Health Issues and Costs.

[Psyber]

I came across this interesting issue on an Internet site.

Smoking tops costs list - 22 Apr 2008 reproduced from Australian Doctor, 9 April 2008.

The cost to the community of tobacco, alcohol and illicit drug use in Australia has reached $56 billion, according to a government-commissioned report. Between 1999 and 2005, the social costs of the three drugs increased by almost 40% and dwarf the $48 billion current federal heath budget.

The report –The Costs of Tobacco, Alcohol and Illicit Drug Abuse-- is meant to be the most comprehensive study of social costs, in terms of ill health, accidents, premature death, crime and lost productivity for over a decade. It claims that $31 billion of the community costs are due to smoking, despite the decline in smoking rates.

The report was published on the same day as the Federal Government announced the creation of its National Preventative Health Taskforce. The taskforce will be asked to come up with a national preventive health strategy by June next year. It will also be asked to provide advice on the next five-year Australian Health Care Agreements, which will now be signed off next year.

The taskforce will be led by Dr Rob Moodie, professor of global health at the Nossal Institute for Global Health at the University of Melbourne.

Other members include:
* Professor Mike Daube, professor of public health at Curtin University of Technology.
* Professor Paul Zimmet AO, director of the International Diabetes Institute.
* Ms Kate Carnell AO, CEO of the Australian General Practice Network.
* Dr Lyn Roberts AM, CEO of the National Heart Foundation.
* Mr Shaun Larkin, general manager at the health insurer HCF.
* Professor Leonie Segal, foundation chair in health economics at the University of South Australia.

[Pseudo]

...
The cost to the community of tobacco, alcohol and illicit drug use in Australia has reached $56 billion, according to a government-commissioned report. Between 1999 and 2005, the social costs of the three drugs increased by almost 40% and dwarf the $48 billion current federal heath budget
[....]

Any idea how these figures compare with the amount made from tax on booze and durries?

[smac]

I hope you also read the retort...

http://blogs.news.com.au/jackmarxlive/i ... k_science/

[Psyber]

I hope you also read the retort...

http://blogs.news.com.au/jackmarxlive/i ... k_science/

No I hadn't found it. It makes some valid points. There is a lot of "junk science" around, on both sides of many arguments, so the truth is often obscured in the huge pile of spin by various interest groups. Once upon a time it was all about "truth", but now it often seems to be about supporting current organisational policy.

I once upset someone significant in Melbourne's drug treatment programmes by arguing in a journal, as Devil's advocate, that people were maintained on methadone or Subutex replacement for Heroin far too long because so many jobs depended on an adequate supply of "addicts" ondergoing treatment to keep the statistics up, and that these policies actually helped maintain the drug taking habit. There was going to be a formal reply about my position to the journal, but it never eventuated, despite my occasionally reminding them it had not appeared yet.

[smac]

Despite the fact I posted it somewhat in jest, you are right - it does raise some good points.

[Leaping Lindner]

I hope you also read the retort...

http://blogs.news.com.au/jackmarxlive/i ... k_science/

No I hadn't found it. It makes some valid points. There is a lot of "junk science" around, on both sides of many arguments, so the truth is often obscured in the huge pile of spin by various interest groups. Once upon a time it was all about "truth", but now it often seems to be about supporting current organisational policy.

I once upset someone significant in Melbourne's drug treatment programmes by arguing in a journal, as Devil's advocate, that people were maintained on methadone or Subutex replacement for Heroin far too long because so many jobs depended on an adequate supply of "addicts" ondergoing treatment to keep the statistics up, and that these policies actually helped maintain the drug taking habit. There was going to be a formal reply about my position to the journal, but it never eventuated, despite my occasionally reminding them it had not appeared yet.

I've worked in drug and alcohol rehab for the best part of the last 8 years, and that is an interesting arguement to say the least. You tend to find that people are on Methadone for a long time as it is very hard drug to get off once you are addicted. It is an easier drug to manage than Heroin but a lot harder to withdraw from.
The sad truth is no matter what "policies" are implented to treat addicts you are never going to run out of patients.

[Psyber]

I hope you also read the retort...

http://blogs.news.com.au/jackmarxlive/i ... k_science/

No I hadn't found it. It makes some valid points. There is a lot of "junk science" around, on both sides of many arguments, so the truth is often obscured in the huge pile of spin by various interest groups. Once upon a time it was all about "truth", but now it often seems to be about supporting current organisational policy.

I once upset someone significant in Melbourne's drug treatment programmes by arguing in a journal, as Devil's advocate, that people were maintained on methadone or Subutex replacement for Heroin far too long because so many jobs depended on an adequate supply of "addicts" ondergoing treatment to keep the statistics up, and that these policies actually helped maintain the drug taking habit. There was going to be a formal reply about my position to the journal, but it never eventuated, despite my occasionally reminding them it had not appeared yet.

I've worked in drug and alcohol rehab for the best part of the last 8 years, and that is an interesting arguement to say the least. You tend to find that people are on Methadone for a long time as it is very hard drug to get off once you are addicted. It is an easier drug to manage than Heroin but a lot harder to withdraw from.
The sad truth is no matter what "policies" are implented to treat addicts you are never going to run out of patients.

I had worked in the area, too, for a while many years ago. I have never been convinced the way to deal with drug [including alcohol] addiction was to substitute another addictive substance except for a very short period to assist withdrawal, and then only under supervision.

Interestingly, years later I took hefty doses of Di-Gesic for a dental abscess that blew up one weekend and developed classical narcotic withdrawal effects two days after stopping it, after being on it for 3 days. I had no problem with my decision to then take one 4x/day for 4 days, 1/2 tablet 4x/day for 4 days then stop, but when I was taking 1/2 tablet and putting the other 1/2 away, the temptation to pick up the broken "crumbs" and have them was strong! [ I'm a slow acetylator, so low doses have impact.]

[Leaping Lindner]

I had worked in the area, too, for a while many years ago. I have never been convinced the way to deal with drug [including alcohol] addiction was to substitute another addictive substance except for a very short period to assist withdrawal, and then only under supervision.

Interesting in theory but...
Problem one - long term addicts can't come off a drug quickly. Long term heroin/benzo/alcohol abuse can't be dealt with quickly successfully.
Problem two - supervision requires staff which requires $$$, and no government state or federal, liberal or labor is giving any extra $$$ out to this area.

[Psyber]

I had worked in the area, too, for a while many years ago. I have never been convinced the way to deal with drug [including alcohol] addiction was to substitute another addictive substance except for a very short period to assist withdrawal, and then only under supervision.

Interesting in theory but...
Problem one - long term addicts can't come off a drug quickly. Long term heroin/benzo/alcohol abuse can't be dealt with quickly successfully.
Problem two - supervision requires staff which requires $$$, and no government state or federal, liberal or labor is giving any extra $$$ out to this area.

Problem 1: I really think a few weeks is sufficient for acute withdrawal from actual physiological addiction if the motivation to stop is there.
Problem 2a: Yes, and I think funding it for acute withdrawal is essential. The tendency in Victoria is to give alcohol withdrawal a 5 day programme, but secondary withdrawal, when the risk of the DTs is high, is more usually days 10-14 according to my reading and experience.
Problem 2b: Governments pay lip service to the whole issue and try to do as little as possible as cheaply as possible - starting at Customs with imported drugs, Policing the marketing, providing adequate acute care, then providing adequate longer term support to fight the habituation.

That may be because of the governments' cynical view of Problem 3: those who say they want to give up but only want to be supported until they can get their next supply.
Then, governments' take a similar view towards minor crime too, and largely ignore it.