Original Article

Journal of Urban Health

, Volume 77, Issue 4, pp 688-722

Social costs of untreated opioid dependence

  • Ronald WallAffiliated withSocial, Prevention, and Health Policy Research Department, Centre for Addiction and Mental HealthClinical Research Department, Centre for Addiction and Mental HealthHealth Systems Research and Consulting Unit, Centre for Addiction and Mental Health Email author 
  • , Jurgen RehmAffiliated withSocial, Prevention, and Health Policy Research Department, Centre for Addiction and Mental HealthDepartment of Public Health Sciences, University of Applied ScienceDepartment of Public Health Sciences, University of Toronto
  • , Benedikt FischerAffiliated withSocial, Prevention, and Health Policy Research Department, Centre for Addiction and Mental HealthDepartment of Public Health Sciences, University of TorontoDepartment of Criminology, University of Toronto
  • , Bruna Brand'sAffiliated withClinical Research Department, Centre for Addiction and Mental HealthDepartment of Psychiatry, University of Toronto
  • , Louis GliksmanAffiliated withSocial, Prevention, and Health Policy Research Department, Centre for Addiction and Mental HealthDepartment of Social Science, The University of Western Ontario (Brescia College)
  • , Jennifer StewartAffiliated withDepartment of Economics, National University of Ireland
  • , Wendy MedvedAffiliated withSocial, Prevention, and Health Policy Research Department, Centre for Addiction and Mental HealthFamily Healthcare Research Centre, Department of Family Medicine, University of TorontoOntario Cancer Institute, Princess Margaret Hospital
  • , Joan BlakeAffiliated withClinical Research Department, Centre for Addiction and Mental Health

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Using cost-of-illness methodology applied to a comprehensive survey of 114 daily opiate users not currently in or seeking treatment for their addiction, we estimated the 1996 social costs of untreated opioid dependence in Toronto (Ontario, Canada). The survey collected data on social and demographic characteristics, drug use history, physical and mental health status, the use of health care and substance treatment services, drug use modality and sex-related risks of infectious diseases, sources of income, as well as criminality and involvement with the law enforcement system. The annual social cost generated by this sample, calculated at Canadian $5.086 million, is explained mostly by crime victimization (44.6%) and law enforcement (42.4%), followed by productivity losses (7.0%) and the utilization of health care (6.1%). Applying the $13,100 cost to the estimated 8,000 to 13,000 users and 2.456 million residents living in Toronto yields a range of social cost between $43 and $69 per capita.

Key Words

Cost of illness Illicit drugs Opioid dependence