How To Save $1 Billion And 800 Lives In Canada

Main Category: Alcohol / Addiction / Illegal Drugs
Also Included In: Public Health
Article Date: 13 Jun 2008 - 0:00 PDT

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The economic burden of alcohol abuse costs each Canadian $463 per year. In fact, the direct health care costs for alcohol abuse in Canada exceed those of cancer. Released by the Centre for Addiction and Mental Health (CAMH), the Avoidable Cost of Alcohol Abuse in Canada 2002 report estimates that, even under very conservative assumptions, implementing six reviewed interventions would result in cost savings of about $1 billion per year and a savings of about 800 lives, close to 26,000 years of life lost to premature death and more than 88,000 acute care hospital days in Canada per year. This pioneering study is Canada's first systematic estimate of the avoidable costs of alcohol abuse, and the first study of its kind worldwide.

To calculate the avoidable burden and avoidable costs of alcohol abuse in Canada for 2002, CAMH Senior Scientist Dr. Jurgen Rehm and his team estimated the potential economic impact of increasing alcohol taxation, lowering the blood alcohol concentration (BAC) legal limit from 0.08 per cent to 0.05 percent, zero tolerance BAC for all drivers under age 21, increasing the legal minimum drinking age from 19 to 21 years of age, a Safer Bars intervention, and brief interventions (routine screening with concise advice for problematic alcohol users by primary care physicians or other health professionals).

The data revealed that:

• Implementing all six interventions would decrease productivity losses by more than $561 million or 58 per cent of the total avoidable cost due to alcohol, decrease health care costs (saving almost $230 million or 24 per cent), and lower criminality costs by almost $178 million or 18 per cent.
  
  
• The most effective intervention to reduce avoidable costs in health care, criminality and productivity losses was the brief interventions (saving almost $602 million per year, 62 per cent of total savings), followed by increasing alcohol taxes (saving more than $211 million per year, 22 per cent of total savings).
  
  
• The most effective intervention for preventing drinking and driving incidents in Canada was lowering the BAC level, which would result in a 19 per cent reduction.
  
  
• The Safer Bars program was the most effective measure to avoid homicide and other violent crimes (more than 3 per cent reductions were estimated).
  
  
• Brief interventions were the most effective measure to avoid other alcohol-attributable criminal activities (e.g., property crime), resulting in an almost 3 per cent reduction in these types of crimes.

"It's clear that the largest impact would come from interventions affecting the level of drinking in general such as brief interventions and increasing alcohol taxation," says Dr. Rehm. "However, the greatest overall cost avoidance would be achieved when multiple rather than single effective and cost-effective alcohol interventions are implemented as part of a comprehensive alcohol policy."

The scientists also estimated the potential impact of privatizing alcohol sales in those provinces that sell alcohol through a government monopoly. The analysis showed that substantial increases in direct and indirect costs would occur if Canadian provinces were to privatize alcohol sales. Productivity losses would increase by more than $468 million (7 per cent), health care costs would increase by more than $258 million (8 per cent), and costs related to criminality would increase by about $102 million (3 per cent).

While studies that investigate the cost of illness are a valuable indicator of the overall economic burden due to substance abuse in Canada, they do not offer potential solutions to reduce the burden. As Dr. Rehm explains, "this study shows the benefits potentially available to the community as a whole by directing public resources to specific policies, strategies and programs. It also helps identify information gaps, target problems, and identify potential solutions."

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The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital, as well as one of the world's leading research centres in the area of addiction and mental health. CAMH combines clinical care, research, education, policy development and health promotion to transform the lives of people affected by mental health and addiction issues.

CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre.

Source: Michael Torres
Centre for Addiction and Mental Health

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