/812013.pdf.

Lastly, while there are no cost estimates available, DOTPF also reports the number of persons who were involved
in impaired (alcohol and/or drug-related) collisions. People involved include occupants of the impaired driver’s
car, occupants of other cars, or pedestrians. In 2011, there were 1,680 persons involved in impairment-caused
collisions; 229 had minor injuries, 64 had major injuries, and 32 were fatalities.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 41

 Chapter 4: Criminal Justice and
Protective Services
Summary
•

In 2014, there were 9,572 drug-related offenses and arrests, representing 27 percent of all offenses.
These offenses affected 12,237 victims and resulted in $277 million in criminal justice system and crime
victim costs.
Table 30. Summary of Criminal Justice Costs Attributable to
Drug Abuse in Alaska, 2014
Drug-Related
Counts
Offenses and arrests

9,572

Percentage offenses-arrests
Crime victims

27%
12,237

Percentage crime victims

29%

Costs
Criminal justice system

$73.4 million

Crime victim – tangible costs

$28.5 million

Crime victim – intangible costs

$175.4 million

Drug Abuse Criminal Justice Costs

$277.3 million

Source: McDowell Group calculations.

•

In SFY 2015, Office of Children Services (OCS) expenditures for child abuse and neglect attributable to
drug abuse totaled an estimated $37 million.

Criminal Justice
Alaskans dependent on or abusing drugs play a role in crimes. Drug abuse can be directly attributed to crimes
such as driving under the influence or the sale of illegal drugs and other violent and nonviolent crimes. Many
costs accompany these crimes including the costs of the criminal justice system (police protection and law
enforcement, legal and adjudication, and incarceration), and costs to crime victims (both tangible and
intangible). Productivity loss due to incarceration is covered in Chapter 2.

Offenses and Arrests
In 2014, among the 11 types of offenses or arrests in the table below, 9,572 (27 percent) were attributable to
drug abuse. The offenses with the highest counts attributable to drugs were larceny-theft (6,002), drug laws
(1,159), and burglary (1,054).

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 42

 Table 31. Offenses and/or Arrests Attributable to Drug Abuse in Alaska, 2014
2014 Alaska
Number of Known
Offenses or Arrests

Type of Offense

Percent
Attributable
to Drug
Abuse 3

Estimated
Offenses/Arrests
Attributable to Drug
Abuse

Criminal homicide 1

47

7%

3

Sexual assault (rape and attempted) 1

764

4%

28

3,224

5%

164

Aggravated assault 1
Other assault

1

Robbery 1
Burglary 1
Larceny-theft

1

Motor vehicle theft 1
Stolen goods

2

Prostitution (commercialized vice)

2

Drug laws 2
Total

8,799

8%

669

627

28%

176

3,136

34%

1,054

15,350

39%

6,002

1,730

18%

306

24

27%

6

36

12%

4

1,159

100%

1,159

34,896

9,572

1 DPS, Crime in Alaska, 2014 (2015). http://www.dps.alaska.gov/statewide/docs/UCR/UCR_2014.pdf.
2
FBI UCR (2015). https://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2014/crime-in-the-u.s.-2014/tables/table-69.
3
U.S. Department of Justice National Drug Intelligence Center (NDIC), The Economic Impact of Illicit Drug Use on American
Society 2011 (2011).

Criminal Justice System Costs
The estimated cost of drug abuse to the criminal justice system in Alaska in 2014 was $73.4 million. Larcenytheft produced the largest costs, an estimated $27.0 million, followed by drug-law infractions ($19.5 million),
and other assaults ($9.0 million). It should be noted that incarceration data does not include Alaska Statute Title
47 Protective Holds by the Department of Corrections.
Table 32. Criminal Justice System Costs Attributable to Drug Abuse by Offense in Alaska, 2014
Type of Offense

Estimated Alaska
Offenses/Arrests
Attributable to
Drug Abuse

Criminal Justice
System Cost per
Arrest/Offense

Estimated Alaska
Drug-Related
Costs

3

$612,035

$2,071,127

Criminal homicide 1
Sexual assault (rape and attempted)

1

28

$41,305

$1,167,608

Aggravated assault 1

164

$13,479

$2,216,306

Other assault 1

669

$13,479

$9,013,872

Robbery

1

Burglary 1
Larceny-theft 1
Motor vehicle theft

1

Stolen goods 1
Prostitution (commercialized vice)
Drug laws

2

2

Total

176

$21,569

$3,786,640

1,054

$6,438

$6,783,444

6,002

$4,491

$26,954,251

306

$6,032

$1,847,115

6

$10,673

$69,161

4

$9,085

$40,555

1,159

$16,797

9,572

$19,468,013
$73.4 million

1 National Institute of Health (NIH), The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program
Evaluation (2010). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835847/pdf/nihms170575.pdf
2 NIH National Institute on Drug Abuse (NIDA), The Economic Costs of Alcohol and Drug Abuse in the United States – 1992

(1998).

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 43

 Crime Victimization
There were approximately 41,992 victims of the crimes in the table below in Alaska in 2014; 12,237 victims were
involved in crimes associated with drug abuse, or approximately 29 percent of victims.
Table 33. Victimizations Attributable to Drug Abuse in Alaska, 2014
Type of Crime

Homicide
Rape/sexual assault

2014 U.S. Victimization
Rate per 1,000 persons
12 years or older or per
1,000 households 1

Estimated
Number of
Alaska Victims 3, 4

Percent
Drug
Related 5

Estimated Number
of Victims
Attributable to
Drug Abuse

-

47 2

7%

3

1.1

670

5%

34

Robbery

2.5

1,523

28%

427

Aggravated assault

4.1

2,498

5%

127

Other assault

12.4

7,555

8%

574

Theft

90.8

22,852

39%

8,935

Burglary

23.1

5,814

34%

1,953

Motor vehicle theft

4.1

1,032

18%

183

Total

41,992

12,237

Criminal Victimization, 2014 (2015). http://www.bjs.gov/content/pub/pdf/cv14.pdf.
2 DPS, Crime in Alaska, 2014 (2015). http://www.dps.alaska.gov/statewide/docs/UCR/UCR_2014.pdf.
1 BJS,

3 2014

population data from DOLWD.
2014 household data from ACS 2010-2014 Five-Year Data.
5
NDIC, The Economic Impact of Illicit Drug Use on American Society 2011 (2011).
4

CRIME V ICTIM T ANGIBLE COSTS
The estimated tangible cost to victims attributable to drug abuse for Alaska in 2014 was $28.5 million. The
offense with the highest cost was other assaults ($7.8 million), followed by theft ($6.7 million), and burglary ($4.2
million).
Table 34. Crime Victim Tangible Costs Attributable to Drug Abuse in Alaska, 2014
Estimated Number
of Victims Attributable
to Drug Abuse

Crime Victim
Tangible Cost Per
Offense 1

Estimated Alaska DrugRelated Tangible Costs

Homicide 2

3

$1,150,463

$3,893,165

Rape/sexual assault

34

$8,667

$296,249

Robbery

427

$5,146

$2,194,886

Aggravated assault

127

$13,571

$1,729,040

Other assault

574

$13,571

$7,792,668

Theft

8,935

$749

$6,690,361

Burglary

1,953

$2,125

$4,150,248

183

$9,537

$1,741,920

Type of Offense

Motor vehicle theft
Total

12,237

$28.5 million

The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program Evaluation (2010).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835847/pdf/nihms170575.pdf
2 Crime victim cost for murder was calculated as the mean present value of lifetime earnings for a homicide victim.
1 NIH,

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 44

 CRIME V ICTIM INTANGIBLE COSTS
The estimated intangible cost to victims attributable to drug abuse for Alaska in 2014 was $175.4 million. The
offense with the highest cost was other assaults ($85.1 million), followed by homicide ($44.6 million), and
aggravated assaults ($18.9 million).
Table 35. Crime Victim Intangible Costs Attributable to Drug Abuse in Alaska, 2014
Estimated Number
of Victims Attributable
to Drug Abuse

Crime Victim
Intangible Cost
Per Offense

Estimated Alaska DrugRelated Intangible Costs

3

$13,168,788 2

$44,563,180

Rape/sexual assault

34

$311,424

$10,645,019

Robbery

427

$35,215

$15,019,568

Aggravated assault

127

$148,228

$18,884,888

Type of Offense
Homicide

Other assault

574

$148,228

$85,112,954

Theft

8,935

$16

$139,383

Burglary

1,953

$501

$978,142

183

$409

Motor vehicle theft
Total

$74,646

12,237

$175.4 million

NIH, “The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program Evaluation” (2010).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835847/pdf/nihms170575.pdf
2 Intangible cost for murder was calculated as the mean value of a statistical life.
1

Protective Services
Substance abuse is a risk factor for abuse and neglect of children and adults. A 1999 study by the National
Center on Addiction and Substance Abuse at Columbia University found that substance-abusing parents were
three times more likely to abuse and four times more likely to neglect their children. Likewise, an adult caregiver
who struggles with substance use is more likely to abuse his or her charge. Because of alcohol and drug abuse,
agencies that assist victims of abuse and neglect see more cases and incur greater costs.
The National Survey of Children and Adolescent Well-Being estimates that 61 percent of infants and 41 percent
of older children in out-of-home care are from families with active alcohol or drug abuse (Wulczyn, Ernst, &
Fisher, 2011). For almost 31 percent of all children placed in foster care in 2012, parental alcohol or drug abuse
was the documented reason for removal and in several states that percentage surpassed 60 percent (National
Data Archive on Child Abuse and Neglect, 2012)

Child Protective Services
Office of Children Services (OCS) expenditures for child abuse and neglect attributable to drug abuse are
estimated at $37 million in SFY2014.
Table 36. Summary of OCS Expenditures Attributable to Drugs, SFY 2015
State Spending

Federal Spending

Total

$25,139,125

$11,493,850

$36,632,975

Source: State of Alaska 2014 Actual Expenditures

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 45

 Title 47 Protective Custody
The Title 47 Protective Custody Statute allows the State of Alaska to take people who are incapacitated by drugs
or otherwise at-risk to a hospital for treatment, place them in the custody of a family member, or commit them
to a detention center for up to 12 hours. In SFY2013, there were a total of 3,726 protective holds; however, it is
estimated by DOC personnel that most (up to 99 percent) of these holds were related to alcohol, not drugs.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 46

 Chapter 5: Health Care
Summary
•

Hospital-related medical costs to treat conditions and diseases attributable to drug abuse totaled $17.8
million in 2012, including $14.6 million in inpatient charges, and $3.1 million in ED charges. Adjusted
for inflation, in 2015, these costs would be $15.1million in inpatient charges and $3.2 million in ED
charges, for a combined total of $18.3 million.
Table 37. Summary of Alaska Medical Charges Attributable to Drug Abuse, 2012 and 2015$

•

Inpatient
Charges

Emergency
Department
Charges

Total
Medical
Charges

Total (2012)

$14,603,710

$3,147,428

$17,751,138

Drug Abuse Total (2016$)

$15,075,863

$3,249,187

$18,325,050

In SFY 2015, Division of Behavior Health funding for drug dependence/abuse to treatment and recovery
grantee agencies accounted for an estimated $23.5 million for drug treatment.

•

In 2015, an estimated $2.5 million in HIV/AIDS medical costs were attributable to injected drug use in
Alaska.

•

In 2015, an estimated $90 million in treatment costs were associated with 1,009 new hepatitis C cases
attributable to injected-drug use.

•

In total, annual drug-abuse-related health care costs totaled $134.3 million in 2015.

Medical Costs
Drug abuse leads to medical conditions and diseases that require treatment in medical settings. This section
covers the costs to treat diseases and conditions that arise from the abuse of drugs. Medical costs are presented
for two hospital setting types: inpatient and ED. Costs for treating addiction may be found in the Costs of

Treating Drug Dependence section below.

Inpatient
Some of the health problems caused by drug abuse require admission to a hospital. In 2012, inpatient charges
in Alaska attributable to drug abuse totaled $14.6 million. Adjusted to 2015 dollars, the total inpatient charges
for drug abuse would be $18.3 million. The number of admissions attributable to drug abuse totaled 511
admissions. The total length of hospital stays resulting from those admissions was 1,866 days.
Table 38. Summary of Alaska Inpatient Hospital Admissions, Length of Stay,
and Total Charges Attributable to Drug Abuse, 2012 and Adjusted 2015$
Total

Number of Admissions

Length of Stay (days)

Total Charges

511

1,866

14,603,710

Total (2015$)

$15,075,863

Source: Alaska Hospital Facilities Data Reporting Program (HFDR). McDowell Group estimates.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 47

 Emergency Department (ED) Costs
Some patients with health problems caused by drug abuse receive treatment in the ED. In 2012, statewide ED
charges attributable to drug abuse totaled $3.1 million. Adjusted to 2015 dollars, the total attributable to drug
abuse would be $3.2 million. The number of ED visits attributable to drug abuse totaled 1,331. The number of
days patients spent in the ED as a result of those visits totaled 1,331 days for drug-related treatment.
Table 39. Summary of Alaska ED Visits, Length of Stay, and Total Charges Attributable to
Drug Abuse, Alaska, 2012 and Adjusted 2015$
Total

Number of Visits

Length of Stay (days)

Total Charges ($)

1,331

1,331

3,147,428

Total (2015$)

$3,249,187

Source: Alaska Hospital Facilities Data Reporting Program (HFDR). McDowell Group estimates.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 48

 Table 40. Inpatient Hospital Admissions, Length of Stay, and Charges, HFDR Total and Attributable to Drugs, Alaska, 2012
Total Inpatient Stays
Age

# of
Discharges

Length of
Stay (days)

Charges

Drug mental disorders and psychoses

All

81

301

1,765,897

Drug dependence

All

11

39

Non-dependent abuse of drugs

All

12

Polyneuropathy due to drugs

All

Drug dependence complicating pregnancy, childbirth, or

Diagnosis or Condition

Attributable
Fraction (%)

Attributable to Drugs
Length
# of
of Stay
Discharges
(days)
Charges

100%

81

301

$1,765,897

175,106

100

11

39

175,106

17

152,812

100

12

17

152,812

-

-

-

100

-

-

-

All

19

51

316,852

100

19

51

316,852

Drugs affecting fetus or newborn via placenta or breast

All

1

6

20,934

100

1

6

20,934

Drug withdrawal syndrome in newborn

All

7

134

741,742

100

7

134

741,742

Fetal damage due to drugs

All

-

-

-

100

-

-

-

Poisoning by opiates and related narcotics

All

71

233

2,239,419

100

71

233

2,239,419

Poisoning by sedatives and hypnotics

All

17

81

667,249

100

17

81

667,249

Poisoning by CNS muscle tone depressants

All

3

3

49,896

100

3

3

49,896

Poisoning by psychotropic agents

All

129

412

3,668,507

100

129

412

3,668,507

Poisoning by CNS stimulants

All

7

29

424,183

100

7

29

424,183

358

1,306

10,222,597

358

1,306

$10,222,597

puerperium

Total

Source: Alaska Hospital Facilities Data Reporting Program (HFDR). McDowell Group estimates.

Table 41. Inpatient Hospital Admissions, Length of Stay, and Charges, Total and Attributable to Drugs, Alaska, 2012
HFDR Attributable to Drugs Total

Total

# of
Admissions

Length of
Stay (days)

Charges

Estimation
Factor

358

1,306

10,222,597

÷ 0.7

Statewide Estimate
Length
# of
of Stay
Admissions
(days)
Charges
511

1,866

14,603,710

Source: Alaska Hospital Facilities Data Reporting Program (HFDR). McDowell Group estimates.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 49

 Table 42. Emergency Department Visits, Length of Stay, and Charges, Total and Attributable to Drug Abuse, Alaska, 2012

Attributable to Drugs

Total Inpatient Stays

# of
Discharges

Length
of Stay
(days)

Charges

100%

60

60

142,741

213,566

100

145

145

213,566

467

1,006,730

100

467

467

1,006,730

-

-

-

100

-

-

-

All

4

4

8,239

100

4

4

8,239

Drugs affecting fetus or newborn via placenta or breast

All

-

-

-

100

-

-

-

Drug withdrawal syndrome in newborn

All

-

-

-

100

-

-

-

Fetal damage due to drugs

All

-

-

-

100

-

-

-

Poisoning by opiates and related narcotics

All

104

104

316,497

100

104

104

316,497

Poisoning by sedatives and hypnotics

All

29

29

84,752

100

29

29

84,752

Poisoning by CNS muscle tone depressants

All

1

1

5,756

100

1

1

5,756

Poisoning by psychotropic agents

All

116

116

404,983

100

116

116

404,983

Poisoning by CNS stimulants

All

6

6

19,936

100

6

6

19,936

932

932

$2,203,200

932

932

$2,203,200

Age

# of
Discharges

Length of
Stay (days)

Charges

Drug mental disorders and psychoses

All

60

60

142,741

Drug dependence

All

145

145

Non-dependent abuse of drugs

All

467

Polyneuropathy due to drugs

All

puerperium

Diagnosis or Condition

Attributable
Fraction (%)

Drug dependence complicating pregnancy, childbirth, or

Total

Source: Alaska Hospital Facilities Data Reporting Program (HFDR). McDowell Group estimates.

Table 43. ED Visits, Length of Stay, and Charges, Total and Attributable to Drug Abuse, Alaska, 2012
HFDR Attributable to Drugs Total

Total

# of Visits

Length of
Stay (days)

Charges

Estimation
Factor

932

932

$2,203,200

÷ 0.7

Statewide Estimate
Length
of Stay
# of Visits
(days)
Charges
1,331

1,331

$3,147,428

Source: Alaska Hospital Facilities Data Reporting Program (HFDR). McDowell Group estimates.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 50

 Costs of Treating Drug Dependence or Addiction
Some individuals who are drug dependent need detoxification, treatment, and/or support services. In SFY 2015,
agencies receiving DBH treatment and recovery grants logged 4,295 admissions for drug abuse disorders, with
31 percent for drugs only, and 69 percent for both alcohol and drug abuse.
Table 44. Percent of Admissions for Drug Only and
Both Alcohol and Drug Treatment, by Treatment Setting, SFY 2015
Substance of Abuse

# of Admissions
1,318

% of Total
31%

Alcohol and Drug

2,977

69%

Total

4,295

100%

Drug Only

Source: State of Alaska Division of Behavioral Health.

Each admission could include enrollment in more than one service type. Of the 4,721 admissions, 1,140 were
associated with drugs only, and 3,311 were associated with both alcohol and drugs.
Table 45. Number of Enrollments for Drug Treatment, by Service Type, SFY 2015

# Enrollments
for Drugs

Service Type

# of
Enrollments
for Both
Alcohol and
Drugs
576

% of Total
17%

Total
Enrollments
867

24-Hr Detoxification

291

% of Total
21%

Residential

334

24%

728

22%

1,062

Outpatient

702

50%

2,002

60%

2,704

Outpatient-Opioid
Total

83

3%

5

<1%

88

1,410

100%

3,311

100%

4,721

Note: Due to rounding some columns may not total. Residential and outpatient treatment settings included 2 and 20 admissions,
respectively, without information on the substance of abuse. These admissions have been added to the “Alcohol and Drug Abuse”
category.
Source: State of Alaska Division of Behavioral Health

In SFY 2015, admissions to 24-hour detoxification and residential services resulted in an estimated 42,376
associated with drugs. A total of 94 percent of these bed days were through residential services.
Table 46. Bed Days at Drug Abuse Treatment, by Treatment Setting, SFY 2015
Service Type
24-Hr Detoxification
Residential
Total

Estimated # of
Bed Days for
Drug Abuse
2,511
39,865
42,376

*Note: As described in methodology, percentages are from
admissions data.
Source: Estimates calculated from data provided by the State of
Alaska Division of Behavioral Health.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 51

 In SFY 2015, DBH funding for drug dependence/abuse to treatment and recovery grantee agencies (including
grant awards and Medicaid payments for services received in state FY2015) totaled $23.5 million, with $12.2
million from DBH grants and $11.3 million from Medicaid.
Table 47. DBH Grants and Medicaid Funding for Drug Abuse Treatment,
by Service Type, SFY 2015
Treatment Setting

Treatment Costs for
Drug Abuse

DBH Grants
24-Hr Detoxification

$1,228,816

Residential

5,446,707

Outpatient

4,342,670

Outpatient-Opioid

1,163,017

DBH Grants Total

$12,181,210

Medicaid
24-Hr Detoxification

$51,541

Residential

3,769,752

Outpatient

7,233,543

Outpatient-Opioid

291,924

Medicaid Total

$11,346,759

DBH Grant and Medicaid Total

$23,527,969

*Note: As described in methodology, percentages are from admissions data.
Source: State of Alaska Division of Behavioral Health.

Prescription Drugs
Prescription drugs such as buprenorphine, naltrexone, acamprosate calcium, and disulfiram play a role in
treating the conditions, disorders, and diseases caused by or related to substance abuse. Prescription drugs also
can be acquired illegally and then abused. Both the legal and illegal use of prescription drugs are assessed
below.

Legal Use
Hepatitis C treatment contributes to prescription drug costs, especially with the advent of new medications.
Those costs are addressed in the hepatitis C section of the report.

Illegal Use
Criminal justice system costs associated with prescription drug cases include costs for law enforcement, legal
and adjudication fees, incarceration costs, treatment costs, and loss of productivity. The report addresses those
costs elsewhere.
Beyond monetary costs, prescription drug cases place an additional burden on the time and resources of the
criminal justice system, and that burden is growing. The Alaska State Troopers 2014 Annual Report marks a rise
in the abuse of opiates, both heroin and prescription opioids. From 2012 to 2014, the pounds of heroin seized

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 52

 rose from 4.93 to 22.42. Likewise, the dosage units of hydrocodone seized rose from 141 to 796 and of
OxyContin/OxyCodone from 609 to 1,183.
The 2015 Youth Risk Behavior Survey of Alaska schools reports 6.4 percent of students at traditional high schools
had taken prescription drugs (such as OxyContin, Percocet, Vicodin, Codeine, Adderall, Ritalin, or Xanax) without
a doctor’s prescription in the past 30 days, while 14.6 percent had taken them once or more in their lives. While
those figures are worrisome enough, for students at alternative high schools, the percentages are much greater,
19.8 percent for use in the past 30 days and 37.4 percent for use once or more in their lives.
SAMHSA’s NSDUH reports that, in 2014, 4.4 percent of all Alaskans age 12 or older, nearly 27,000 people, had
used pain relievers in the past year for nonmedical use.

HIV and AIDS Costs
While HIV and AIDS are most often thought of as sexually transmitted diseases, a portion of cases can be
attributed to intravenous drug use through the sharing of unhygienic needles. Due to advances in health care
for HIV and AIDS, extensive inpatient care is not always required, nor is it as expensive as it was in the past.
However, treatment remains costly.
In 2015, there were an estimated 671 people with HIV/AIDS living in Alaska. The Alaska Injection-drug use (IDU)
attribution rate suggests there are approximately 132 cases of people living with HIV/AIDS in Alaska attributable
to IDU. In 2011, the NDIC estimated the average annual cost of antiretroviral treatment (ART) for an individual
with HIV/AIDS at $12,500. Adjusted for inflation and Alaska’s medical cost-of-living differential, in 2015, Alaska
had an estimated HIV/AIDS medical cost of $2.5 million attributable to injected drug use.
Table 48. Alaska Cases of HIV/AIDS and Estimated Medical Costs, 2015
2015
Counts
Number of cases of HIV and HIV with AIDS living in Alaska 1
Alaska IDU attribution rate

1

Estimated number of Alaska cases attributed to IDU

671
19.6%
132

Cost
Annual cost of ART, adjusted for inflation and cost-of-living 2
Total Estimated Medical Cost of HIV/AIDS in Alaska

$19,250
$2.5 million

DHSS Division of Public Health, “HIV Surveillance Report – Alaska, 1982-2015” (2016).
2 U.S. Department of Justice National Drug Intelligence Center (NDIC), “The Economic Impact of
Illicit Drug Use on American Society 2011” (2011).
1

Hepatitis B and C Drug Treatment Costs
The estimated costs below pertain only to the drug treatment costs associated with hepatitis and does not
include costs associated with hepatitis impacts, such as liver transplants and other impatient or outpatient
expenses. These costs are included under the section on medical costs found earlier in this chapter.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 53

 Hepatitis B
Per the World Health Organization (WHO), a vaccine that is safe and 95 percent effective for Hepatitis B (HBV)
has been available since 1982. However, even in the 1990s, the HBV vaccine was still relatively new, so the
number of HBV cases, and subsequent medical and treatment costs, were much higher for this infectious disease
than they are now.
According to the Alaska Department of Health and Social Services (DHSS) Division of Public Health’s
Epidemiology Section, there were three cases of HBV reported in Alaska in 2014. Per WHO, more than 90 percent
of healthy adults will recover naturally from the disease, and less than 5 percent of those infected will develop
a chronic illness, and costs attributable to IDU are negligible.

Hepatitis C
IDU is now the most common means of Hepatitis C virus (HCV) transmission in the United States. 9 HCV spreads
easily when materials such as needles are shared among drug users. 10 Rates of infection declined in the 1990s,
plateaued in the 2000s, and have risen in recent years, especially among younger populations. Increased use of
heroin is linked to this rise. 11 While still highly costly, with the FDA’s approval of direct-acting antiviral
medication with high cure rates in 2013 and 2014, the treatment landscape and associated costs have changed
considerably. In 2015, treatment of 1,009 new reported HCV cases attributable to IDU cost an estimated $90
million. It is important to recognize that new reported cases do not necessarily indicate when HCV was
contracted. An analysis of the costs to Alaska to treat Hepatitis C contracted through IDU use is shown in the
table below.
Table 49. Hepatitis C Cases and Estimated Drug Treatment Costs, 2015
# New Reported
HCV Cases*

% Attributable to
IDU**

# Cases
Attributable to
IDU

Estimated Cost
per Treatment

Estimated Total
HCV Treatment
Costs

1,638*

61.6%**

1,009

$89,250***

$90,053,964

Source: *State of Alaska Infectious Disease Program, **Surveillance for Viral Hepatitis – United States, 2013, ***University of
Washington Hepatitis C Online.

http://www.cdc.gov/hepatitis/hcv/hcvfaq.htm
Surveillance for Acute Viral Hepatitis – United States, 2007. The Centers for Disease Control and Prevention Morbidity and Mortality
Weekly Report, 58. http://www.cdc.gov/mmwr/pdf/ss/ss5803.pdf
11
https://www.aids.gov/pdf/hcv-and-young-pwid-consultation-report.pdf
9

10

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 54

 Chapter 6: Public Assistance and Social Services
Summary
•

In federal fiscal year 2014, the federal government provided $5 million in social welfare support for
people who were drug abusers.

•

The State of Alaska also contributes funding to social welfare programs, such as SNAP, Adult Public
Assistance, Alaska Temporary Assistance, Tribal Assistance Services, and Child Care Benefits. In SFY 2015,
drug abuse accounted for $3 million of State funded social welfare.

Social Welfare Funding
Drug abuse can result in greater demand for social welfare services. For example, problems with drugs can
reduce personal income or lead to disability, qualifying individuals for publicly funded social programs like food
stamps, public assistance, and vocational rehabilitation. The following section addresses the portion of social
welfare funding from federal and state sources that is attributable to drug abuse.
Social welfare spending includes two broad categories: administrative expenses and benefits paid to
beneficiaries. This distinction is noted because benefit payments are transfer payments, representing a
redistribution of money rather than an actual cost and net loss. This report presents aggregate totals including
both administrative costs and benefit payments.

Federal
The federal government funds numerous social welfare benefits in Alaska. Federal programs transfer money to
the State of Alaska, which then allocates funding to an array of state-run programs. (For sources of attribution

rates, please refer to the Methodology section.) In federal fiscal year (FFY) 2014, $4.7 million of federal funds
were designated for drug-abuse-related social welfare in Alaska.
Table 50. Federal Social Welfare Spending in Alaska Attributable to Drug Abuse, FFY 2014
Social Welfare Program
OASDI
SSI
TANF

Federal Funding Total
1

$103,133,000
1

6,366,000

2

49,361,402

3

% Attributable to
Drug Abuse4

Drug Abuse4

0.6%

$578,576

1.0%

63,023

1.7%

847,042

SNAP

184,438,186

1.7%

3,164,959

Total

$343,298,588

1.4%

$4,653,600

Source: 1Social Security Administration; 2USDHHS Office of Family Assistance; 3Supplemental Nutrition Assistance Program State
Activity Report Fiscal Year 2014; 41998 NIDA study, The Economic Costs of Alcohol and Drug Abuse in the United States – 1992.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 55

 State
The State of Alaska also contributes funding to social welfare programs. In SFY 2015, $2.6 million of State funds
were designated for drug abuse-related social welfare.
Table 51. State Social Welfare Program Spending Attributable to Drug Abuse, Alaska, SFY 2015
State Funding Total1

% Attributable to
Drug Abuse3

Drug Abuse3

$10,674,5232

0.2%

$185,025

Adult Public Assistance

59,419,200

1.4%

812,062

Public Assistance Field Services

14,799,800

1.7%

256,530

Public Assistance Admin

1,256,200

1.7%

21,774

Alaska Temporary Assistance Program

15,164,300

1.7%

262,848

Work Services

3,750,000

1.4%

51,250

Tribal Assistance Services

10,084,200

1.4%

137,817

Women, Infants, and Children

10,574,400

1.1%

116,318

Energy Assistance

23,729,400

1.4%

324,302

Child Care Benefits

2,728,200

1.4%

37,285

General Relief Assistance

3,135,200

1.4%

42,848

Senior Benefits Payment Program

22,665,400

1.4%

309,760

$177,980,823

1.4%

$2,557,821

Social Welfare Program
SNAP Administrative Costs

Total

Source: 1Division of Public Assistance Actual Expenditures, SFY 2015, State of Alaska Office of Management and Budget;
2
Supplemental Nutrition Assistance Program State Activity Report Fiscal Year 2014; 31998 NIDA study, The Economic Costs of

Alcohol and Drug Abuse in the United States – 1992.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 56

 Chapter 7: Drug Abuse Impacts on the State
General Fund Budget
The purpose of this chapter is to highlight the impacts of drug abuse on the State of Alaska’s General Fund
budget.

Summary
•

In SFY 2015, the Division of Behavioral Health funded $780,391 in drug abuse prevention.

•

Of the $780,391 allocated toward the prevention of drug abuse, $383,200 million (or 49 percent) was
funded through Undesignated General Funds (UGF).

•

In SFY 2015, $178 million supported 12 different social welfare programs administered by DHSS.
Approximately $2.6 million (or 1.4 percent) funded social welfare for drug abusers, of which $1.7 million
was supported with UGF.

•

Based on national proportions, the State of Alaska Justice System’s total spending in SFY 2015 of $655.1
million would represent 33 percent of the total justice systems budgets of an estimated $1.99 billion in
Alaska (including federal and local government systems). If an estimated $73.4 million is attributed to
drug abuse arrests and offenses in Alaska, then this would conservatively represent about 4 percent of
total justice systems costs in Alaska. The estimated UGF portion of the state budget would be $21.5
million.

Healthcare Related Costs
Prevention Grants
The State of Alaska Division of Behavioral Health (DBH) allocates grant funding to programs that prevent mental
health problems and drug abuse. Some of these programs operate at the systems level, guiding governments
and communities to implement and organize services. Other programs work directly with individuals suffering
from poor mental health or addiction and their families. This section of the report presents the total amount of
DBH grants directed towards drug abuse.
In SFY 2015, DBH allocated an estimated total of $780,391 towards the prevention of drug abuse.
Table 52. State of Alaska DBH Prevention Grant Funding for the
Prevention of Drug Abuse, SFY 2015
Grant Recipient
Reentry Program
Rural Human Services System
Therapeutic Court
Total

Total Grant Value
600,000

% for Drug
Abuse
25

Grant Total for
Drug Abuse
150,000

1,991,565

25

497,891

265,000

50

132,500

$10,158,313

7.7%

$780,391

Source: DHSS, Division of Behavioral Health.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 57

 Of the $780,391 allocated toward the grants supporting prevention of drug abuse, approximately $383,200 was
funded through Undesignated General Funds (UDF).
Table 53. Undesignated General Fund Portion of DBH Prevention Grant Funding, (‘000$) FY 2015
Grant Recipient
Reentry Program

Total State
Budget
$600.0

UGF Portion
$600.0

% UGF
of Total
100%

% for
Drug Abuse
$150.0

UGF Portion of Drug
Abuse Grants
$150.0

$3,468.3

$869.4

25%

$497.9

$124.5

$5,565.2

4,565.9

82%

$21,437.4

$14,385.8

Rural Human Services System
Therapeutic Court
Total

$132.5

$108.7

$780.4

$383.2

Source: DHSS, Division of Behavioral Health.

Social Welfare Related Costs
There are 12 different social welfare programs administered by DHSS. Funding for these programs in SFY 2015
was $178.0 million. Among the programs are Adult Public Assistance, Energy Assistance, Senior Benefits
Payment Programs, and Alaska Temporary Assistance Program. Approximately $2.6 million funded social
welfare for drug abusers, of which $1.7 million was supported with UGF.
Table 54. Undesignated General Fund Portion of State of Alaska Social Welfare Program Spending
Attributable to Drug Abuse, SFY 2015
State Funding
Total1
$10,674,5232

% UGF
Funding
43.9

Drug Abuse
Spending
$185,025

Portion UGF
Funding
$81,226

Adult Public Assistance

$59,419,200

90.2

$812,062

$732,480

Public Assistance Field Services

$14,799,800

45.7

$256,530

$117,234

Social Welfare Program
SNAP Administrative Costs

Public Assistance Admin

$1,256,200

32.0

$21,774

$6,968

Alaska Temporary Assistance Program

$15,164,300

43.9

$262,848

$115,390

Work Services

$3,750,000

17.5

$51,250

$8,969

Tribal Assistance Services

$10,084,200

93.7

$137,817

$129,135

Women, Infants, and Children

$10,574,400

1.5

$116,318

$1,745

Energy Assistance

$23,729,400

47.2

$324,302

$153,071

Child Care Benefits

$2,728,200

19.5

$37,285

$7,271

General Relief Assistance

$3,135,200

100

$42,848

$42,848

Senior Benefits Payment Program

$22,665,400

100

$309,760

$309,760

$177,980,823

67%

$2,557,821

$1,706,095

Total
1Division

Source:
of Public Assistance Actual Expenditures, SFY 2015, State of Alaska Office of Management and Budget;
2Supplemental Nutrition Assistance Program State Activity Report Fiscal Year 2014;

Criminal Justice/Corrections Related Costs
Based on analysis of Criminal Justice impacts presented in Chapter 4, there were 9,572 offenses/arrests related
to drug abuse in 2014, representing about 27 percent of total offenses/arrests. The total criminal justice systems
costs associated with these offenses and arrests is estimated at $73.4 million. These costs include local, state,
and federal government funds spent on police protection, legal and adjudication services, and corrections
programs occurring in Alaska.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 58

 Table 55. Summary of Criminal Justice Costs Attributed to Drug Abuse in Alaska, 2014
Drug-Related
Counts
Offenses and arrests

9,572

Percentage offenses-arrests

27%

Costs
Criminal justice system

$73.4 million

Source: McDowell Group calculations.

Based on a 2012 Survey, the Bureau of Justice Statistics provides a national breakout of federal, state, and local
government expenditures on justice systems for police protection, judicial and legal services, and corrections.
When combined, on a national basis, state government expenditures for justice systems are about 33 percent
of total expenditures ($86 billion out of total national justice system spending of $265 billion).
Table 56. National Justice System Expenditures by Type of Government,
Percent and in $Thousands, Federal FY2012
Category

Percent

$Thousands

Federal

25%

$31,395,000

State

12%

$14,815,502

Local

66%

Police Protection

Total

$84,053,185
$126,434,125

Judicial and Legal Services
Federal

27%

$15,894,000

State

39%

$22,770,081

Local

38%

Total

$22,049,483
$57,935,169

Corrections
Federal

11%

$8,978,000

State

60%

$48,680,649

Local

33%

Total

$26,397,777
$80,791,046

Total Justice System
Federal

21%

$56,267,000

State

33%

$86,266,232

Local

50%

Total

$132,500,445
$265,160,340

Note: Totals will not sum due to the removal of any fund duplications.
Source: Bureau of Justice Statistics (BJS) Justice Expenditure and Employment
Extracts Program (JEE).

In SFY 2015, $111.9 million out of $115.7 million (or 97 percent) of the Alaska Court System was funded with
Undesignated General Funds (UGF). A total of 83 percent (or $171.3 million) of the Alaska Department of Public
Safety’s budget was from UGF. The Department of Correction’s budget was 89 percent funded with UGF (or
$297.7 million). Combined, $580.9 million in UGF supported 89 percent of the combined budgets for the Alaska
Court System, Department of Public Safety, and Department of Corrections.
The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 59

 Table 57. State of Alaska Justice System Budgets, SFY 2015
Undesignated General Funds

Total State Budget

% UGF of Total Budget

Alaska Court System

$111.9 million

$115.7 million

96.7%

Dept. of Public Safety

$171.3 million

$206.3 million

83.0%

Dept. of Corrections

$297.7 million

$333.0 million

89.4%

Total

$580.9 million

$655.1 million

88.7%

Note: Columns may not add due to rounding.
Source: State of Alaska, Office of Management and Budget, McDowell Group calculations.

Using national proportions, the State of Alaska Justice System’s total spending in SFY 2015 of $655.1 million
would represent approximately 33 percent of the total justice system’s budget in Alaska (including federal and
local government systems) totaling about $1.99 billion.
If an estimated $73.4 million is attributed to drug abuse arrests and offenses in Alaska, then this would represent
about 4 percent of total justice systems costs in Alaska. The portion of those costs impacting the state budget
is approximately $24.2 million (33 percent of $73.4 million). The estimated UGF portion of the state budget
would be $21.5 million (using the proportion of 89 percent of the total budget). Therefore, of the total UGF
funding of $580.9 million in the state’s justice system, approximately 4 percent is directly attributed to drug
abuse-related costs. This is likely a conservative estimate. State of Alaska spending on criminal justice probably
accounts for a higher percentage (than the national average) of total criminal justice spending in Alaska. For
example, in Alaska there are no federal penitentiaries or correctional institutions.

The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 60

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Alaska Department of Corrections (DOC). “Alaska Offender Profile, 2014.” June 2015.
http://www.correct.state.ak.us/admin/docs/Final_2014_Profile.pdf. Accessed March 2016.
Alaska Department of Health and Social Services. Bureau of Vital Statistics. Special data request. Received April
2016.
Alaska Department of Health and Social Services, Division of Public Health, Epidemiology Section. “HIV

Surveillance Report – Alaska, 1982-2015.” 2016.
http://dhss.alaska.gov/dph/Epi/hivstd/Documents/HIVSurveillanceReport1982-2015.pdf. Accessed April
2016.
Alaska Department of Health and Social Services, Division of Public Health, Epidemiology Section. “2014

Annual (January-December) Infectious Disease Report.” 5 June 2015.
http://epibulletins.dhss.alaska.gov/Document/Display?DocumentId=36. Accessed April 2016.
Alaska Department of Labor and Workforce Development (DOLWD). “Population Estimates.” 2015.
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Bureau of Economic Analysis. SA4 Personal Income and Employment by Major Component. (2016).
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Caulkins, Jonathan P. and Mark A.R. Kleiman. Prepared for the U.S. Department of Justice. “How Much Crime is

Drug-Related and Potential Improvements of Estimation Methods.” April 2014.
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Accessed

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The Economic Costs of Drug Abuse in Alaska, 2016 Update

McDowell Group, Inc.  Page 62

 Appendix: Mortality
Table 58. ICD-10 Codes and Drug Attributable Fractions (DAF)
by Cause of Death, Gender, and Age Group
Cause

ICD-10

DAF

F11, F12, F13, F14, F15, F16, F17.0, F17.3-F17.9, F18, F19

100%

Accidental poisoning by and exposure to
drugs, medicaments, and biological
substances

X40-X44

100%

Intentional self-poisoning (suicide) by and
exposure to drugs, medicaments, and
biological substances

X60-X64

100%

Assault (homicide) by drugs, medicaments
and biological substances

X85

100%

Y10-Y14

100%

X42

100%

Direct Causes
Behavioral Health Disorders due to
psychoactive substance

Poisoning by and exposure to drugs,
medicaments and biological substances,
undetermined intent
Others
Accidental poisoning by and exposure to
narcotics and psycodysleptics, not
elsewhere classified
Poisonings by drugs

T40.0, T40.1, T40.2, T40.3, T40.4, T40.5, T40.7, T41.3

Drugs, medicament and biological
substances causing adverse effects in
therapeutic use; Opioids and related
analgesics causing adverse effects in
therapeutic use

100%

Y45.0

100%

X85-Y09, Y87.1

13%

Indirect Causes
Homicide
HIV/AIDS
Hepatitis B
Hepatitis C

B20-B24

5%

B16.9, B18.0, and B18.1

28%

B17.1, B18.2

28%

Source: Attribution rates from Centers for Disease Control and Prevention’s (CDC) Vital Statistics; Patra et al. “Substance-attributable
morbidity and mortality changes to Canada's epidemiological profile: Measurable differences over a ten-year period;” and Rogers et. al. “The

Costs of Alcohol and Drug Abuse in Maine.”

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McDowell Group, Inc.  Page 63

 Table 59. Alaska Drug-Related Deaths, by Cause, 2010-2014
Total # of
Deaths
756

Causes of Death 100 Percent Attributable

Drug Attributable
Annual Average Drug
Deaths
Attributable Deaths/Year
756
151

Accidental poisoning by and exposure to drugs,
medicaments, and biological substances

478

478

95.6

Assault (homicide) by drugs, medicaments and
biological substances

198

198

39.6

Behavioral Health Disorders due to psychoactive
substance

12

12

2.4

Drugs, medicament and biological substances causing
adverse effects in therapeutic use

0

0

0.0

Intentional self-poisoning (suicide) by and exposure to
drugs, medicaments, and biological substances

57

57

11.4

Poisoning by drugs

0

0

0.0

Poisoning by and exposure to drugs, medicaments and
biological substances, undetermined intent

11

11

2.2

152

36

7.2

Hepatitis B

11

3

0.6

Hepatitis C

113

32

6.3

HIV/AIDS

28

1

0.3

906

790

158

Causes of Death Partially Attributable

Total

Notes: Due to rounding columns may not add to totals. See Appendix for ICD-10 codes used and drug attribution rates.
Source: Death counts from DHSS’ BVS’ unpublished data, and McDowell Group calculations. Attribution rates from Centers for Disease
Control and Prevention’s (CDC) Vital Statistics; Patra et al. “Substance-attributable morbidity and mortality changes to Canada's
epidemiological profile: Measurable differences over a ten-year period;” and Rogers et. al. “The Costs of Alcohol and Drug Abuse in Maine.”

Table 60. Estimated Potential Years of Life Lost (PYLL) Due to Causes of Death Attributable to Drugs
in Alaska, 2010-2014
Causes of Death 100 Percent Attributable

Total # of Drug
Attributable Deaths
557

PYLL Attributable
to Drugs
18,391

Estimated Average
PYLL/Year
3,678

BH Disorders due to psychoactive substance

10

333

67

Accidental poisoning by and exposure to drugs,
medicaments, and biological substances

479

16,153

3,231

Intentional self-poisoning (suicide) by and
exposure to drugs, medicaments, and biological
substances

57

1,677

335

Assault (homicide) by drugs, medicaments and
biological substances

0

0

0

Poisoning by and exposure to drugs,
medicaments and biological substances,
undetermined intent

11

228

46

Poisoning by drugs

0

0

0

Drugs, medicament and biological substances
causing adverse effects in therapeutic use

0

0

0

Causes of Death Partially Attributable

61

1,636

327

HIV/AIDS

1.4

36

7

Hepatitis B

3.1

55

11

Hepatitis C

30.8

537

107

Homicide

25.5

1,008

202

Total

618

20,027

4,005

Note: Due to rounding columns may not add to totals.
Source: DHSS’ BVS’ unpublished data, and McDowell Group calculations. Attribution rates from CDC’s Vital Statistics; Patra et al., Rogers

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