Report 3 Issues in estimating the economic cost of drug abuse in consuming nations

Rosalie Liccardo Pacula
Stijn Hoorens
Beau Kilmer
Peter Reuter
Jim Burgdorf
Priscilia Hunt

Abstract
This report considers the current feasibility of constructing an estimate of the global cost of drug use. While national estimates
exist for seven developed countries, most countries have yet to construct a comprehensive estimate. Furthermore, it is
impossible to compare the existing national estimates because of differences in the construction, which may reflect varying
political and social environments that influence the nature of use and its related harms.
This report lays out a conceptual framework for initiating the construction of country-specific estimates in a fashion that
would facilitate cross-national comparisons. It demonstrates the difficulty in trying to implement this framework using
existing data, as current data available in the various countries suffer from inconsistencies in definitions, coverage, and
measurement. For example, in Australia a death caused by a car-accident involving a drugged driver would be included
as a drug-related death; the EMCDDA definition only includes deaths in which drugs were the direct cause. Similarly,
although it is clear what is meant conceptually by an injection drug user, the measurement of the total number of injection
drug users within some countries is based on injection drug use among the treatment population and in other countries it
is based on nationally representative surveys. The pitfalls and assumptions necessary to construct a comparable estimate
using existing data, therefore, are quite significant.
We conclude that it is not possible at this time to develop a meaningful comparative estimate of the cost of drug use across
countries. We believe, however, that steps could be taken to improve the consistency of measurement in many of the indicators
in future years through coordinated international efforts, not unlike that currently being undertaken by the EMCDDA
for the European Community.