1. Meeting of Caribbean National Drug Observatories CICAD Programme to Estimate the Human Social and Economic Cost of Drugs in the Americas (Cost Programme) Pernell Clarke Coordinator of Information and Research for the Caribbean OID/CICAD Barbados, June 14 – 16, 2005

2. Summary of Presentation  Introduction  Background of Programme  The Methodology: A Synopsis  Current Status of Programme  The Future of the Cost Project in the Caribbean  Discussion

3. Introduction  Drug use and abuse has several consequences:  Primary Behavior, Family, Productivity, Health  Secondary Specialised treatment, Health care costs (accidents or violence), Prevention, Supply reduction  If we convert all of these consequences to dollars and cents, and we add them all together, what would the price tag be?

4. Usefulness of Cost Studies (1)  Helps to enunciate the real magnitude of the problem in a language that most of us (but especially policy makers!) understand  Provides several ways to present estimates of the costs of substance abuse  Good for controlling resources  Good for controlling programmes

5. Usefulness of Cost Studies (2)  Helps to justify the priority that is given (or not given) to this social problem  Identify priorities with greater precision  Facilitates evaluation and ensures greater cost- effectiveness  Assists in the detection of gaps in statistical information Promotes research to fill these gaps Leads to a better understanding of problem Leads to better solutions

6. Background of CICAD Cost Programme  In 1999, CICAD implemented the first round of the MEM  One of the Indicators of the MEM was the existence of a system to measure the economic costs of drugs  Most countries (except for Canada and USA), could provide any info.  Hence the CICAD Cost Programme

7. The Methodology  Based on the International Guidelines  Estimates Direct Costs  Estimates Indirect Costs  Focuses on 4 principal areas  Utilizes a system of 17 Indicators, divided into 2 levels of complexity.

8. Four (4) Major Areas  Costs to the health system,  Costs due to loss of productivity,  Costs to the police, legal and judicial systems,  Other costs: morbidity and mortality due to accidents, crime and drug consumption, and other indirect costs.

9. Level 1 indicators 1.Number of requests for treatment at public and private institutions. 2.Number of drug-related deaths or serious injuries due to homicides, accidents, or suicides. 3.Number of convictions and length of sentence for drug trafficking. 4.Substance use studies in the general population, among students, or in the workplace. 5.Determination of the validity of data supplied by countries on the standard form created by Jeffrey Merrill

10. Level 1 Indicators 6.Number of substance-use induced hospital admissions and length of stay. 7.Number of persons undergoing treatment, type of treatment, and length of treatment. 8.Destruction of Physical Assets 9.Economic costs of premature deaths in terms of productivity

11. Level 2 Indicators 10.Number of Arrests for possession and consumption 11.Number of prisoners for committing misdemeanors and felonies associated with consumption (as a cause or a consequence). 12.Follow-up of Treatment (Cost-effectiveness) 13.Economic costs of Absenteeism. 14.Methodology to determine labor productivity loss.

12. Level 2 Indicators 15.Economic loss due to morbidity. 16.Social impact of property (tangible and intangible) loss. 17.Opportunity cost due to substance use.

13. Current Status of Project  Several studies and data collection exercises completed in Barbados, Chile, Costa Rica, El Salvador, Mexico, Uruguay http://www.cicadcostos.org/ http://www.cicadcostos.org/  Data management web page created and is currently being updated. http://www.cicadcostos.org/http://www.cicadcostos.org/  Manual documenting the methodology has been prepared  Peer review of the Cost Programme was carried out by the CICAD Scientific Advisory Committee

14. Current Status of Project cont’d  Updating the website with data from the countries  Completing current studies in participating countries  Preparing individual economic reports for countries  Preparing a comparative analysis of the 6 countries to the extent that this is possible  Preparing an analysis of lessons learned and policy implications of final results

15. Future Activities  Manual to be finalised  Pilot project will come to an end officially in November  A plan to expand the Cost Programme to the rest of the countries in the hemisphere will be developed  If approved, project will be expanded in 2006

16. To Recap…. 1.Finalise the Manual 2.Complete Studies 3.Prepare Country Reports 4.Prepare Comparative Analysis 5.Evaluate Pilot 6.Prepare Expansion Plan

17. The End Thank you for your attention! For more info visit: http://www.cicad.oas.org/oid/MainPage/Costs/ http://www.cicad.oas.org/oid/MainPage/Costs/ Pernell Clarke 2005/05/25