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Prevention: The “Front End” of Health and Wellness



At the recent Rx Conference in Atlanta, Georgia, President Obama stated that “Instead of letting people leave hospitals and jails with no help and letting them and their families continue to suffer, it’s just smarter for us to do the right thing on the front end.”  While treatment and intervention are necessary and critical once any disease has emerged, the obvious “front end” of any disease must be prevention.  The complex brain disease of addiction is no exception.

Forbes reports that “opioids have killed over 500,000 people since 1999, which is more than World War II, the Korean War, and the Vietnam War combined. According to the CDC, Heroin use alone has more than doubled in young adults aged 18-25 in the last decade. The American Society of Addiction Medicine (ASAM) also estimates that of the 21.5 million Americans 12 or older that had a substance use disorder in 2014, 1.9 million of those individuals were addicted to prescription pain relievers and 586,000 involving heroin”.

Costs of Substance Abuse Studies have shown the annual cost of substance abuse to the Nation to be $510.8 billion in 1999 (Harwood, 2000). More specifically, alcoholism costs the Nation $191.6 billion.  Tobacco use cost the Nation $167.8 billion.  Substance Use Disorder (SUD) and Addiction cost the Nation $151.4 billion.  (SAMHSA)

“If effective prevention programs were implemented nationwide, substance use initiation would decline for 1.5 million youth and be delayed for 2 years on average. In 2003, an estimated 8 percent fewer youth ages 13–15 would not have engaged in binge drinking, 11.5 percent fewer youth would not have used marijuana, 45.8 percent fewer youth would not have used cocaine, 10.7 percent fewer youth would not have smoked regularly.  The average effective school-based program costs $220 per pupil. It would save an estimated $18 per $1 invested if implemented nationwide. Nationwide school-based effective programming in 2002 would have had the following fiscal impact:   Saved State and local governments $1.3 billion, including $1.05 billion in educational costs during 2003 and 2004, reduced social costs of substance-abuse–related medical care, other resources, and lost productivity over a lifetime by an estimated $33.5 billion, preserved the quality of life over a lifetime valued at $65 billion.

These cost-benefit estimates show that effective school-based programs pay for themselves and more. For every dollar spent on these programs, an average of $18 dollars per student would be saved over their lifetime”. (SAMHSA)

“The scope and problem of behavioral health problems is significant.  One in five young people have one or more mental, emotional or behavioral disorders at any given time. An estimated 23.5 million Americans ages 12 and older needed treatment for an illicit drug or alcohol problem in 2009—that is almost 1 out of every 10 people.  The total societal cost of substance abuse in the Unites States is estimated to be about $511 billion annually”.  (SAMHSA/CAPT/SAPST 2012).

“One in ten people who need treatment for addiction receive it.  Genetics account for 50-75% of addiction.  Greater than 90% of those affected by addiction began smoking, drinking or using other drugs before the age of 18. Eighty- five percent of all inmates in the adult corrections system are substance involved”. (CASA Columbia)

The bottom line: less than two percent of every dollar goes to prevention and treatment (CASA Columbia). Prevention is the front end of reducing disease.  Addiction is a disease and 58% of people with addiction also have another health condition that should be treated.  Disease management is not prevention.  Incarceration is not prevention.

“The Institute of Medicine’s (IOM) continuum of care, (also known as the mental health intervention spectrum), is a classification system that presents the scope of behavioral health services:  promotion of health, prevention of illness/disorder, treatment, and maintenance/recovery”. (SAPST 2012)

“The focus of promotion is on well-being, according to the National Research Council and IOM, with the goal of enhancing people’s ability to:

  • Achieve developmentally appropriate tasks
  • Acquire a positive sense of self- esteem, mastery, well-being and social inclusion
  • Strengthen their ability to cope with adversity

Prevention focuses on interventions that occur prior to the onset of a disorder and which are intended to prevent the occurrence of the disorder or reduce risk for the disorder.

Treatment interventions include case identification (diagnosis) and standard forms of treatment (e.g. detoxification, outpatient treatment, in-patient treatment, medication- assisted treatment).

Maintenance includes interventions that focus on compliance with long term treatment to reduce relapse and recurrence and aftercare including rehabilitation and recovery support”. (SAPST 2012)

At the 2016 Rx conference in Atlanta, Georgia, Congressman Hal Rogers of Kentucky spoke eloquently as a member of the planning committee for this national event.  He addressed the single biggest stumbling block to successful prevention with one quote, “A vision without funding is a hallucination”.  Until such time as we move the needle on the spending for prevention, we cannot claim that we are truly advocates for prevention but rather supporters of the status quo.  For those among us who may have the disease or have lived with a loved one who struggles with the disease, for those among us who have lost a family member or friend to the disease, there is no question—our wish is that it had been prevented!

Elaine Trumpetto, M.A.


Parents Supporting Parents: The parent support group is currently undergoing reorganization.
Thursday, August 4: Victim Impact Panel – 6:30pm, 807 Route 52, Fishkill NY
Color Blaze Run – More information, Click Here
Saturday, October 29: Second Annual Masquerade Ball “Lifting the Mask”

More information for upcoming events and programs can be found on our website events calendar or by contacting our office at (845) 765-8301 or e-mailing Victoria at vchumas@capedc.org.


Alive @ 25 Information: Click Here for the 2016 Schedule. Contact at 845-765-8301 x110 for questions or to sign up! Victim Impact Panel Information: The Victim Impact Panel runs the FIRST THURSDAY of each month, excluding July. Click here for the 2016 Schedule.
Contact Victoria at 845-765-8301 x100 for more information or for volunteer opportunities!