05 Feb 2009

The real cost of tik

The economic cost of the use of methamphetamine - better know as "tik" - in the United States reached $23.4 billion (over R237 billion) in 2005. This included the burden of addiction, premature death, drug treatment and many other aspects of the drug, according to a new RAND Corporation study.

Although no such detailed statistics exist in South Africa, Grant Jardine, director of the Cape Town Drug Counselling Centre believes that the same is true for South Africa. "The use of methamphetamine is a great financial burden for this country in terms of health costs, absenteeism, accidents and more," says Jardine.

Jardine emphasised that another factor that comes into play in the South African context is the spread of HIV/Aids. "High-risk sexual behaviour is commonly associated with the use of mind-altering drugs." Jardine argues that when costs in terms of HIV-treatment and years of life lost are added, the real cost of the use methamphetamine far exceeds the per person cost estimated for the US.

David Fourie, regional director for the South African National Council on Alcohol and Drug Dependence (SANCA), agrees: "The use of tik has a great social impact – it leads to young people leaving school early, uncontrollable behaviour, crime-related behaviour in order to get money, high risk sexual relations and HIV- infection."

Fourie lists the following as the direct and indirect financial burdens brought on by the use of tik:

Many users abandon formal education early and are economically dependent on others.
Cost of treatment is mostly state-subsidised and amounts to around R10 000 per person for one or two treatments.
Medical treatment for illness, especially psychiatric conditions like depression.
The danger of sexually transmitted infections (STIs), especially HIV infection and all the accompanying medical expenses.
Costs involved in controlling criminal and violent behaviour.
The average cost of tik use is between R50 and R1 000 per person per month. Therefore 450 addicts (which is the figure for the Western Cape) can spend as much as R225 000 per month on the substance. It is estimated that only 10% of addicts receive treatment, therefore this total for the Western Cape can, conservatively spoken, be upped by 90%.

US study first of its kind
The RAND study is the first effort to construct a comprehensive national assessment of the costs of the methamphetamine problem in the United States.

"Our findings show that the economic burden of methamphetamine abuse is substantial," said Nancy Nicosia, the study's lead author and an economist at RAND, a non-profit research organisation.

Although methamphetamine causes some unique harm, the study finds that many of the primary issues that account for the burden of methamphetamine use are similar to those identified in economic assessments of other illicit drugs.

Reinforces the need to invest
Given the uncertainty in estimating the costs of methamphetamine use, researchers created a range of estimates. The lowest estimate for the cost of methamphetamine use in 2005 was $16.2 billion (R164.3 billion), while $48.3 billion (almost R500 billion) was the highest estimate. Researchers' best estimate of the overall economic burden of methamphetamine use is $23.4 billion (R237 billion).

"We commissioned this study to provide decision makers with the best possible estimate of the financial burden that methamphetamine use places on the American public," said Tom Siebel, founder and chairman of the Meth Project. "This is the first comprehensive economic impact study ever to be conducted with the rigour of a traditional cost of illness study, applied specifically to methamphetamine. It provides a conservative estimate of the total cost of meth, and it reinforces the need to invest in serious prevention programs that work."

The RAND analysis found that nearly two-thirds of the economic costs caused by methamphetamine use resulted from the burden of addiction and an estimated 900 premature deaths among users in 2005. The burden of addiction was measured by quantifying the impact of the lower quality of life experienced by those addicted to the drug.

Cost of capture, incarceration
Crime and criminal justice expenses account for the second-largest category of economic costs, according to researchers. These costs include the burden of arresting and incarcerating drug offenders, as well as the costs of additional non-drug crimes caused by methamphetamine use, such as thefts committed to support a drug habit.

Other costs that significantly contribute to the RAND estimate include lost productivity, the expense of removing children from their parents' homes because of methamphetamine use, and spending for drug treatment.

One new category of cost captured in the analysis is the expense associated with the production of methamphetamine. Producing methamphetamine requires toxic chemicals that can result in fire, explosions and other events. The resulting costs include the injuries suffered by emergency personnel and other victims, and efforts to clean up the hazardous waste generated by the production process.

Researchers caution that their estimates are, in some cases, based on an emerging understanding of methamphetamine's role in these problems and should be further refined as understanding of these issues matures. The RAND report also identifies costs that cannot yet be adequately quantified.

"Estimates of the economic costs of illicit drug use can highlight the consequences of illegal drug use on our society, and focus attention on the primary drivers of those costs," Nicosia said. "But more work is needed to identify areas where interventions to reduce these problems could prove most effective." – (EurekAlert!)