fod volksgezondheid, veiligheid van de voedselketen en leefmilieu 8.11.2013 - symposium b inge d...

FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU

8.11.2013 - Symposium

BINGE DRINKING IN BELGIAN MINORS : AN INNOCENT PROBLEM ?

Health policy and the social cost of alcohol use in Belgium

KURT DOMSHead Drugs Unit, FPS Health, Food chain safety and Environment

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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013


Structure

1. Mission Drug Unit

2. Social cost studies

1. International

2. National

3. Public expenditure : one element of social cost

4. General policy implications

5. Health policy implications


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1. Mission Drug Unit

• Stimulating quality improvement and innovation in alcohol and drug treatment

• Supporting development and implementation of integrated and global drug policy

• Promoting Belgian drug policy views internationally


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2. Social cost studies

‘The social cost of alcohol is the cost to society of

everything that happens that would not happen in a

world without alcohol. It does not show how much

could be saved by any particular policy measure, nor

does it show how much could be saved if alcohol

suddenly vanished.’ (ANDERSON & BAUMBERG, 2006)

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Concepts

- Tangible and intangible costs-Tangible: monetary harms -Intangible : non monetary harms (value placed on harms)

- Direct and indirect costs-Direct : immediately linked with harm-Indirect : e.g. productivity losses, …

Ideal : combination, not always possible/available

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International data

Total tangible costs of alcohol use to the

European Union in 2010 amount to € 155,8

billion (REHM, 2012).

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Total tangible social cost of alcohol use, in billion €, EU, 2010

REHM, 2012

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41.4

12.6

21.4

6.3

45.2

11.3

17.6 Crime

Traffic accidents

Health

Treatment and prevention

Mortality

Absenteism

Unemployment



High public health costs : epidemiology

- Several alcohol attributable diseases: neuropsychiatric disorders, cancer, cardiovascular and gastro-intestinal diseases (mainly liver cirrosis) (REHM, 2013)

- 11 million people in EU with alcohol dependence (Belgium : 1,9 % of women and 5,4 % of men) (REHM, 2013)

- Net burden of alcohol consumption in EU was 1 in 7 deaths in men, and 1 in 13 deaths in women (REHM, 2012)

- Alcohol use is fifth most important risk factor for burden of disease in 2010 in 21 regions worldwide (LIM, 2012)

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Belgian data

Total tangible costs of alcohol use in Belgium

amount to € 4,2 billion in 2007 (ANNEMANS, 2013).

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Total tangible social cost of alcohol use, in billion €, by field, Belgium, 2007

ANNEMANS, 2013

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1.1

0.520.64

0.151.08

0.27

0.42

Crime

Traffic accidents

Health

Treatment and prevention

Mortality

Absenteism

Unemployment



Comparisons

1. On the EU level roughly the same as for tobacco

(ANDERSON,2006)

2. Total tangible costs of alcohol use in Belgium amount

to

€ 6 billion in 1999 (DEGREEF & PACOLET, 2003). Difference

due to decline of accidents and absenteeism (ANNEMANS,

2013)

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Quid benefits ? (DEGREEF & PACOLET, 2003)

- Gains through avoided morbidity and mortality : medical costs, productivity, …

- Taxation revenues

net social cost of alcohol use in Belgium in 1999 : € 4,4 billion

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Limitations

- Different methodologies- Data availability- Wide margins of error- Assumptions under discussion : transfers of

unemployment, consumed goods, …- No thorough comparisons with other substances/diseases

Need of internationally validated instrument : review and update of WHO Guidelines on Estimating the Cost of

Substance Abuse (SINGLE, 2003)

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Discussion

- Global analysis

- Social cost studies as starting point of economic contributions to policy making

- Cost-effectiveness studies remain essential

- Ideological debates : solidarity ?

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Further research

- University of Ghent (VANDER LAENEN, ET. AL.) : social cost study of tobacco, alcohol, illicit drugs and psychoactive medication

- Objectives-Definition of social cost-Screening of existing national and international data -Estimation of social cost of substances in Belgium-SWOT analysis of the method used-Formulate general conclusions and policy recommandations

- 11.2013-10.2015

- Belgian Science Policy Office

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3. Public expenditure : one element of social cost

University of Ghent and Vrije Universiteit Brussel (VANDER LAENEN, 2011), ‘Drugs in figures III’

Scope: • Expenses made by public services, no external,

private or social costs• Alcohol, illicit drugs, tobacco and psychoactive

medication• 2008

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Results

Total public expenditure on drug policy in 2008 amounts to € 975 million, of which

- alcohol : € 632 million - illicit drugs : € 273 million- psychoactive medication : € 35 million- tobacco : € 11 million - substances combined : rest

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64.82%

28.00%

3.59%

1.13% 2.46% Alcohol

Illicit drugs

Psychoactive medica-tion

Tobacco

Substances combined

Total expenditure on drug policy, by substance, percentages, 2008, Belgium

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VANDER LAENEN, 2011



1.63%

86.73%

11.64%

Prevention

Treatment

Security

Public expenditure on alcohol policy, by piller, percentages, 2008, Belgium

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VANDER LAENEN, 2011



4. General policy implications

Awareness of social and economic harms of alcohol


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Need of intersectoral approach

Effectiveness and monitoring


General policy initiative

Alcoholplan 2014-2018 by the Interministerial Conference on Drugs

1. Intersectoral approach2. WHO priorities3. Actions and responsabilities4. Monitoring

To be decided on the 9th December 2013


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5. Health policy implications

Jointed priority for awareness building


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Evidence based care innovation

Monitoring


Some health policy initiatives

Monitoring


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Treatment Demand Indicator

Review Minimal Psychiatric Registration


Evidence based care innovation


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‘UP-TO-DATE’ study : GP’s and occupational practitioners

Mental health sector reform, including for minors


Awareness building


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Prevention, early detection and intervention

Agenda setting with involvement of civil society


References- ANDERSON, P. & BAUMBERG, B. (2006), Alcohol in Europe. London : Insitute of Alcohol

Studies- ANNEMANS, L. (2013), The health, social and economic burden of alcohol dependence. A

Brief Update, Brussels.- DEGREEF, T., PACOLET, J. & R. BOUTEN (2003), Sociale kosten-batenanalyse van

alcoholgebruik en –misbruik in België, Leuven: HIVA.- LIM, S. ET. AL. (2012), A comparative risk assessment of burden of disease and injury

attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010 : a systematic analysis of the Global Burden of Disease Study 2010, Lancet, 380, 2224-60.

- REHM, J. ET. AL. (2012), Alcohol consumption, alcohol dependance and attributable burden of disease in Europe : Potential gains from effective interventions for alcohol dependence, Centre for Addiction and Mental Health, Canada.

- REHM, J. ET. AL. (2013), Modeling the impact of alcohol dependence on mortality burden and the effect of available treatment interventions in the European Union, European Neuropsychopharmacology, 23, 89-87.

- SINGLE, E. ET. AL. (2003), International Guidelines for Estimating the Cost of Substance Abuse, 2, WHO.

- VANDER LAENEN, F., DE RUYVER, B., CHRISTIAENS, J. & D. LIEVENS (2011), Drugs in Cijfers III. Onderzoek naar de overheidsuitgaven voor het drugsbeleid in België, Gent: Academia Press.

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Thank you

Contact : [email protected]

Info : www.health.belgium.be/drugs

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fod volksgezondheid, veiligheid van de voedselketen en leefmilieu 8.11.2013 - symposium b inge d...

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