fod volksgezondheid, veiligheid van de voedselketen en leefmilieu 8.11.2013 - symposium b inge d...
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FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
8.11.2013 - Symposium
BINGE DRINKING IN BELGIAN MINORS : AN INNOCENT PROBLEM ?
Health policy and the social cost of alcohol use in Belgium
KURT DOMSHead Drugs Unit, FPS Health, Food chain safety and Environment
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Structure
1. Mission Drug Unit
2. Social cost studies
1. International
2. National
3. Public expenditure : one element of social cost
4. General policy implications
5. Health policy implications
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
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FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
1. Mission Drug Unit
• Stimulating quality improvement and innovation in alcohol and drug treatment
• Supporting development and implementation of integrated and global drug policy
• Promoting Belgian drug policy views internationally
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
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FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
2. Social cost studies
‘The social cost of alcohol is the cost to society of
everything that happens that would not happen in a
world without alcohol. It does not show how much
could be saved by any particular policy measure, nor
does it show how much could be saved if alcohol
suddenly vanished.’ (ANDERSON & BAUMBERG, 2006)
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Concepts
- Tangible and intangible costs-Tangible: monetary harms -Intangible : non monetary harms (value placed on harms)
- Direct and indirect costs-Direct : immediately linked with harm-Indirect : e.g. productivity losses, …
Ideal : combination, not always possible/available
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
International data
Total tangible costs of alcohol use to the
European Union in 2010 amount to € 155,8
billion (REHM, 2012).
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Total tangible social cost of alcohol use, in billion €, EU, 2010
REHM, 2012
7
41.4
12.6
21.4
6.3
45.2
11.3
17.6 Crime
Traffic accidents
Health
Treatment and prevention
Mortality
Absenteism
Unemployment
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
High public health costs : epidemiology
- Several alcohol attributable diseases: neuropsychiatric disorders, cancer, cardiovascular and gastro-intestinal diseases (mainly liver cirrosis) (REHM, 2013)
- 11 million people in EU with alcohol dependence (Belgium : 1,9 % of women and 5,4 % of men) (REHM, 2013)
- Net burden of alcohol consumption in EU was 1 in 7 deaths in men, and 1 in 13 deaths in women (REHM, 2012)
- Alcohol use is fifth most important risk factor for burden of disease in 2010 in 21 regions worldwide (LIM, 2012)
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Belgian data
Total tangible costs of alcohol use in Belgium
amount to € 4,2 billion in 2007 (ANNEMANS, 2013).
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Total tangible social cost of alcohol use, in billion €, by field, Belgium, 2007
ANNEMANS, 2013
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1.1
0.520.64
0.151.08
0.27
0.42
Crime
Traffic accidents
Health
Treatment and prevention
Mortality
Absenteism
Unemployment
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Comparisons
1. On the EU level roughly the same as for tobacco
(ANDERSON,2006)
2. Total tangible costs of alcohol use in Belgium amount
to
€ 6 billion in 1999 (DEGREEF & PACOLET, 2003). Difference
due to decline of accidents and absenteeism (ANNEMANS,
2013)
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Quid benefits ? (DEGREEF & PACOLET, 2003)
- Gains through avoided morbidity and mortality : medical costs, productivity, …
- Taxation revenues
net social cost of alcohol use in Belgium in 1999 : € 4,4 billion
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Limitations
- Different methodologies- Data availability- Wide margins of error- Assumptions under discussion : transfers of
unemployment, consumed goods, …- No thorough comparisons with other substances/diseases
Need of internationally validated instrument : review and update of WHO Guidelines on Estimating the Cost of
Substance Abuse (SINGLE, 2003)
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Discussion
- Global analysis
- Social cost studies as starting point of economic contributions to policy making
- Cost-effectiveness studies remain essential
- Ideological debates : solidarity ?
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Further research
- University of Ghent (VANDER LAENEN, ET. AL.) : social cost study of tobacco, alcohol, illicit drugs and psychoactive medication
- Objectives-Definition of social cost-Screening of existing national and international data -Estimation of social cost of substances in Belgium-SWOT analysis of the method used-Formulate general conclusions and policy recommandations
- 11.2013-10.2015
- Belgian Science Policy Office
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
3. Public expenditure : one element of social cost
University of Ghent and Vrije Universiteit Brussel (VANDER LAENEN, 2011), ‘Drugs in figures III’
Scope: • Expenses made by public services, no external,
private or social costs• Alcohol, illicit drugs, tobacco and psychoactive
medication• 2008
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Results
Total public expenditure on drug policy in 2008 amounts to € 975 million, of which
- alcohol : € 632 million - illicit drugs : € 273 million- psychoactive medication : € 35 million- tobacco : € 11 million - substances combined : rest
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
64.82%
28.00%
3.59%
1.13% 2.46% Alcohol
Illicit drugs
Psychoactive medica-tion
Tobacco
Substances combined
Total expenditure on drug policy, by substance, percentages, 2008, Belgium
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VANDER LAENEN, 2011
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
1.63%
86.73%
11.64%
Prevention
Treatment
Security
Public expenditure on alcohol policy, by piller, percentages, 2008, Belgium
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VANDER LAENEN, 2011
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
4. General policy implications
Awareness of social and economic harms of alcohol
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
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Need of intersectoral approach
Effectiveness and monitoring
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
General policy initiative
Alcoholplan 2014-2018 by the Interministerial Conference on Drugs
1. Intersectoral approach2. WHO priorities3. Actions and responsabilities4. Monitoring
To be decided on the 9th December 2013
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
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FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
5. Health policy implications
Jointed priority for awareness building
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
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Evidence based care innovation
Monitoring
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Some health policy initiatives
Monitoring
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
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Treatment Demand Indicator
Review Minimal Psychiatric Registration
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Evidence based care innovation
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
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‘UP-TO-DATE’ study : GP’s and occupational practitioners
Mental health sector reform, including for minors
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Awareness building
‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
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Prevention, early detection and intervention
Agenda setting with involvement of civil society
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
References- ANDERSON, P. & BAUMBERG, B. (2006), Alcohol in Europe. London : Insitute of Alcohol
Studies- ANNEMANS, L. (2013), The health, social and economic burden of alcohol dependence. A
Brief Update, Brussels.- DEGREEF, T., PACOLET, J. & R. BOUTEN (2003), Sociale kosten-batenanalyse van
alcoholgebruik en –misbruik in België, Leuven: HIVA.- LIM, S. ET. AL. (2012), A comparative risk assessment of burden of disease and injury
attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010 : a systematic analysis of the Global Burden of Disease Study 2010, Lancet, 380, 2224-60.
- REHM, J. ET. AL. (2012), Alcohol consumption, alcohol dependance and attributable burden of disease in Europe : Potential gains from effective interventions for alcohol dependence, Centre for Addiction and Mental Health, Canada.
- REHM, J. ET. AL. (2013), Modeling the impact of alcohol dependence on mortality burden and the effect of available treatment interventions in the European Union, European Neuropsychopharmacology, 23, 89-87.
- SINGLE, E. ET. AL. (2003), International Guidelines for Estimating the Cost of Substance Abuse, 2, WHO.
- VANDER LAENEN, F., DE RUYVER, B., CHRISTIAENS, J. & D. LIEVENS (2011), Drugs in Cijfers III. Onderzoek naar de overheidsuitgaven voor het drugsbeleid in België, Gent: Academia Press.
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013
FOD VOLKSGEZONDHEID, VEILIGHEID VAN DE VOEDSELKETEN EN LEEFMILIEU
Thank you
Contact : [email protected]
Info : www.health.belgium.be/drugs
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‘Binge Drinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013