Substance use cost Canada more than $38 billion in 2014, and legal drugs like alcohol and tobacco contribute the most by far, according to a new report.
The report, by the Canadian Centre on Substance Use and Addiction and the Canadian Institute for Substance Use Research, attempted to quantify the costs to health care, the criminal justice system and lost productivity due to substance use in Canada, by putting together survey and demographic data.
Alcohol and tobacco together accounted for 70 per cent of the estimated costs in 2014, according to the study. Opioids came in a distant third, with only about 10 per cent of the total costs, though study co-author Tim Stockwell, of the Canadian Institute for Substance Use Research, said that the opioid crisis was not in full swing by that point, the most recent year for which they had data.
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He’s not surprised that alcohol and tobacco came out on top though, beating out opioids. “That’s always been the case.”
“So many more people use alcohol and tobacco still, particularly alcohol, so there is a toll that is affecting more Canadians than those using opioids.”
Although he isn’t always sure about the exact dollar amounts assigned to every drug, Jurgen Rehm, senior director of the Institute for Mental Health Policy Research, said that he agrees with the overall thrust of the report — which he was not involved in writing. Politicians, decision-makers and researchers need these kinds of estimates to develop sound policy, he said.
Alcohol-related crime
Tobacco accounted for higher health care costs, and lost productivity due to premature death, than alcohol. However, alcohol was the clear winner in one category: crime.
According to the researchers, roughly 20 per cent of all violent crime would not have occurred if the perpetrator was not under the influence of or seeking alcohol.
Stockwell suggests that this is a conservative estimate.
“If you talk to police, particularly ones who work late at night, they would say about 70 per cent of their work is alcohol-related, and that flows through to the courts and to the prison costs.”
Alcohol was associated with about $3.2 billion in criminal justice costs. Cocaine was second, with about $1.9 billion. These costs include police work, courts and corrections.
“There is a causal relation between alcohol and criminal activity,” said Rehm. “There is a causal relation between alcohol and violence.”
Governments across Canada, all put together, got roughly $10.5 billion in revenue and taxes from the sale of alcohol in 2013-2014, according to Statistics Canada, still much less than the $14.6 billion that the researchers estimate alcohol cost.
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Higher taxes on alcohol could result in more government profit and less harmful costs, Stockwell thinks.
Rehm agrees. “Alcohol is completely underrated as a cause of death,” he said.
“We, all of us, are paying for alcohol use and tobacco smoking. We are paying for the health care costs. We are paying for the legal costs. Our society is paying way more than we earn from taxes.”
Canada could avoid a lot of cancer and liver cirrhosis by drinking and smoking less, he said.
Stockwell hopes his report draws attention to the “drugs we take for granted” — legal ones like alcohol and tobacco. “I think it’s really important for the public and for our decisionmakers to have a clear sense about the relative harms of all these different substances,” he said.
He would also like people to remember that it’s not just about the economic cost.
“Behind those estimates we’ve got some pretty striking figures for the number of deaths and the number of years of life lost,” he said.
Altogether, the researchers estimate that substance use contributed to 67,515 deaths in Canada in 2014.