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The Economic Impact of Addiction<br />Lisa M. Lines, MPH<br />University of Massachusetts Medical School<br />March 2011<b...
Definitions<br />The economic impact of addiction is the cost associated with substance abuse and addiction as expressed i...
Which costs?<br />The broadest estimates include all the costs associated with the following:<br />Direct<br />Medical car...
Approaches to Calculating Cost of Illness<br />Bottom-up<br />Excess risks * costs associated with each consequence * prev...
Caveats<br />Difficult to determine whether costs incurred by an individual substance user are related to addiction per se...
Estimates of the Economic Impact of Addiction<br />Note: total does not account for overlap between addictions<br />
Direct and Indirect Costs of Alcohol, Tobacco, and Other Drugs by Category, 1999<br />Source: Miller 2008<br />
Total Cost of Illness in Context<br />Source: RTI 2006<br />
Actual Causes of Death, 2000<br />Source: Mokdad 2006<br />
Total Direct Costs of Drug Abuse, 1992-2002<br />Source: ONDCP  2004<br />
Source: ONDCP  2010<br />Per Capita Costs of Drug Abuse by State, 2002<br />
Source: ONDCP  2010<br />Price and Purity of Cocaine, 1981-2001<br />
Source: ONDCP  2010<br />Price and Purity of Heroin, 1981-2007<br />
Sources<br />Grinols EL, Mustard DB. Business Profitability versus Social Profitability: Evaluating Industries with Extern...
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Economic impact of addiction

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Economic impact of addiction

  1. 1. The Economic Impact of Addiction<br />Lisa M. Lines, MPH<br />University of Massachusetts Medical School<br />March 2011<br />
  2. 2. Definitions<br />The economic impact of addiction is the cost associated with substance abuse and addiction as expressed in dollars<br />Dollars spent (aka direct or resource costs)<br />Dollars not earned (aka indirect or productivity costs)<br />Which addictions?<br />Alcohol<br />Tobacco<br />Illicit drugs & nonmedical use of pharmaceutical drugs<br />Gambling<br />
  3. 3. Which costs?<br />The broadest estimates include all the costs associated with the following:<br />Direct<br />Medical care: treatment for addiction & treatment for the health consequences of addiction (eg, cirrhosis of the liver)<br />Criminal justice: enforcement of laws, consequences of property crimes, costs of incarceration<br />Social services (eg, foster care for children of methamphetamine addicts)<br />The substances or behaviors themselves<br />Indirect<br />Excess substance abuse-related deaths (lost earnings for addicts who die prematurely)<br />Absenteeism and lost productivity (both for substance abusers and their families)<br />
  4. 4. Approaches to Calculating Cost of Illness<br />Bottom-up<br />Excess risks * costs associated with each consequence * prevalence<br />Top-down<br />Total amount spent in each category * percentage attributable to people with addictions<br />Econometric <br />Compare two matched cohorts, one with and one without condition – excess costs are attributed to condition<br />
  5. 5. Caveats<br />Difficult to determine whether costs incurred by an individual substance user are related to addiction per se<br />For example, not everyone who has an alcohol-related car accident is necessarily addicted to or dependent on alcohol in a physical sense<br />Many people have multiple addictions<br />Somewhat misleading to simply sum up the costs associated with each addiction and call that the total economic impact of addiction; in reality, the total is likely to be less than the sum of its parts<br />Difficult to determine causal relationships between addiction and some of the costs associated with addiction<br />Do criminals gamble, or do gamblers become criminals? Or is there a separate causal factor that results in both gambling and crime?<br />
  6. 6. Estimates of the Economic Impact of Addiction<br />Note: total does not account for overlap between addictions<br />
  7. 7. Direct and Indirect Costs of Alcohol, Tobacco, and Other Drugs by Category, 1999<br />Source: Miller 2008<br />
  8. 8. Total Cost of Illness in Context<br />Source: RTI 2006<br />
  9. 9. Actual Causes of Death, 2000<br />Source: Mokdad 2006<br />
  10. 10. Total Direct Costs of Drug Abuse, 1992-2002<br />Source: ONDCP 2004<br />
  11. 11. Source: ONDCP 2010<br />Per Capita Costs of Drug Abuse by State, 2002<br />
  12. 12. Source: ONDCP 2010<br />Price and Purity of Cocaine, 1981-2001<br />
  13. 13. Source: ONDCP 2010<br />Price and Purity of Heroin, 1981-2007<br />
  14. 14. Sources<br />Grinols EL, Mustard DB. Business Profitability versus Social Profitability: Evaluating Industries with Externalities, the Case of Casinos. Managerial and Decision Economics. 2001:22(1-3);143-162.<br />Miller TR, Hendrie D. Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis, DHHS Pub. No. (SMA) 07-4298. Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, 2008. Available at: http://store.samhsa.gov/shin/content//SMA07-4298/SMA07-4298.pdf<br />Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004 Mar 10;291(10):1238-45.<br />National Gambling Impact Study Commission. Final Report to Congress. 1999. Available at: http://govinfo.library.unt.edu/ngisc/reports/fullrpt.html<br />Office of National Drug Control Policy. The Economic Costs of Drug Abuse in the United States, 1992-2002. 2004. Washington, DC: Executive Office of the President (Publication No. 207303). Available at: http://www.ncjrs.gov/ondcppubs/publications/pdf/economic_costs.pdf.<br />Office of National Drug Control Policy. The National Drug Control Strategy: Data Supplement. 2010. Available at: http://www.whitehousedrugpolicy.gov/publications/policy/ndcs10/ndcs10_data_supl/index.html<br />RTI International. Cost of Illness Summaries for Selected Conditions. 2006. Available at http://www.rti.org/page.cfm?objectid=CA1E1F48-8B6C-4F07-849D6A4C12CBF3C3<br />

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