International Guidelines for the Estimation of the Avoidable Costs of Substance Abuse

1^st edition - November 2006

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Table of contents

Preface

Acknowledgments

1. Introduction

2 Social costs

3 Avoidable costs: the Feasible Minimum

4 Special considerations in developing countries

5 Time lags associated with policies to reduce substance abuse

6 The reliability and usefulness of avoidable cost estimates

7 Policy implications of avoidable cost estimates

8 Conclusion

References

Appendix A - World Health Organisation information on drug-attributable fractions

Appendix B - Conditions attributable to substance abuse, classified by substance (source: Ridolfo and Stevenson, 2001)

Appendix C - Estimating the social costs of drug-attributable crime

Appendix D - Evidence on the effectiveness of interventions to reduce drug- attributable crime

Appendix E - Evidence on the prevention of substance use risk and harm

Appendix F - Implications of unrecorded alcohol production and consumption for the estimation of the aggregate and avoidable social costs of alcohol

Appendix G - Estimating the present value of social benefits resulting from future reductions in substance abuse

Appendix H - Issues relating to the estimation of aggregate and avoidable costs of substance abuse in Central and Southern America

List of tables

Table 1 - Substance abuse cost estimates and their policy uses

Table 2 - Social costs associated with substance abuse

Table 3 - Drug-attributable diseases for which the WHO has estimated attributable fractions

Table 4 - Resulting prevalence of tobacco smoking in per cent after a -10 per cent shift in exposure distribution in Canada 2003, by gender

Table 5 - Impact of exposure shift of -10 per cent in exposure to tobacco smoking on disease-specific, tobacco-attributable mortality in Canada, 2002 (number of deaths)

Table 6 - Estimates of potentially preventable mortality in Australia

Table 7 - Adult smoking prevalence, WHO sub-region AMR-D

Table 8 - Avoidable proportions of smoking burdens, WHO sub-region AMR-D

Table 9 - Estimated numbers of lives lost and saved due to low risk and risky/high risk drinking when compared to abstinence, Australia, 1998

Table 10 - The 14 epidemiological sub-regions

Table 11 - Sample of the epidemiological information presented in Ezzati et al (2004)

Table 12 - Crime-attributable fractions (prisoners), by category of crime, Australia, 2001

Table 13 - Crime-attributable fractions (police detainees) by category of crime, Australia, 2001

Table 14 - Summary: The effectiveness of childhood interventions

Table 15 - Summary: The effectiveness of interventions for young people

Table 16 - Summary of broad-based strategies

Table 17 - Summary: The effectiveness of demand reduction interventions

Table 18 - Summary: The effectiveness of law enforcement interventions for licit drugs

Table 19 - Summary: The effectiveness of law enforcement interventions for illicit drugs

Table 20 - Summary: The effectiveness of judicial procedures for the reduction of drug-attributable crime

Table 21 - Summary: The effectiveness of tobacco and alcohol harm reduction

Table 22 - Summary: The effectiveness of illicit drug harm reduction interventions

Table 23 - Relevance of avoidable costs to the health and welfare system in Central and South American countries

Table 24 - Attributed relevance of alcohol and drugs to the commission of specific crimes/offences in Central and South American countries

Table 25 - Relevance of illicit drugs to the judiciary system in Central and South American countries