The total economic cost was an estimated $246 billion in 1992. Alcohol abuse and alcoholism cost an estimated $148 billion, while drug abuse and drug dependence cost an estimated $98 billion. The alcohol estimates for 1992 were similar to cost estimates produced over the past 20 years when adjusted for inflation and population. In contrast, the drug estimates demonstrated a steady and strong pattern of increase. More than $28 billion of the costs resulted from health care expenditures, which consisted of alcohol and drug abuse services and the costs of medical consequences of alcohol and drug abuse. The more than $176 billion costs in productivity effects resulted from premature death, impaired productivity, institutionalized populations, incarceration, crime careers, and victims of alcohol-related crime and drug-related crime. Other effects on society included crime, social welfare administration, motor vehicle crashes, and fire destruction and cost more than $40 billion. Government, private insurance, and victims bore most of the economic burden of alcohol and drug problems. Alcohol abusers and their households bore $66.8 billion of the alcohol-related costs; drug abusers and their households bore $42.9 billion of the drug-related costs. The economic effects of alcohol and drug abuse have increased an estimated 12.5 percent between 1992 and 1995 due to inflation and growth in the population. Tables, figures, footnotes, appended health disorder codes and additional tables, and approximately 200 references