Social costs of untreated opioid dependence

Abstract

Using cost-of-illness methodology applied to a comprehensive survey of 114 daily opiate users not currently in or seeking treatment for their addiction, we estimated the 1996 social costs of untreated opioid dependence in Toronto (Ontario, Canada). The survey collected data on social and demographic characteristics, drug use history, physical and mental health status, the use of health care and substance treatment services, drug use modality and sex-related risks of infectious diseases, sources of income, as well as criminality and involvement with the law enforcement system. The annual social cost generated by this sample, calculated at Canadian $5.086 million, is explained mostly by crime victimization (44.6%) and law enforcement (42.4%), followed by productivity losses (7.0%) and the utilization of health care (6.1%). Applying the $13,100 cost to the estimated 8,000 to 13,000 users and 2.456 million residents living in Toronto yields a range of social cost between $43 and $69 per capita. KEY WORDSCost of illness, Illicit drugs, Opioid dependence.

Displacement of Canada's largest public illicit drug market in response to a police crackdown

“…1,2003, and 400 382 were distributed in the 3 months after this date (t test of monthly averages: p = 0.516). As Fig.…”

“…n Canada and elsewhere, policy-makers have primarily relied on law enforcement to curb the social, 1 community 2 and health-related harms of illicit drug use. 3,4 However, this approach has been criticized because of the lack of evaluation of interventions and the growing evidence that it may be harmful when applied in isolation.…”

Nonfatal Overdose Among a Cohort of Street-Involved Youth

“…The high cost of medical intervention and emergency room visits for non-fatal overdoses is well documented [9]. Considering these costs, our findings that 52% of reported overdoses involved assistance by ambulance paramedics and that 50% resulted in the participant being taken to hospital suggest that evidence-based health and preventive interventions that reduce the high rate of overdose among this population such as take-home naloxone [10] will, if successful in reducing the incidence of overdose among street-involved youth, likely have costbenefits as well.…”

Illicit Opioid Use in Canada: Comparing Social, Health, and Drug Use Characteristics of Untreated Users in Five Cities (OPICAN Study)

“…19 International research evidence suggests a substantive societal, morbidity, and mortality burden associated with illicit opioid use and specifically among those users outside treatment. 20,21 However, this evidence also points to an increasingly diversified and heterogeneous picture of illicit opioid use populations, with implications for both intervention needs and prospects. Specifically, illicit opioid users are at risk for drug overdose death.…”

“…35,36 A recent cost-of-illness analysis of a local sample of illicit opioid users in Toronto found a social cost burden of $45,000 per untreated user/year. 20 In Canada and globally, methadone maintenance treatment (MMT) is currently the main treatment response for opioid dependence. 21,37 MMT has been shown to improve physical and mental health status, to reduce illicit drug use, infectious disease risks, and crime involvement among those retained in treatment.…”