The annual societal cost of alcohol misuse in Scotland

Objective: To estimate the annual socioeconomic burden imposed by alcohol misuse on Scottish society. Design and setting: Resource use attributable to alcohol misuse was obtained from appropriate databases, published literature and a Working Party on Social Work Caseload and Alcohol Misuse. Unit resource costs at 2001/2002 prices were applied to the resource use estimates to determine the annual direct cost attributable to alcohol misuse. Indirect costs arising from excess unemployment, absenteeism from work and premature mortality were also estimated as was the human cost of alcohol misuse arising from premature mortality among the non-working population. Main outcome measures and results: The annual healthcare cost of managing alcohol misuse was estimated to be pound95.6 million. Hospital admissions (57%) and accident and emergency attendances (10%) accounted for the greatest health service costs. Social work services including the Children's Hearing System were estimated to cost pound85.9 million whilst the criminal justice system was estimated to cost pound267.9 million. Indirect costs were estimated to account for pound404.5 million. The human cost of premature mortality among the non-working population was estimated to be pound216.7 million. Conclusions: Alcohol misuse imposes a substantial burden on Scottish society, costing pound1071 million per year at 2001/2002 prices, which is greater than many prevalent illnesses such as stroke, depression and diabetes mellitus. In terms of the statutory agencies, alcohol misuse imposes a greater burden on the criminal justice system than both the health service and social work services. However, the greatest burden is on the individual and society as a whole arising from lost productivity.