Societal Costs of Illegal Drug Use in Sweden

Hofmarcher T, Leppänen A, Månsdotter A, Strandberg J, Håkansson A

This article is the result of a collaboration with researchers at Lund University and the Public Health Agency of Sweden. The article builds on an earlier analysis presented in IHE Rapport 2022:5 (in Swedish).

Background
The use of illegal drugs (such as cannabis, cocaine, or ecstasy) has been increasing in Sweden. 3.5% of adults reported use during the past 12 months according to survey data from 2020, up from 2.5% in 2014. Sweden had the joint second highest number of drug-induced deaths per capita in Europe in 2020. The aim of this study was to provide a comprehensive and up-to-date estimation of the societal costs of illegal drug use in Sweden, relying as much as possible on registry and administrative data.

Methods
A prevalence-based cost-of-illness study of illegal drug use in Sweden in 2020 was conducted. A societal approach was chosen and included direct costs (such as costs of health care, social services, and the criminal justice system), indirect costs (such as lost productivity due to unemployment and drug-induced death), and intangible costs (such as reduced quality of life among people who use drugs and their family members). Costs were estimated by combining registry, administrative, and survey data with unit cost data.

Results
The estimated societal costs of illegal drug use were 3.7 billion euros in 2020. This corresponded to 355 euros per capita and 0.78% of GDP. The direct and intangible costs were of similar sizes, each contributing to approximately 40% of total costs, whereas indirect costs contributed to approximately 20%. The largest individual cost components were reduced quality of life among people who use drugs and costs of the criminal justice system.

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International Journal of Drug Policy, 2024;123:104259
DOI:  https://doi.org/10.1016/j.drugpo.2023.104259