His main professional effort for many years was to come up with estimates and plans concerning America's drug problem. Vallance's analysis builds on several sources. First he used the 250-page report prepared for the NIH by Dorothy Rice and her colleagues at the University of California. Dr. Rice compared the direct and indirect costs of alcohol and drug abuse as well as of mental illness. Direct costs refer to actual program expenditures such as those by health professionals, the police, the courts, and the prison system.
Indirect costs refer to such things as premature mortalities and morbidities due to substance abuse.
These reflect real losses in terms of productivity and participation in normal society. For alcohol, most of the cost was for treatment and estimated damage to personal health. For drugs, most of the cost was for law enforcement and losses sustained by crime victims. Let me just review the drug-abuse numbers. The figures for direct costs are surely much higher today.