The costs of alcoholism

Background: Alcohol dependence is one of the most common psychiatric disorders, placing many health, social and economic burdens upon society. Aims: To review evidence regarding the socioeconomic burden of alcoholism and the cost-effectiveness of available treatments. Methods: Relevant literature was identified from searches of electronic databases covering the period from 1980 to February 2002. Results: Total economic costs to society from alcohol abuse have been estimated at $148 billion (1992) in the USA, DM6 billion (€3.1 billion, 1990) in West Germany and 638 billion ptas (€3.8 billion, 1996) in Spain. Lost productivity costs far outweighed direct medical costs in each of these countries. Regarding comparative cost-effectiveness evidence, no economic evaluations could be identified on specific interventions, except the several modelling studies that have been published recently on acamprosate. They showed potential cost savings by acamprosate, primarily through reduced acute hospitalization and rehabilitation. Existing effectiveness and cost data suggest that brief motivational counselling is also a potentially cost-effective intervention. A few papers examining the cost-effectiveness of different treatment programmes were also reviewed. Conclusions: Results of this review further emphasize the necessity of efficient resource allocation in health care and the need for comprehensive, standardized management strategies for people with alcohol abuse. © Shadowfax Publishing and Taylor and Francis Group Ltd