When someone decides they need addiction treatment, one of the first practical questions is usually what it will cost. That’s understandable. Treatment may come with a clear price and families need to know whether they can afford it, but it’s also a strangely late point to start counting.
By then, addiction may already have cost the family years of missed work, borrowed money and nights spent dealing with another crisis. Someone may have reduced their hours to keep an eye on things, taken over the school run or covered rent that hasn’t been paid again. These costs are real, but they’re absorbed gradually and usually by several people, so they don’t always get recognised as the price of addiction.
The same thing happens at a national level. We debate whether treatment is affordable while paying for the consequences of addiction through hospitals, police forces, courts, housing services and workplaces. Because those costs sit in different places, they rarely receive the same scrutiny as the cost of helping somebody recover.
The government’s current Addiction Healthcare Goals put the annual health and wider social cost of illegal drug use in England at approximately £20 billion. Harm from alcohol is estimated to cost more than £27 billion. The two estimates use different methods and shouldn’t simply be combined into one headline figure, but either one is enough to show that doing nothing isn’t free.
These totals include costs that are relatively easy to count, such as healthcare and criminal justice. They also attempt to account for wider losses, including time away from work. What they can’t fully capture is the everyday work done by families: the lift home, the childcare, the money transferred to prevent an eviction and the morning spent calling services instead of going to work.
That matters because treatment is often compared with an imaginary alternative in which no treatment means no spending. In reality, the spending continues. It appears as another hospital visit, another period of sickness absence or another intervention once the situation has become more difficult to manage.
A treatment place has a provider, a start date and an amount attached to it. Somebody has to approve that spending, whether it’s a local authority funding a service or a family considering private residential treatment. It can feel like a new expense because it’s one large amount to find at once, often when the family has only a short time to decide whether to take an available treatment place.
The cost of untreated addiction is spread across different people and services. The NHS may pay for ambulance callouts, A&E visits and hospital care. The police and courts may deal with incidents linked to someone’s drug or alcohol use, while an employer covers repeated absences or lost working hours. Families may pay overdue rent, clear debts, take unpaid time off, provide childcare or travel late at night to bring someone home. Because nobody receives one bill showing all of these costs together, it’s easy to miss how much is already being spent.
This is part of the reason treatment is so easy to challenge. Its cost is visible and concentrated, while the cost of leaving somebody without effective help is spread across several budgets and many months or years. We end up examining the price of the response more closely than the price of the problem.
The argument for spending less on treatment has been tried in practice. The National Audit Office found that reported local authority spending on drug and alcohol services in England fell by 27% in real terms between its peak in 2014–15 and 2021–22. A separate NAO review, using a narrower measure of adult treatment services, put the real-terms reduction at 40% over the same period.
Those percentages aren’t interchangeable, but they describe the same period of decline. The 2021 independent review of drugs reported that public health funding cuts had reduced service capacity, weakened the workforce and made it harder to provide good treatment. This wasn’t money removed from a system that had stopped being needed. It was money removed while addiction continued to create costs elsewhere.
Government investment has since started to rebuild parts of the system, and the number of people receiving help has risen. In 2024–25, 329,646 adults were in contact with drug and alcohol treatment services in England, the highest number since reporting began. That’s welcome, although it also shows how much demand the system has to meet.
There is also a practical problem with the way the money is divided. The organisation that pays for treatment may not be the one that benefits financially. A local authority may fund treatment while some of the later savings appear in NHS, criminal justice or welfare budgets, which can make sensible spending look less valuable when each budget is viewed on its own.
Families face a version of the same problem when they consider private treatment. They see the full price of a residential stay in front of them, while the cost of carrying on is spread between missed work, debts, damaged relationships and the small emergencies they’ve gradually become used to managing. One is a number on paper; the other has become part of life.
Cost still matters, and most families don’t have unlimited options. Publicly funded treatment, help through a GP or support from a local drug and alcohol service may be available, while some people will consider paying for residential treatment. The cheapest option on paper won’t necessarily offer the type or level of support a person needs, but the most expensive option shouldn’t be assumed to be the right one either.
A more honest conversation about affordability would start earlier. It would look at what addiction is already costing, where that money is being spent and who is doing unpaid work to keep daily life moving. It would also recognise that waiting for a situation to become more serious doesn’t protect public money; it often moves the expense into services designed to respond after something has gone wrong.
England will continue to spend billions on addiction whether treatment is funded properly or not. The real decision is how much of that money goes towards helping people recover, and how much continues to be spent managing the consequences when support hasn’t been available or hasn’t been enough.
If you’re considering private residential treatment, call Abbington House to talk through what’s been happening and whether treatment here may be appropriate. If it isn’t, we’ll tell you.
