International Guidelines for Estimating the Costs Of Substance Abuse: (2 Ed)

Report prepared for the Canadian Centre for Substance Abuse by Eric Single (coordinator–Canada), David Collins (Australia), Brian Easton (New Zealand), Henrick Harwood (United States), Helen Lapsley (Australia), Pierre Kopp (France) and Ernesto Wilson (Colombia).

This report was published by the World Health Organisation in September 2003.

Keywords: Health Economics

This revised edition of these guidelines represent modifications and additions to the first edition of the International Guidelines on Estimating the Social and Economic Costs of Substance Abuse, based on discussions held at the Third International Symposium on Estimating the Economic and Social Costs of Substance Abuse, held in Banff, Alberta, Canada, in 2000.

Executive Summary

The use of alcohol, tobacco, pharmaceuticals and illicit drugs involves a wide variety of adverse health and social consequences. There is a strong need for improved estimates of the economic costs of substance abuse. Cost estimates help to prioritize substance abuse issues, provide useful information for targeting programming, and identify information gaps. The development of improved cost estimates also offers the potential to develop more complete cost-benefit analyses of policies and programmes aimed at reducing the harm associated with the use of psychoactive substances.

This document presents a general framework for the development of cost estimates. Studies of the economic costs of substance abuse are described as a type of cost-of-illness study in which the impact of substance abuse on the material welfare of a society is estimated by examining the social costs of treatment, prevention, research, law enforcement and lost productivity plus some measure of the quality of life years lost, relative to a counterfactual scenario in which there is no substance abuse. A matrix of the types of costs to be considered is presented, and there is a detailed discussion of the theoretical issues involved, including: the definition of abuse, determination of causality, comparison of the demographic and human capital approaches to cost estimation, the treatment and measurement of addictive consumption, the treatment of private costs, the measurement of intangible costs, the treatment of non-workforce mortality and morbidity, the treatment of research, education, law enforcement costs, the estimation of avoidable costs and budgetary impact of substance abuse.

Special considerations are discussed with regard to developing economies and drug-producing countries. The guidelines conclude with a brief discussion of future directions, with particular attention to the expansion of economic cost studies to developing countries, and the implications of these guidelines to research agendas and data collection systems.


The full guidelines are available at International Guidelines for Estimating the Costs of Substance Abuse: Second Edition, 2001