The estimates presented above place illicit drug use on par with other serious chronic health problems in the United States. A recent study conducted by the National Institute of Diabetes and Digestive and Kidney Diseases (2008) estimated that diabetes costs the United States more than $174 billion each year. As was the case here, that study included both direct costs (medical care and services) and indirect costs (short-term and permanent disability as well as premature death). Finkelstein et al. (2009) report that medical costs associated with obesity totaled more than $147 billion in 2008. This is driven largely by the fact that obese Americans spend approximately 40 percent more on medical services (an average of $1,429 per year) than those whose weight is in the healthy range. The Centers for Disease Control and Prevention (CDC) report that between 1995 and 1999, smoking caused an estimated 440,000 premature deaths each year and was responsible for at least $157 billion annually in health-related economic costs (CDC, 2002). The approach taken by the CDC authors was similar to the approach taken here and was based upon estimates of annual smoking attributable mortality, years of potential life lost, smoking-attributable medical expenditures for adults and infants, and lost productivity for adults. Heart disease exacts perhaps the highest toll. During 2010 alone, it cost the United States an estimated $316 billion. This includes the costs of health care services, medications, and lost productivity (CDC, 2010).
