Economic evidence in addiction: a review (2004)

Substance abuse accounts for one of the major disease groups in Europe within mental health in terms of prevalence, and has earned undeserved by little attention in health economic research. Tobacco, alcohol and illicit drug use pose a significant threat to the health, social and economic fabric of families, communities and nations. In an initial estimate of factors responsible for the global burden of disease, tobacco contributed to 6% of all deaths world wide, followed by alcohol at 1.5% and illicit drugs at 0.2%. Looking at the percentage of total years of life lost due to these substances, it has been estimated that tobacco accounts for 2.1% of the total years of life lost, alcohol for 6% and illicit drugs for 0.3%. According to the global burden of disease study, morbidity from alcohol and tobacco, measured in years of life lost to disability, have a greater impact on health than poor sanitation or hypertension. The potential savings to individuals, households, businesses and the public sector from effective measures to minimise harm from substance abuse could therefore be large. Resources available to treat people with substance misuse problems have always been scarce. This situation is likely to continue as there are always competing demands from other client groups for health and social care. Ensuring that resources are used to give the greatest benefit is therefore one important aim of any provider of client services. Monitoring the use of resources and their cost is part of this process. A few European studies have been made on substance abuse in the past, which makes an initial review and analysis of the costs of substance abuse in Europe possible. This study aims at reviewing the economic data available on substance abuse in Europe. Furthermore, the study aims at identifying information gaps, research needs and desirable refinements of economic data on substance abuse in Europe. The analysis is based on readily available published cost data and the analysis is performed for the territory of Europe, including all 25 member states in the EU as well as the three EFTA countries: Norway, Iceland and Switzerland. (Extract of the publication)