The National Center on Addiction and Substance Abuse (CASA) developed a survey of substance abuse-related spending for all 50 States, the District of Columbia and Puerto Rico. Results showed that States spent $81.3 billion on substance abuse and addiction problems in 1998. Substance abuse and addiction overwhelms social service systems, impedes education, and causes illness, injury, death and crime. This $81.3 billion did not include the financial toll such as abuse extracts from Federal or local spending or the hefty private costs such as lost productivity or premature death. The drug linked to the largest percentage of State substance abuse costs was alcohol. For each dollar in alcohol and tobacco taxes that hit State coffers, States spent $7.13 on the problem of alcoholism and drug addiction. The first recommendation to reduce the burden imposed on public programs was investment in prevention and treatment. Treatment is a cost-effective intervention as it both reduces the costs to State programs in the short term and avoids future costs. The second recommendation was expansion of use of State powers of legislation, regulation, and taxation to reduce the impact of substance abuse. States can do this by eliminating mandatory sentences for drug and alcohol abusers, and requiring treatment in state-funded programs such as prison and welfare. The third recommendation was to provide management practices to reduce the impact of substance abuse on their budgets which included comprehensive screening for substance abuse in programs such as welfare; and investing in research and evaluation of cost-effective substance abuse prevention and treatment policies and programs.