Addiction costs Oklahoma and its residents an estimated $7.2 billion a year.
That's more than the state government's budget of $6.7 billion.
That's roughly $1,900 for every man, woman and child in the state. It's enough to create about 273,000 median-wage jobs, or to build nine skyscrapers like Oklahoma City's Devon tower.
It's not just a matter of money. The abuse of street and prescription drugs, alcohol, tobacco and other addictive substances exacts a terrible toll on people's health, well-being and quality of life.
“The bottom line is, we're witnessing this crisis, this silent cancer that is just growing,” said Darrell Weaver, director of the Oklahoma Bureau of Narcotics and Dangerous Drugs Control.
The problem is spreading through every stratum of society: poor, middle-class, wealthy; rural, urban and suburban.
The direct and indirect costs are enormous. Incarceration chews up tax dollars. Business productivity plummets. Families crumble. Crime festers.
Government, churches and private ventures offer a variety of treatment and recovery programs, but evidence indicates they are inadequate and overloaded.
Addiction touches just about everyone in some way: a friend or family member struggling with substance abuse, a crime tied to drug use, a workplace accident caused by an addled employee.
Last year, the federal government reported Oklahoma had the nation's highest percentage of adolescents and adults who abused prescription drugs over a 12-month period — about 8 percent, or nearly 240,000 people.
Part of the problem, Weaver said, is a complacent public.
“It seems like they've grown immune to the drug issues,” Weaver said.
“They think that they've heard it so much, is it really even out there? The scary part is, it's probably affecting more lives in our state than at any time ever in history. Ever.”
Cost of complacency
The $7.2 billion cost estimate was calculated by the National Association of State Alcohol and Drug Abuse Directors, which tracks substance abuse trends.
Direct costs account for an estimated $1.8 billion a year — spending on hospital care, doctors, police and prisons, for example.
Indirect costs account for another $5.4 billion in diminished productivity, work and goods never produced and people who die or fall ill.
“In the oil fields of Oklahoma, if you've got oil workers who miss work because they're drunk or on meth, they still pump the oil, but they have to hire more people,” said Rick Harwood, the association's research director.
“Maybe they overstaff because they know that one out of 20 is going to be absent on a given day. That's a cost that somebody has to pay, one way or another, and usually those increases in costs are passed on.”
A yearlong study by a task force of Oklahoma lawmakers and state leaders reached similar conclusions.
The 2005 report said Oklahoma pays more than $3 billion annually in direct costs related to untreated and under-treated people with addictions and mental illness. Indirect human costs added $5 billion to the toll.
The group estimated that 200,000 Oklahoma workers dealing with depression and addiction were costing employers $600 million annually in additional medical expenses alone.
“If you think about vibrant communities and a good economy, we have to have healthy and engaged brains ready to work,” said Terri White, commissioner of the state Mental Health and Substance Abuse Services Department.
In 2010, parental neglect accounted for 88 percent of the 18,000 children removed from their homes by the courts and the state Department of Human Services.
“Untreated addiction is a major part of that, and it could've been prevented if those parents had received treatment,” White said.
White added that one of the keys to confronting Oklahoma's addiction crisis is dealing with teenage drinking.
The part of a person's brain that handles critical thinking and decision-making is the prefrontal cortex.
It typically does not become fully developed until a person reaches the age of 20 to 25.
Alcohol impairs its development.
“Significant alcohol use can actually permanently damage or stunt the growth or our prefrontal cortex,” White said.
“One of the most dangerous things that happens is underage drinking.”
Certain risk factors are found frequently among people struggling with substance abuse.
Research shows that family history and genetics account for about 60 percent of the risk of addiction.
The age at which a person starts using substances increases it. The younger someone starts, the higher the probability for addiction.
Joey's wasted years
Joey Dawson, 36, of Hobart, had his first drink at 13. Hobart, in southwest Oklahoma, was like many small towns — there wasn't much to do, and it seemed like everybody drank, Dawson said.
Dawson had family members who had tried meth. He had seen them struggle, had seen them change; he knew the dangers. But at the age of 23, at a party, he decided to give it a try himself.
“From the day that I tried it, I didn't stop until I got in trouble,” Dawson said.
After about a year, Dawson started manufacturing meth. By 2002, he had meth-related charges pending in Kiowa County. When he got in trouble four months later in Cordell, he knew he was probably going to prison.
He spent 11 months in the county jail. His girlfriend gave birth to his son while he was there. That was a game-changer for Dawson, he said.
“After he was born, I realized it wasn't about me any more,” Dawson said. “I think if they had let me out right then, I would have been fine.”
Dawson was convicted on charges of manufacturing meth and possession of a controlled dangerous substance with intent to distribute. He got two 10-year sentences that ran concurrently.
He spent four years in prison at the Bill Johnson Correctional Center, in Alva, matching almost day for day for the four years he was addicted to meth.
Dawson got into a treatment program at the prison. Between the program and his son, he was ready for a change.
Once Dawson got out, he said, he told all of his old “friends” that he had become a government snitch. It was a good way to ensure he wouldn't repeat his past.
Dawson now works for an oil and gas drilling company, is married and has custody of his 9-year-old son.
Users behind bars
Like Dawson, the majority of people headed to prison are nonviolent offenders. An analysis of nonviolent prison admissions from 2005-10 showed 44 percent involved drug-related offenses, mainly possession.
Not all offenders are as lucky as Dawson.
In 2010, for example, 885 female offenders who left prison had been assessed as needing substance abuse treatment.
About 72 percent of them, or 633 offenders, had not received it.
A recent state Corrections Department study determined that offenders who completed an approved substance abuse treatment program reduced their chances of returning to prison by 20 percent.
For every $100 that Oklahoma spends on substance abuse and addiction, only about $2 goes to prevention, treatment and research, while $97 goes to cover other direct costs such as incarceration, according to a study by the National Center on Addiction and Substance Abuse at Columbia University.
“And the horror is that it doesn't have to be that way because we know more effective ways to make use of the tax dollar,” said Susan Foster, the center's policy director.
“We just haven't done it — policy hasn't caught up with science.”
Waiting for help
On any given day, 600 to 900 Oklahomans are on a waiting list for a bed in a publicly funded residential substance abuse center.
About 160,000 Oklahomans need treatment for drug and alcohol addiction, according to the state Mental Health Department. An estimated 20,000 teenagers are in need of drug and alcohol treatment.
Alcohol abuse is far more common than drug addiction. For every seven people who need treatment for alcohol, only one needs help for drugs.
But only a few get state-funded help. To qualify, a person must have no other means to pay and no other sources of assistance. That excludes anyone with private insurance, unless it's a child whose private insurance company won't cover the costs.
“In our system, we have enough resources to serve about one-third of the Oklahomans who financially qualify for our services and need help,” said White, the mental health commissioner.
“So on any given day, two-thirds of Oklahomans who need help, and qualify, can't get it.”
Rhonda McGough faces this challenge every day as a drug and alcohol counselor in Idabel, a town of about 7,000 in southeast Oklahoma.
“You have to try to look outside the box to get your clients access to resources readily available in their towns,” said McGough, who works for the Kiamichi Council on Alcoholism & Other Drug Abuse.
The lengthy wait for an inpatient bed sometimes is a deal-breaker.
“A lot can happen in three to four months,” McGough said.
“A person who comes in today and says, ‘I'm ready to do this' may not be saying that two weeks from now.”
SUBSTANCE ABUSE IN OKLAHOMA
State population age 12 and older 2,927,119
Alcohol use in past month45.66% 1,336,523
Tobacco use in past month34.82% 1,019,223
Binge alcohol use in past month 22.34% 653,918
Illicit drug use in past month 8.94% 261,684
Nonmedical use of painkillers in past year 8.13% 237,975
Cocaine use in past year 1.51%44,199
Nearly half of all Oklahomans aged 12 and above use some form of psychoactive drugs at least occasionally, according to a federal survey of drug use in America completed in 2009. The most frequently used substance is alcohol, followed by tobacco, street drugs and prescription painkillers.
Source: Substance Abuse and Mental Health Services Administration
DRUG OVERDOSE DEATHS
West Virginia 25.8
Oklahoma ranks among the top 10 states for number of drug overdose deaths, with 15.8 for every 100,000 residents in 2008. Oklahoma's rate is higher than those in any surrounding state except New Mexico.
Source: Centers for Disease Control and Prevention