Public Costs of Substance Abuse in Canada

"The same is not necessarily true with alcohol [Decreased tobacco use cost to the public]. In many ways, alcohol has become more widely available and allowing industry self-regulation results in a loss of policy control over alcohol marketing and advertising, especially online."
"We have not invested in public health interventions designed to reduce alcohol use to the same degree as we have with tobacco and the data are showing this."
"When we look at use [of opioids], the main measure of that is past-year use. So what you're seeing there is the effective public health messaging and prescription monitoring programs and better education in doctors to not use prescription opioids for chronic pain conditions -- all of these kinds of things."
"But at the same time, the harms tend to be concentrated among a smaller group of people, and among that group of people, the harms are increasing."
Canadian Centre on Substance Abuse (CCSA) scientist Matthew Young

Substance use in Canada costs $46 Billion

According to figures newly released by the Canadian Centre on Substance Use and Addiction, its Canadian Substance Use Costs and Harms report informs that substance use by Canadians costs close to $46 billion annually, representing just over $1,250 borne by every individual in the country. Fallout of substance use accorded with 275,000 hospitalizations and close to 78,000 deaths in the country, given figures reflecting 2017 data.

The report was meant to examine health-care and criminal justice costs, along with costs relating to lost productivity and other factors that can be attributed to the use of substances such as alcohol, tobacco, opioids, cannabis and cocaine, by the Canadian public. The years 2015-17 were covered by the report which shows alcohol and tobacco to represent the most damaging financially, accounting for $16.6 and $12.3 billion respectively (close to 63 percent of total costs).

Substance abuse costs 75,000 lives

When addictive drugs are examined, opioids accounted for $6 billion in public expenditures (12.9 percent), cocaine $3.7 billion (8.1 percent), cannabis $3.2 billion (7.0 percent) and categories of other central nervous depressants and stimulants, each of which accounted for close to $2 billion. The issues of lost productivity, associations of premature deaths, short- and long-term disabilities represented the largest proportion of substance-use costs at $20 billion, while health care at $13.1 billion and criminal justice costs $9.2 billion followed, as did other direct costs representing federal research funding, fire and motor vehicle damage, workplace drug testing and employee-assistance programs at $3.6 billion.

In comparison to a decade earlier, the per-person costs have steadily increased to about 30 percent with the costs associated with opioids having jumped over 20 percent and the costs confirmed for central nervous system stimulants including amphetamines and methamphetamines (excluding cocaine) to $54 per person. This, while alcohol consumption-related costs increased to $455 per person while the financial burdens reflecting tobacco use decreased to $336 per person.

With cannabis legalization, justice system costs will likely decrease. (CBC )

Cocaine is linked to the most significant trend, its costs and harms reflecting the impact it has on the larger society. "This matches a lot of reports we're getting from people working in harm-reduction and police enforcement. It was decreasing (during the years 2007 to 2014) because a lot of people saw cocaine as really dirty, with a lot of contaminants", explained Dr. Young.

Ontario accounts for the lowest per-person cost for substance use in the country where Nunavut and Northwest Territories had the highest because rates of alcohol and tobacco consumption are higher, and health care delivery is more expensive. COVID-19 is recognized as having an impact on the use of substances given initial increases of alcohol consumption at the pandemic onset -- since reduced and stabilized. Anticipation that the legalization of cannabis may lead to a decrease in criminal-justice costs is yet to be established.

"But the question some people are asking is are we going to see commensurate increases in health-related costs? My suspicion is not to the same degree because there aren't as many conditions associated with cannabis", concluded Dr. Young.

Alcohol and tobacco are costing Canada more than illegal substances per person. (Master1305/Shutterstock )