ECONOMIC COST OF DRUG USE AND ABUSE

描述（由申请人提供）： 自从对美国滥用毒品的成本进行全面估计以来，已经有七年了。最后一次综合估计采用了传统的疾病成本（COI）方法，使用了1992年和1993年的数据（Harwood等人，1998年）。非常需要更新估计数，以便能够将药物治疗和预防干预措施的效益与稀缺公共资金的其他用途的效益进行适当比较。还需要改进先前的COI方法，使其不仅考虑问题的总体规模，而且考虑不同药物和不同社会成员之间的成本分配。 我们建议使用传统的经济学方法来估计美国药物滥用的总经济成本，该方法将使用者承担的药物使用的内部成本与这种使用强加给非使用者的外部成本区分开来（Keeler等人，1989; Manning等人，1991年）。作为这一替代框架的一部分，我们将统一采用生命周期方法来计算以下费用：（a）戒毒治疗;（B）与毒品有关的健康状况，包括艾滋病毒/艾滋病、B肝炎和丙型肝炎以及精神疾病;（c）与生产力有关的损失;（d）与毒品有关的犯罪;以及（e）吸毒/滥用毒品的无形费用。在可能的情况下，我们将使用同样一致的方法学原则，对四种特定的滥用药物（可卡因、海洛因、甲基苯丙胺和大麻）以及任何药物使用情况进行估计，以便能够根据每种药物对疾病总负担的相对贡献，容易地对每种药物的内部和外部负担进行比较和评估。最后，除了提供药物使用总成本的一般估计外，本研究还将提供与不同使用阶段相关的经济成本的初步估计。使用模拟建模，我们将估计开始使用的预期成本，逐步使用（从实验到定期使用），并成为依赖于非法物质。与这些特定阶段的药物使用相关的成本估计将是非常宝贵的研究人员和政策分析家有兴趣评估的成本效益和成本效益的替代药物预防或治疗方案针对替代阶段的药物使用。

DESCRIPTION (provided by applicant): It has been seven years since a comprehensive estimate of the cost of drug abuse for the United States has been constructed. The last comprehensive estimate employed the traditional cost- of-illness, or COI, approach, using data from 1992 and 1993 (Harwood et al., 1998). There is a tremendous need for an updated estimate so that the benefits of drug treatment and prevention interventions can be properly compared to the benefits of alternative uses of the scarce public dollars. There is also a need to improve upon prior COI methodology so that it considers not just the total magnitude of the problem, but the distribution of costs across different drugs and across different members of society. We propose to estimate the total economic cost of drug abuse in the United States using a traditional economics approach that distinguishes the internal costs of drug use borne by the user from the external costs this use imposes on non-users (Keeler et al., 1989; Manning et al., 1991). As part of this alternative framework, we will uniformly adopt a life-cycle approach for calculating the costs of (a) drug treatment, (b) drug-attributable health conditions, including HIV/AIDS, Hepatitis B and C, and mental illness; (c) productivity-related losses, (d) drug-attributable crime, and (e) the intangible costs of drug use/abuse. We will generate, where possible, estimates for four specific drugs of abuse (cocaine, heroin, methamphetamines and marijuana) as well as an estimate for any drug use using the same consistent methodological principals so that the internal and external burden of each drug can be easily compared and assessed in terms of its relative contribution to the total burden of disease. Finally, in addition to providing a general estimate of the total cost of drug use, this study will provide the first estimates of the economic costs associated with different stages of use. Using simulation modeling we will estimate the expected cost of initiating use, of escalating use (from experimentation to regular use), and of becoming dependent on an illegal substance. Estimates of the cost associated with these particular stages of drug use will be invaluable to researchers and policy analysts interested in evaluating the cost-effectiveness and cost-benefit of alternative drug prevention or treatment programs targeting alternative stages of drug use.