Alcohol, tobacco and other drug abuse exacts a tremendous toll on Denver residents. The costs of the human suffering involved cannot be measured in dollars and cents. No monetary value can be placed on grief for a dead friend or family member; the trauma of a disfiguring car crash; the turmoil of those fighting addiction and the havoc experienced by their loved ones; or the fear of falling victim to a crime.

At the same time, many of the harms inflicted by substance abuse can be quantified economically, and the costs are steep. For the country as a whole, federal government estimates place the economic costs of alcohol and drug abuse at nearly $375 billion annually—a burden shared by individuals, businesses and all levels of government.^[148] Direct medical expenses and lost economic productivity due to smoking-related illness and premature death account for another $170 billion in costs each year.^[149] Extrapolating from these figures, Drug Strategies estimates that the economic costs of alcohol, tobacco and other drug abuse in Denver exceed $1.5 billion per year—about $2,600 per person.

Medical Costs and Lost Productivity Due to Smoking in Denver
In Colorado, more than $1 billion in direct medical expenditures are attributable to cigarette smoking each year, part of $75 billion in such expenditures nationwide.^[150] Smoking-related illnesses and premature death cost Colorado another $1 billion in lost economic productivity each year, part of national losses totaling $93 billion.^[151] Given that Denver accounts for close to 18 percent of all smoking-related deaths in Colorado,^[152] Drug Strategies estimates that smoking-related medical expenditures in the city amount to about $185 million per year, and that smoking-related productivity losses cost Denver another $185 million each year. Smoking’s economic toll in Denver, therefore, is about $370 million a year.

Economic Costs of Alcohol and Other Drug Abuse in Denver
Alcohol and drug abuse cost the nation at least $375 billion each year. Published jointly by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), the basis for this cost estimate includes spending on prevention, treatment, enforcement and criminal justice; medical expenditures resulting from alcohol and drug-related illness and injury; and lost earnings due to illness, premature death, criminal victimization and incarceration.^[153] The overall $375 billion nationwide cost figure should be understood as a conservative estimate, since some likely costs—such as the impact of employee substance abuse on a company’s performance—cannot be calculated for lack of appropriate data.

If substance abuse problems in Denver were no more severe than they are on average nationwide, then the city’s estimated economic costs would be directly proportional to Denver’s share of the total U.S. population—about $735 million per year.^[154] However, as earlier chapters have documented, Denver’s alcohol and drug-related problems are significantly more serious than the national average:

· Rates of binge drinking and chronic drinking are about 40 percent higher among Denver adults than among adults nationwide.^[155]

· Denver residents are hospitalized for alcohol-related illnesses at nearly twice the national rate.^[156]

· Denver’s alcohol-related death rate is 44 percent higher than the national rate, while the city’s death rate due to other drugs is nearly double the U.S. rate.^[157]

· Drug-related hospital emergencies occur in Denver at 2½ times the national rate.^[158]

· Drug-related AIDS cases are diagnosed in Denver at twice the national rate.^[159]

· Denver arrests^[161] and imprisons^[162] drug offenders at more than twice the rate nationwide.

Drug Strategies estimates that alcohol and other drug abuse costs Denver between $1.1 billion and $1.5 billion per year.^[163] With an additional $370 million in annual economic costs attributable to smoking, substance abuse costs Denver residents, businesses and government at least $1.5 billion—and as much as $1.9 billion—each year.

[148]. National Institute on Drug Abuse & National Institute on Alcohol Abuse and Alcoholism. The Economic Costs of Drug and Alcohol Abuse in the United States, 1992. September 1998.

Office of National Drug Control Policy. The Economic Costs of Drug Abuse in the United States, 1992-1998. September 2001.

NIDA and NIAAA (1998) estimated that alcohol abuse cost the nation $166.543 billion in 1995, and that drug abuse cost the nation $109.832 billion in 1995. Updating NIDA-NIAAA’s 1995 alcohol abuse cost figure for population growth and inflation, Drug Strategies estimates that alcohol abuse cost the nation $212.680 billion in the year 2000. ONDCP (2001) revised and updated NIDA-NIAAA’s drug abuse cost figure, estimating that drug abuse cost the nation $160.664 billion in the year 2000. Combining these revised and updated estimates yields $373.344 billion in economic costs to the United States due to alcohol and drug abuse in the year 2000.

[149]. Centers for Disease Control and Prevention. “Annual smoking-attributable mortality, years of potential life lost, and economic costs—United States, 1995-1999.” Morbidity and Mortality Weekly Report, 51(14):300-303, April 2002.

Centers for Disease Control and Prevention. “Medical-care expenditures attributable to cigarette smoking—United States, 1993.” Morbidity and Mortality Weekly Report, 43(26):469-472, July 1994.

[150]. Centers for Disease Control and Prevention. “Annual smoking-attributable mortality, years of potential life lost, and economic costs—United States, 1995-1999.” Morbidity and Mortality Weekly Report, 51(14):300-303, April 2002.

[151]. Centers for Disease Control and Prevention. “Medical-care expenditures attributable to cigarette smoking—United States, 1993.” Morbidity and Mortality Weekly Report, 43(26):469-472, July 1994.

[153]. National Institute on Drug Abuse & National Institute on Alcohol Abuse and Alcoholism. The Economic Costs of Drug and Alcohol Abuse in the United States, 1992. September 1998.

Office of National Drug Control Policy. The Economic Costs of Drug Abuse in the United States, 1992-1998. September 2001.

[154]. U.S. Census Bureau. In the year 2000, Denver accounted for 0.0019708 of the entire U.S. population (554,636 of 281,421,906). If the economic costs of alcohol and drug abuse in Denver were directly proportional to Denver’s share of the U.S. population, then Denver’s year 2000 economic costs due to alcohol and drug abuse would have been an estimated $735.786 million (0.0019708 times $373.344 billion).

[155]. Colorado Department of Public Health and Environment and U.S. Centers for Disease Control and Prevention. The CDC sponsors the Behavior Risk Factor Survey (BRFS), which is administered annually in Colorado by the Department of Public Health and Environment. Since 1993, questions on alcohol use have been included in the Colorado survey every other year (e.g., 1993, 1995, 1997 and 1999). According to BRFS results for 1993, 1995, 1997 and 1999, an average of 20.7 percent of Denver adults engaged in binge drinking (five or more drinks on one occasion at least once during the past month), compared to 14.5 percent of adults nationwide on average over the same years. The rate of binge drinking among Denver adults is therefore 42.7 percent higher than the national average. In the same years, an average of 5.1 percent of Denver adults engaged in chronic drinking (at least 60 drinks in the past month), compared to 3.1 percent of adults nationwide. The rate of chronic drinking among Denver adults is therefore 64.5 percent higher than the national average.

[156]. Colorado Department of Public Health and Environment.

National Institute on Alcohol Abuse and Alcoholism. Trends in Alcohol-Related Morbidity Among Short-Stay Community Hospital Discharges, United States, 1979-1999. December 2001.

From 1994-1998, the U.S. rate of alcohol-related hospital discharges declined steadily from 22.6 discharges per 10,000 population 15 and older to 19.3 per 10,000. According to data maintained by CDPHE, Denver’s rate of alcohol-related hospital discharges rose from 21.1 per 10,000 in 1995 to 35.2 per 10,000 in 1998, 82.4 percent higher than the U.S. rate in 1998.

[157]. Colorado Department of Public Health and Environment and National Center for Health Statistics. From 1994-1998, Denver’s annual alcohol-related death rate of 58.5 per 100,000 residents was 43.7 percent higher than the U.S. rate (40.7 per 100,000). Over the same period, Denver’s annual drug-related death rate of 18.5 per 100,000 residents was 98.9 percent higher than the U.S. rate (9.3 per 100,000).

[158]. Substance Abuse and Mental Health Services Administration. Year-End 2000 Emergency Department Data from the Drug Abuse Warning Network (DAWN). July 2001. The published DAWN report provides hospital emergency department (ED) data for 21 metropolitan areas in their entirety, without distinguishing between trends in each metro area’s central city and its surrounding counties. SAMHSA’s Office of Applied Studies provided Drug Strategies with hospital emergency department data for the City & County of Denver and for the surrounding counties separately. From 1996-2000, Denver averaged 563 drug-related hospital ED episodes per 100,000 residents age 6 and older, nearly 2½ times higher than the national average (227 per 100,000).

[159]. Colorado Department of Public Health and Environment and U.S. Centers for Disease Control and Prevention. Although Denver’s rate of newly diagnosed drug-related AIDS cases fell from 15.4 per 100,000 population in 1995 to 8.8 in the year 2000, it was still nearly five times higher than the year 2000 rate for the rest of Colorado (1.8) and more than double the year 2000 U.S. rate (4.1 per 100,000).

[160]. Federal Bureau of Investigation. Crime in the United States, 2000. October 2001. Denver’s year 2000 crime rate—4,742 crimes per 100,000 residents—was 15 percent higher than the national average and 23 percent higher than in the rest of Colorado.

[161]. Denver Department of Safety and Federal Bureau of Investigation. From 1996-2000, Denver made an annual average of 1,233.2 drug arrests per 100,000 population, 2.15 times higher than the U.S. rate of 574.1 per 100,000 over the same period.

[162]. Colorado Office of the State Court Administrator; Colorado Division of Criminal Justice; and Bureau Justice Statistics. In 1994, Denver’s rate of imprisoning drug offenders stood about 20 percent higher than the national average (73.0 versus 60.5 per 100,000 population). As the U.S. drug offense imprisonment rate rose slowly over the next five years, reaching 65.3 per 100,000 in 1998, Denver’s rate more than doubled. At 162.0 drug imprisonments per 100,000 population 1998, Denver’s rate was 2.48 times higher than the national average.

[163]. In light of the numerous indicators for which the available data reveal Denver’s alcohol and other drug abuse problems to be considerably more severe than the national averages (as documented in this report), Drug Strategies estimates that the economic costs of alcohol and other drug abuse in Denver are between 50 percent and 100 percent higher than the $735.786 million figure derived assuming costs would be in direct proportion to Denver’s share of the total U.S. population. Therefore, Drug Strategies estimates the year 2000 economic costs of alcohol and drug abuse in Denver to have been between $1.104 billion and $1.472 billion (or, rounding to the nearest hundred million, between $1.1 billion and $1.5 billion).