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Ravages of substance abuse: economic costs and implications
Substance abuse as a Societal Issue not just has an Adverse Impact on Individuals and Stakeholders, but also Impacts Organisational Performance in ways Unimaginable. There has been no formal Approach to Addressing this ill, but recent initiatives might Succeed in Working out a model that appeals to The Business fraternity as well.
Issue Date - 23/06/2011
Do you have any idea how much economic and social damage is caused by substance abuse? And are you aware of how much could be done to address the problems if only the business opportunities inherent in finding solutions were better developed and more widely known?

The social and economic costs
Think about the distribution pertaining to the severity of substance abuse in India. It ranges from low to high, with a large proportion of the population in the category of those with little or no use, the lowest level of severity, and with no need for any sort of special treatment. In the US, this category includes roughly two thirds of the population. At the high end are alcoholics and addicts whose problems have been diagnosed and are under going treatment. This is a very small proportion of the population, less than 1% in the US. In between these two extremes, however, are two other groups – those who would be diagnosed clinically as being dependent but who are not receiving treatment and many more whose alcohol and other substance use – though not addictive — is significantly harming their ability to function soundly. You would be surprised at how much of the population falls into these two categories. In the US, for example, some 24 million people are dependent but are not receiving treatment, and another 60-70 million people are not clinically dependent but fall into the category of “harmful use”, i.e. their use of substances has harmful effects not only on themselves but also on those around them. While, we don’t have reliable information for India, we suspect that the proportions are not too dissimilar, with somewhere around one-third of the population needing or standing to benefit from treatment but not receiving it.

Now stop and think for a moment about how substance abuse affects people’s performance in the workplace. Not only are employees less productive than they might otherwise be, but the probability that they will have accidents in the workplace increases and their impact on their fellow employees reduces overall productivity. And these are the people whose level of substance abuse is moderate; despite their involvement with alcohol or opiates, they are able to hold down a job notwithstanding their absenteeism and diminished productivity. They fall into that category described above called “harmful use”. What if there were interventions that employers could use to help them reduce their involvement with substances? How big would the economic payoffs to the companies be? Were they to receive treatment, we can hypothesise that not only would they be more productive in the workplace, they might be more effective in other roles they play in their families and communities. And finally, what about those people who would be defined clinically as dependent and who need treatment but are not currently getting any? What are the costs, economic and otherwise, to Indian society? Estimates of the economic costs alone run into tens of billions of dollars or more.

Finding solutions: innovative Approaches & Opportunities
Finding solutions to the ravages of substance abuse would have huge economic and social benefits. But until the last several years, the problems of substance abuse and dependence have been thought to be intractable — like poverty. But thanks to the accumulation of over 20 years of science, there are now effective prevention, early intervention and continuing treatment services. Most of these have been developed through federal research initiatives and have not yet been translated into practical products and services that can be brought to scale The pressing need for solutions and the emerging foundation of research-derived interventions forms the basis for an innovative initiative now being undertaken at the University of Pennsylvania. The premise is that the number of people needing treatment actually represents a remarkable business opportunity, one which marries the power of market forces and profit incentive with the possibility of contributing to social welfare. Will it be possible to combine good science with smart business to bring about wide use of effective, practical solutions to reduce the morbidity, mortality, productivity losses and costs associated with substance abuse problems? That is the question posed by Penn’s new Center for Substance Abuse Solutions.

The precedents for this are clear. There are many areas where the combination of scientific research and business acumen has been important in developing solutions to health and social problems. But historically this has occurred in industries such as pharmaceuticals and medical devices, where there has been active translation of findings from scientific research into practical, marketable products and services. To date, there has been no organisational entity dedicated to translating and adapting the substantial body of scientific discoveries in the area of substance abuse into practical tools that all areas of society could use to address the problems it creates. The mission of the new Center is to identify potential “products” — medicines, services, interventions and/or policies — through the work of university investigators and to work with skilled business people work out a mutually beneficial model. These solutions will then be marketed aggressively to hospitals, schools, businesses and government agencies with the twin goals of reducing the devastating effects of substance use disorders on all aspects of society while making a profit in so doing. The idea is to create a “virtuous circle” of relationships among university researchers, business people and those individuals and organisations that need the solutions developed. If this innovative and ambitious experiment succeeds, it can perhaps serve as a sort of prototype that could be adapted for use in India and elsewhere in ways that are compatible with existing legal, structural and behavioral arrangements.

It is in everyone’s interest to find solutions to the ravages of substance abuse. The World Health Organisation has recognised it as a global priority. The business of developing and disseminating substance abuse solutions actually makes sense. We need to join together in this most worthwhile enterprise.


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