Estimation of the impacts of substance use on workplace productivity: a hybrid human capital and prevalence-based approach applied to Canada



Policy makers require evidence-based estimates of the economic costs of substance use-attributable lost productivity to set strategies aimed at reducing substance use-related harms. Building on a study by Rehm et al. (2006), we provide estimates of workplace costs using updated methods and data sources.


We estimated substance use-attributable productivity losses due to premature mortality, long-term disability, and presenteeism/absenteeism in Canada between 2007 and 2014. Lost productivity was estimated using a hybrid prevalence and incidence approach. Substance use prevalence data were drawn from three national self-report surveys. Premature mortality data were from the Canadian Vital Statistics Death Database, and long-term disability and workplace interference data were from the Canadian Community Health Survey.


In 2014, the total cost of lost productivity due to substance use was $15.7 billion, or approximately $440 per Canadian, an increase of 8% from 2007. Substances responsible for the greatest economic costs were alcohol (38% of per capita costs), tobacco (37%), opioids (12%), other central nervous system (CNS) depressants (4%), other CNS stimulants (3%), cannabis (2%), cocaine (2%), and finally other psychoactive substances (2%).


In 2014, alcohol and tobacco represent three quarters of substance use-related lost productivity costs in Canada, followed by opioids. These costs provide a valuable baseline that can be used to assess the impact of future substance use policy, practice, and other interventions, especially important given Canada’s opioid crisis and recent cannabis legalization.



Les décideurs ont besoin d’estimations factuelles des coûts économiques de la perte de productivité attribuable à l’usage de substances pour pouvoir mettre en place des stratégies de réduction des méfaits. Partant d’une étude faite par Rehm et coll. (2006), nous avons estimé les coûts en milieu de travail à l’aide de méthodes et de sources de données à jour.


Nous avons estimé la perte de productivité (mortalité prématurée, invalidité de longue durée et présentéisme/absentéisme) attribuable à l’usage de substances au Canada, de 2007 à 2014. Les estimations des coûts liés à la perte de productivité ont été faites au moyen d’une méthode hybride de prévalence et d’incidence. Les données sur la prévalence de l’usage de substances ont été tirées de trois enquêtes nationales d’autodéclaration. Les données sur la mortalité prématurée ont été obtenues de la Base de données canadienne sur les décès (statistiques de l’état civil), et les données sur l’invalidité de longue durée et l’interférence professionnelle, elles, de l’Enquête sur la santé dans les collectivités canadiennes.


En 2014, les coûts de perte de productivité attribuable à l’usage de substances totalisaient 15,7 milliards de dollars (environ 440 $ par Canadien), soit une hausse de 8 % par rapport à 2007. Les substances responsables de ces coûts étaient l’alcool (38 % des coûts par personne), le tabac (37 %), les opioïdes (12 %), les autres dépresseurs du système nerveux central (SNC) (4 %), les autres stimulants du SNC (3 %), le cannabis (2 %), la cocaïne (2 %) et les autres substances psychoactives (2 %).


En 2014, l’alcool et le tabac représentaient les trois quarts des coûts de perte de productivité liée à l’usage de substances au Canada, suivis des opioïdes. Ces coûts fournissent un point de référence utile pour évaluer les retombées des politiques, pratiques et autres interventions qui seront mises en place, compte tenu de la crise des opioïdes qui sévit et de la récente légalisation du cannabis au Canada.

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  1. 1.

    While reduced effectiveness at work is clearly a reduction in labour productivity, and increased LTD can be seen as reduced labour productivity of the working age population as a whole, premature mortality warrants further distinction. While it has the same effect on total output as increased LTD in the sense that output drops because of a reduction in aggregate labour input, it may not be precise to label the effects as “lost productivity.” However, for simplicity, we will refer to the lost output arising from removal from the workforce due to premature mortality as “lost productivity” throughout this paper.


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The authors would like to thank Alan Diener, PhD, Public Health Agency of Canada, for technical support and review of methods; and Amanda Farrell-Low, Canadian Institute for Substance Use Research, for providing valuable feedback on drafts of this study.

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Correspondence to Justin T. Sorge.

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This study was approved by the Research Ethics Board of the University of Victoria (17-068).

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Sorge, J.T., Young, M., Maloney-Hall, B. et al. Estimation of the impacts of substance use on workplace productivity: a hybrid human capital and prevalence-based approach applied to Canada. Can J Public Health 111, 202–211 (2020).

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  • Lost productivity
  • Substance use
  • Cost of illness
  • Harms
  • Burden of disease


  • Perte de productivité
  • Usage de substances
  • Coût de la maladie
  • Méfaits
  • Charge de morbidité