Abstract

Background: Addiction accounts for one of the main disease groups in Europe, with relevant consequences to both individuals and society. There is therefore an increasing need to evaluate the economic consequences of addiction in order to develop appropriate policies. In this deliverable, we aim at evaluating the social costs of illegal drugs, alcohol and tobacco in the European Union, based on currently available publications.

Methods: A systematic search of relevant databases was conducted. Grey literature and previous systematic reviews were also searched. Studies reporting on social costs of illegal drugs, alcohol and tobacco were included. The methodology and the cost components, as well as cost estimates, were extracted from individual studies. To compare across studies, final costs were transformed to 2014 Euros.

Results: 42 studies reported in 40 papers met the inclusion criteria (8 for illegal drugs, 26 for alcohol and 8 for tobacco). There was a predominance of prevalence estimates and the human capital approach for the estimation of indirect costs. While there was a constant inclusion of direct costs related to treatment of substance use and comorbidities, there was a high variability for the rest of cost components. Intangibles were only included in two alcohol studies. Total costs showed also a great variability between studies for the three substances. Price per capita for the year 2014 ranged from 0.38€ to 78€ for illegal drugs, from 26€ to 1,500€ for alcohol and from 10.55 to 391€ for tobacco. A rough estimate for the total cost of addiction to the EU zone revealed it ranges between 1.2% and 3.9% of the total gross domestic product (GDP).

Conclusions: Addiction imposes a heavy economic burden to Europe. Given the high methodological heterogeneity that exists in the field, and in order to better assess this burden and to effectively develop adequate policies, methodological guidance is urgently needed.