Alcohol and other drug use, abuse, and dependence have a huge direct and indirect economic impact on society through health care expenditures, lost earnings, and expenses associated with crime and injury. The heaviest economic burden of alcohol and other drug problems falls on states and localities, funding public programs like Medicaid and child welfare systems (CASA, 2001; Join Together, 2006).

The cost of alcohol and other drug problems to society is even greater when the impact on public health is considered: as they contribute to the spread of infectious diseases like HIV/AIDS either through sharing of drug paraphernalia or unprotected sex; homelessness; and motor vehicle crashes. Other associated costs are more difficult to quantify, such as compromised family environments that contribute to poor developmental outcomes in children, lower socioeconomic status, poor marital relations, and parental conflict (McMahon and Giannini, 2003).