National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
South Australian Centre for Economic Studies, University of Adelaide, Adelaide, SA, Australia.
Int J Drug Policy. 2018 Dec;62:30-36. doi: 10.1016/j.drugpo.2018.08.015. Epub 2018 Oct 21.
Globally, there are increasing concerns about the harms associated with methamphetamine use. This paper i) reports on the results of a cost-of-illness (CoI) study that quantified the social costs associated with methamphetamine use in Australia and, ii) drawing on examples from this study, critically examines the general applicability of CoI studies for the alcohol and other drug field. A prevalence approach was used to estimate costs in 2013/2014, the most recent year for which reasonably comprehensive data were available. The value selected for a statistical life-year in our central estimate was AUD 281,798. Other costs were estimated from diverse sources. Total cost was estimated at AUD 5023.8 million in 2013/14 (range, AUD 2502.3 to AUD 7016.8 million). The greatest cost areas were crime including costs related to policing, courts, corrections and victims of crime (AUD 3244.5 million); followed by premature death (AUD 781.8 million); and, workplace costs (AUD 289.4 million). The social costs of methamphetamine use in Australia in 2013/14 are high, and the identification of crime and premature mortality as the largest cost areas is similar to USA findings and represents important areas for prevention and cost remediation. However, caution is required in interpreting the findings of any CoI study, as there is uncertainty associated with estimates owing to data limitations. Moreover, CoI estimates on their own do not identify which, if any, of the costs are avoidable (with drug substitution being a particular problem) nor do they shed light on the effectiveness of any potential interventions. We also recognise that data limitations prevent some costs from being estimated at all.
全球范围内,人们对与甲基苯丙胺使用相关的危害日益关注。本文:i)报告了一项疾病成本(CoI)研究的结果,该研究量化了澳大利亚与甲基苯丙胺使用相关的社会成本;ii)通过该研究的实例,批判性地审查了 CoI 研究在酒精和其他药物领域的普遍适用性。采用流行率方法估算 2013/2014 年的成本,这是有合理全面数据可用的最近一年。我们的中心估计中选择的统计生命年的价值为 281798 澳元。其他成本来自不同来源估算。2013/14 年总成本估计为 5023800 万澳元(范围为 2502300 万至 7016800 万澳元)。最大的成本领域是犯罪,包括与警察、法院、惩教和犯罪受害者相关的成本(3244500 万澳元);其次是过早死亡(781800 万澳元);以及工作场所成本(289400 万澳元)。2013/14 年澳大利亚甲基苯丙胺使用的社会成本很高,犯罪和过早死亡被确定为最大的成本领域,这与美国的发现相似,代表了预防和成本补救的重要领域。然而,在解释任何 CoI 研究的结果时需要谨慎,因为由于数据限制,估计存在不确定性。此外,CoI 估计本身并不能确定哪些成本是可以避免的(药物替代是一个特别的问题),也不能说明任何潜在干预措施的效果。我们还认识到,数据限制使一些成本根本无法估算。