If you asked the average person on the street how many people in the United States are addicted to drugs or alcohol, he or she might be able to use anecdotal observations or half-remembered news reports to hazard a reasonable guess. The actual answer, according to the latest installment of the National Survey on Drug Use and Health, is 8 in every 100.2
However, if you asked the same person how many substance abuse charities exist to help those people, or even how many charities of any description there are in the United States, it’s safe to say they wouldn’t have a clue. That’s because, unless their work is being promoted by celebrities like Elton John or Ted Danson,3 substance abuse charities rarely make the headlines.
We’ve trawled data from IRS tax returns to explore how billions of dollars are spent by more than 4,000 substance abuse charities across the country. The results show that, in spite of falling dramatically in the wake of the 2008 economic crisis, addiction nonprofit revenues currently account for $21 out of every $100 spent on the prevention and treatment of substance abuse in the United States. While nonprofits account for 20 percent of the efforts to reduce the effects of substance abuse, the growth of nonprofits in the space has not kept pace with the increasing number of individuals in need of substance abuse treatment.
The graphic above shows how the 739,847 public charities that filed tax returns within 24 months of April 2016 were split by category. Almost one-third belong to Human Services, which includes recreation and sports; housing and shelter; and food, agriculture, and nutrition. About 1 in 5 belongs to Education; roughly 1 in 10 to Arts, Culture, & Humanities; 1 in 20 to Environment, and just under 2 in 100 to Mental Health & Crisis Intervention. This final category includes all substance abuse charities.
There are three categories of substance abuse charities: 47% focus on treatment only; 34.5% tackle dependency, prevention and treatment; and 18.5% are dedicated solely to prevention.
Health, which includes Mental Health & Crisis Intervention (and therefore substance abuse nonprofits), only grew an average of 1.7% per year. Substance abuse charities alone grew just 0.7% – this was in large part due to a significant decrease in the number of organizations filing tax returns between 2010 and 2013. In contrast, the number of people using drugs (mostly marijuana and prescription pills without a prescription) has risen more dramatically in recent years, with about 1 in 10 Americans reporting past month use in 2014, which was more than in any other year from 2002 through 2013.1
The chart above compares the total annual revenues of all Mental Health & Crisis Intervention charities with the total annual revenues of Substance Abuse charities between 2000 and 2013. We’ve chosen 2013 as our most recent year because many charities are up to two years in arrears filing their tax returns, due to when their fiscal years begin, IRS filing extensions, and other factors (see the notes at the end for a full explanation).7
Mental Health & Crisis Intervention charities’ total revenue was $29.8 billion in 2013, which was 1.7% of the $1.74 trillion in total public charity revenue. 21.2% of Mental Health and Crisis Intervention revenue was by Substance Abuse charities, equivalent to $6.3 billion. Preliminary data show the equivalent figure for 2016 is $6.7 billion, which, after adjusting for inflation, is 3% ($200 million) more than in 2013.
Now we have an idea of how many substance abuse charities there are in the whole of the United States and how much revenue they generate, let’s see which parts of the country have the most charities per person and how the finances differ at the state-level.
Most of the people who admit to using illicit substances are marijuana users,1 but Vermont has faced major problems in recent years with harder drugs. Gov. Peter Shumlin said in 2014 that the region was in a “full-blown heroin crisis,”11 which further justifies the need for substance abuse charity funds within the state.
Certain states in the ranking above stand out because they have high rates of substance abuse charities but low rates of public charities in general. For instance, Nevada ranked lowest in the country for public charities per 100,000 residents, but 13th for substance abuse nonprofits.
Unfortunately, this doesn’t mean Nevadan drug users are necessarily better off than those in other parts of the country. The health care consulting firm Advocates for Human Potential calculated the number of psychiatrists, psychologists, counselors, and social workers available to treat every 1,000 people with a substance use disorder in each state. They found that Nevada ranked the very lowest in the nation, at 11 (the average was 32).12 Highest was Vermont, which as we’ve just seen was also top for substance abuse charities per capita in our analysis.
Most substance abuse charities spend the majority of their revenue on the programs and services for which they were awarded tax-exempt status, like treatment, counseling, and public education. The map above shows the annual expenses of the average substance abuse charity in each state.
Substance abuse charities in New York have higher average annual expenses than those in any other state, at $4.3 million per organization. We checked to see if this is because charities of all kinds tend to be larger in New York than in other states; it appears it could be because New York ranked fourth in the country for average annual expenses per public charity. However, there is a difference between the average amount spent by a substance abuse charity in New York versus the average public charity. The average annual expenses of a substance abuse nonprofit in the Empire State are 70% of the average public charity.
This is the case in almost all states: Substance abuse charities tend to have lower revenue than the average charity. South Dakota showed the biggest gap, with the average substance abuse nonprofit’s expenses equaling just 8.4% of the average charity’s expenses.
The ranking for average spending per person in need is very similar to the one for average annual expenses per substance abuse charity. In fact, because they have similar rates of drug abuse, nine states appear in the top 10 for both. The only one that doesn’t is Arizona, which ranked ninth for average spending per organization, but – because it has a significantly higher rate of drug abuse – 17th for spending per person in need.
To more clearly reveal the supply/demand relationship between how much the average substance abuse charity spends per person in need and how many people in need of help there are, we have contrasted the two metrics against each other on the scatter plot below.
However, the states in the lower right quadrant are in the opposite situation, with above average percentages of persons in need and below average charitable spending on them.
Overall, substance abuse charities have consistently increased their total annual revenue over the last 25 years. The distribution of revenue across the three charity types has remained remarkably similar as well. The only change has been a slight and gradual shift toward a higher proportion of revenue coming from charities that focus on all the issues surrounding substance abuse and addiction, as opposed to only prevention or treatment.
According to the same report, in 2016, $14.7 billion will be spent by the U.S. government on substance abuse prevention and treatment. Preliminary 2016 IRS data we have analyzed shows that approximately $6.7 billion in substance abuse charity revenue will be focused on the same cause. In other words, across these two major sources of funds, substance abuse charities are responsible for $21 out of every $100 spent on preventing and treating drug addiction in the United States. The positive impact of these nonprofit organizations in the fight against addiction, therefore, cannot be underestimated.
|If you would like to donate to a substance abuse charity in your state, you can find out which ones come highly recommended by local community members at GreatNonProfits.If you would like to speak to someone who can recommend the best place to receive treatment for your substance dependence, call .|
Sources and Notes
The bulk of the data for this analysis were taken from the IRS’s Exempt Organizations Business Master File and the clearinghouse of data maintained by the National Center for Charitable Statistics.
- Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health
- 8.1% of persons 12 or older had substance abuse or dependence in 2014, according to the National Survey on Drug Use and Health
- Exempt Organizations Business Master File Extract (EO BMF)
- Urban Institute: The Nonprofit Sector in Brief 2015
- Figure includes all substance abuse charities that filed Form 990 within 24 months of April 2016
- Most of the financial data we’ve used come from the IRS’s Exempt Organizations Business Master File. The most recent release at the time of publication is May 2016, but for the majority of our maps and rankings, we’ve chosen to use data from 2013. This is for three main reasons. First, the time of year charities file their tax returns depends on when their fiscal year ends, meaning that two charities could have filed their return for 2014 in two completely different months in 2015. Second, all tax returns are at least one year behind the current year (a 2014 form might not have been submitted until November 2015). Finally, some charities are up to two years behind in filing, because of the above two reasons plus IRS filing extensions, which they request using Form 8886. This form extends the deadline by three months and can be used twice, totaling six months. For all of these reasons combined, we’ve chosen to use IRS financial data from 2013, as it is the most likely to be complete and fully representative of the entire public charity landscape.
- Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) (https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/drug-addiction-treatment-worth-its-cost)
- 2013 National Survey on Drug Use and Health, SAMHSA
- Shoveling Up II: The Impact of Substance Abuse on Federal, State, and Local Budgets
- National Drug Control Budget, 2017
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