Monday, June 23, 2008

So what IS the cost of drugs?

The NZ Herald is reporting a study conducted called the Drug Harm Index. It reports it was "designed by economists to help police decide where drugs do the most harm and enable them to use resources more efficiently."

On the face of it the report claims a $1.3 billion "social" cost for drugs. That, of course raises some big issues:

- How many of those costs are costs of prohibition? If prohibition ended, how many would go up, how many would go down or disappear?
- How many of these costs could be born by those using if the incentives were in place to do so? These wouldn't be "social" costs, they would be internalised. Indeed how many of these costs ARE internal?
- What are the benefits? People spend money on drugs not for nothing, but because they gain value in it. The value is not dissimilar to the value from drinking, eating a dessert, sex or the like. You see people take drugs because they feel good isn't it missing part of the equation to ignore that?

Now I don't think that long term drug use is a particular clever thing to do. It can be highly destructive and damaging, much as consistently high levels of alcohol consumption can be too. However, it is important to consider drugs dispassionately. It's not me to judge what another adult ingests, as long as it doesn't harm anyone else. So let's look at least at some points reported:

- "373,310 people used cannabis, but only 17 per cent of these were frequent users". It may suggest that the bulk of users are getting about their life reasonably well. At least no worse than the regular drinker. However if we enforced the law strictly, that would be equal to the population of Christchurch being in prison. That's what winning the war on drugs would mean.

- "Nearly 23,000 people used crystal methamphetamine (36 per cent of them often)" compared with 81,890 using MDMA and 38,890 using cocaine. Suggests the "P epidemic" isn't quite that, although it is undoubtedly the most destructive of the drugs listed.

- Drug use is related to absences at work, which is hardly surprising. However, this IS a matter between the user and the employer, and if the employer has the legal right to dismiss someone for excessive absences then the issue can be addressed. However, you wouldn't arrest a drug user purely for not turning up at work enough would you?

- 16% of the prison population is occupied by "drug related crimes", although it is unclear whether this is drug crimes per se. $108.7 million per annum to keep them there. However, this isn't a cost of drug use - it is a cost of drug prohibition. Add the $374 million court, community sentence and home detention costs also to drug prohibition, not drug use.

- 2292 patients admitted to hospital for drug related reasons, costing $6.76 million p.a. Hardly noticeable in a health budget of $11 billion p.a. The Ministry of Health says that the annual cost of alcohol related hospitalisations is $74 million p.a. Of course, if drug users had to pay for hospital costs it wouldn't be a social cost anymore.

- 1920 drug related deaths (including associated with homicide and road accidents). That statistic itself sounds like a wide catchment. Does it include people murdered in the criminalised drug sector? Curiously ALAC's website claims in 2000 that 1040 deaths were attributable to alcohol, but 980 were PREVENTED by alcohol, although the deaths were more likely to be premature and the deaths avoided older (presumably the preventive effect of red wine on heart disease and the like). Back to drugs, how many drug related deaths could have been avoided had it been easy to present information on safer use of MDMA and other drugs, for example? How many drug related deaths could have been avoided had drugs not been "fortified" by a range of substances to make them "go a bit further" for dealers - a consequence of prohibition.

- "While stimulants contributed 41 per cent of the total costs, figures showed that in 2006, police and Customs seized 33,480kg of cannabis compared with only 155kg of stimulants." It demonstrates the law enforcement agencies concentrate on the high volume easy catches, not the low volumes harder drugs. What does that say about incentives to target "catching people" rather than harm?

So the story is mixed. Yes drugs undoubtedly cost in productivity, and cost more in less tangible ways socially as their misuse can be highly destructive to motivation, character and attitude to life. However, is that a reason to lock up 1578 people? Are their wider education, cultural and philosophical reasons why this happens?

Yes drugs send people to hospital, but at a fraction of the rate of alcohol. We also don't know whether drugs have any positive health effect - some cancer patients report cannabis soothing their pain. We also don't know what other positive effects they have on people, relieving stress for example. Yes there are sceptics, but I'd like to see someone dispassionately investigating this. The cost of drugs is only half of the equation, what value are there on the benefits? I don't have any idea whether this would be smaller or larger than the costs, but surely we should ask both before coming to a conclusion.

Finally, the cost of the criminal justice system is not a cost of drug use, it is the cost of drug prohibition. That is also worthy of a study. The cost of prohibition includes all of those imprisonment and court costs, and Police costs. It also includes the higher price users pay, and an element of the health costs by reducing quality. Finally, if a cost of drug use is reduced productivity, a cost of prohibition is the cost to individuals of being incarcerated and forever having a drug conviction in their records. The cost in time can be calculated, the cost in lost earnings over life, and reduced opportunities to travel. The benefits would be worth calculating too - what do we save from prohibition?

Now none of this is about developing an economists answer to a question of individual freedom, but it is useful in identifying the consequences of policies and getting some order of magnitude. It is telling in itself that the health costs of drug use are quite low.

1 comment:

Anonymous said...

Yes, funny how most of the costs are to do with prohibition, and this report is then used to lobby for more spending on... prohibition.
Excluding the two biggest harmful drugs - alcohol and nicotine - undermines any credibility this index might have.