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30 Nov 2020, 10:14
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From the mid-1980s to the early 2000s, most substance abuse treatment in the U.S. was provided by specialty centers. These centers offered two main types of care:
• Outpatient care, where patients receive treatment during scheduled visits and do not stay overnight
• Inpatient care, where patients stay at the facility during treatment
In the early to mid-1990s, inpatient programs were seen as too expensive and less cost-effective than outpatient alternatives. As a result, there was a general shift toward outpatient care. Private insurers, in particular, began covering fewer inpatient treatments and focused more on outpatient programs.
During this period, spending on prescription medications for substance abuse remained a small portion of total treatment costs. Few FDA-approved drugs (the U.S. Food and Drug Administration is the agency that authorizes medications for use in the United States) were available: disulfiram and naltrexone were already in use for alcohol addiction, and acamprosate was added in 2004. Buprenorphine was FDA-approved in 2002 for opioid addiction. Methadone, another FDA-approved medication for opioid treatment, is not sold through regular pharmacies. Instead, it is administered at treatment centers, and its cost is counted as part of spending on those centers.
• Outpatient care, where patients receive treatment during scheduled visits and do not stay overnight
• Inpatient care, where patients stay at the facility during treatment
In the early to mid-1990s, inpatient programs were seen as too expensive and less cost-effective than outpatient alternatives. As a result, there was a general shift toward outpatient care. Private insurers, in particular, began covering fewer inpatient treatments and focused more on outpatient programs.
During this period, spending on prescription medications for substance abuse remained a small portion of total treatment costs. Few FDA-approved drugs (the U.S. Food and Drug Administration is the agency that authorizes medications for use in the United States) were available: disulfiram and naltrexone were already in use for alcohol addiction, and acamprosate was added in 2004. Buprenorphine was FDA-approved in 2002 for opioid addiction. Methadone, another FDA-approved medication for opioid treatment, is not sold through regular pharmacies. Instead, it is administered at treatment centers, and its cost is counted as part of spending on those centers.
Private spending on substance abuse treatment—across all three private payer categories—grew only from $4.6 billion in 1986 to $4.7 billion in 2003. Based on this and the information in the tabs, for each of the following statements, select Yes if the statement is accurate. Otherwise, select No.
| Yes | No | |
| Overall spending on substance abuse treatment more than doubled from 1986 to 2003. | ||
| State and local government programs (Public Other State and Local) accounted for approximately $18 billion in substance abuse spending in 2003. | ||
| Medicare spending on substance abuse treatment remained unchanged between 1986 and 2003. |
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Official Answer
Overall spending on substance abuse treatment more than doubled from 1986 to 2003.: Yes
State and local government programs (Public Other State and Local) accounted for approximately $18 billion in substance abuse spending in 2003.: No
Medicare spending on substance abuse treatment remained unchanged between 1986 and 2003.: No
30 Nov 2020, 10:14
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Official Solution:
Statement 1:
Private spending on substance abuse treatment stayed roughly the same, but its share dropped from about 50% in 1986 to around 22% in 2003. That means total spending must have risen by about 50/22 ≈ 2.3, i.e. more than doubled. So, this statement is accurate.
Statement 2:
If private spending was $4.7 billion and made up 25% of the total, then total spending was around $18.8 billion. State and local programs made up 40% of that, or about $7.5 billion—not $18 billion. So, this statement is not accurate.
Statement 3:
Medicare’s share stayed about the same from 1986 to 2003, but since total spending doubled, Medicare spending in dollars also doubled. So, this statement is not accurate.
Correct answer:
Overall spending on substance abuse treatment more than doubled from 1986 to 2003. "Yes"
State and local government programs (Public Other State and Local) accounted for approximately $18 billion in substance abuse spending in 2003. "No"
Medicare spending on substance abuse treatment remained unchanged between 1986 and 2003. "No"
Bunuel
Statement 1:
Private spending on substance abuse treatment stayed roughly the same, but its share dropped from about 50% in 1986 to around 22% in 2003. That means total spending must have risen by about 50/22 ≈ 2.3, i.e. more than doubled. So, this statement is accurate.
Statement 2:
If private spending was $4.7 billion and made up 25% of the total, then total spending was around $18.8 billion. State and local programs made up 40% of that, or about $7.5 billion—not $18 billion. So, this statement is not accurate.
Statement 3:
Medicare’s share stayed about the same from 1986 to 2003, but since total spending doubled, Medicare spending in dollars also doubled. So, this statement is not accurate.
Correct answer:
Overall spending on substance abuse treatment more than doubled from 1986 to 2003. "Yes"
State and local government programs (Public Other State and Local) accounted for approximately $18 billion in substance abuse spending in 2003. "No"
Medicare spending on substance abuse treatment remained unchanged between 1986 and 2003. "No"
01 Apr 2025, 05:08
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This MSR question and its solutions have been completely revised and improved.
