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8.11.2013 - Symposium Binge Drinking in Belgian minors : an innocent problem ?

8.11.2013 - Symposium Binge Drinking in Belgian minors : an innocent problem ?. Health policy and the social cost of alcohol use in Belgium Kurt Doms Head Drugs Unit, FPS Health , Food chain safety and Environment.

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8.11.2013 - Symposium Binge Drinking in Belgian minors : an innocent problem ?

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  1. 8.11.2013 - SymposiumBinge Drinking in Belgian minors : an innocent problem ? Healthpolicy and the social cost of alcohol use in Belgium Kurt Doms Head Drugs Unit, FPS Health, Food chainsafety and Environment ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  2. Structure • Mission Drug Unit • Social coststudies • International • National • Public expenditure : one element of social cost • General policy implications • Healthpolicy implications ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  3. 1. Mission Drug Unit • Stimulatingqualityimprovement and innovation in alcohol and drugtreatment • Supportingdevelopment and implementation of integrated and global drugpolicy • Promoting Belgian drugpolicyviewsinternationally ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  4. 2. Social coststudies • ‘The social cost of alcoholis the cost to society of everythingthathappensthatwould not happen in a world withoutalcohol. It does not show how muchcouldbesaved by anyparticularpolicymeasure, nordoesit show how muchcouldbesaved if alcoholsuddenlyvanished.’ (Anderson & Baumberg, 2006) ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  5. Concepts • Tangible and intangible costs • Tangible: monetaryharms • Intangible : non monetaryharms(value placed on harms) • Direct and indirect costs • Direct : immediately linked with harm • Indirect : e.g. productivity losses, … • Ideal : combination, not always possible/available ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  6. International data • Total tangible costs of alcohol use to the European Union in 2010 amount to € 155,8 billion(Rehm, 2012). ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  7. Total tangible social cost of alcohol use, in billion €, EU, 2010 • Rehm, 2012 ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  8. High public healthcosts : epidemiology • Severalalcoholattributablediseases: neuropsychiatricdisorders, cancer, cardiovascular and gastro-intestinal diseases (mainlylivercirrosis) (Rehm, 2013) • 11 million people in EU withalcoholdependence (Belgium : 1,9 % of women and 5,4 % of men) (Rehm, 2013) • Net burden of alcoholconsumption 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) ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  9. Belgian data • Total tangible costs of alcohol use in Belgium amount to € 4,2 billion in 2007 (Annemans, 2013). ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  10. Total tangible social cost of alcohol use, in billion €, by field, Belgium, 2007 • Annemans, 2013 ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  11. Comparisons • On the EU level roughly the same as for tobacco(Anderson,2006) • Total tangible costs of alcohol use in Belgium amountto • € 6 billion in 1999 (Degreef & Pacolet, 2003). Difference due to decline of accidents and absenteeism (Annemans, 2013) ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  12. 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 ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  13. Limitations • Differentmethodologies • Data availability • Wide margins of error • Assumptionsunder discussion : transfers of unemployment, consumedgoods, … • 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) ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  14. Discussion • Global analysis • Social coststudies as starting point of economic contributions to policymaking • Cost-effectiveness studies remain essential • Ideologicaldebates : solidarity ? ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  15. 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 methodused • Formulategeneral conclusions and policy recommandations • 11.2013-10.2015 • Belgian Science Policy Office ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  16. 3. Public expenditure : one element of social cost • University of Ghent and VrijeUniversiteit Brussel (Vander Laenen, 2011), ‘Drugs in figures III’ • Scope: • Expenses made by public services, no external, private or social costs • Alcohol, illicitdrugs, tobacco and psychoactive medication • 2008 ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  17. Results Total public expenditure on drugpolicy in 2008 amounts to € 975 million, of which • alcohol : € 632 million • illicitdrugs : € 273 million • psychoactive medication : € 35 million • tobacco : € 11 million • substances combined : rest ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  18. Total expenditure on drugpolicy, by substance, percentages, 2008, Belgium • Vander Laenen, 2011 ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  19. Public expenditure on alcoholpolicy, by piller, percentages, 2008, Belgium • Vander Laenen, 2011 ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  20. 4. General policy implications • Awareness of social and economicharms of alcohol • Need of intersectoralapproach • Effectiveness and monitoring ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  21. General policy initiative • Alcoholplan 2014-2018 by the InterministerialConference on Drugs • Intersectoralapproach • WHO priorities • Actions and responsabilities • Monitoring • To bedecided on the 9th December 2013 ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  22. 5. Healthpolicy implications • Jointedpriority for awareness building • Evidence based care innovation • Monitoring ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  23. Somehealthpolicy initiatives • Monitoring • TreatmentDemandIndicator • Review Minimal Psychiatric Registration ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  24. Evidence based care innovation • ‘UP-TO-DATE’ study : GP’s and occupationalpractitioners • Mental healthsectorreform, including for minors ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  25. Awareness building • Prevention, earlydetection and intervention • Agenda setting withinvolvement of civil society ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  26. References • Anderson, P. & Baumberg, B. (2006), Alcohol in Europe. London : Insitute of AlcoholStudies • Annemans, L. (2013), The health, social and economicburden of alcoholdependence. 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 riskassessment of burden of disease and injuryattributable to 67 riskfactors and risk factor clusters in 21 regions, 1990-2010 : a systematicanalysis of the Global Burden of DiseaseStudy 2010, Lancet, 380, 2224-60. • Rehm, J. et. al. (2012), Alcoholconsumption, alcoholdependance and attributableburden of disease in Europe : Potential gains from effective interventions for alcoholdependence, Centre for Addiction and Mental Health, Canada. • Rehm, J. et. al. (2013), Modeling the impact of alcoholdependence on mortalityburden and the effect of availabletreatment interventions in the European Union, EuropeanNeuropsychopharmacology, 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. Onderzoeknaar de overheidsuitgavenvoorhetdrugsbeleid in België, Gent: AcademiaPress. ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the social cost of alcohol use in Belgium – 8.11.2013

  27. ThankyouContact :kurt.doms@gezondheid.belgie.beInfo :www.health.belgium.be/drugs ‘BingeDrinking in Belgian Minors : an innocent problem ? ‘ - Health policy and the socialcost of alcohol use in Belgium – 8.11.2013

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