Cost of alcohol harm
The true cost of alcohol harm is impossible to quantify as there is not only the very real financial burden to the state, but also a human cost to people, their families and communities.
In Ireland, a cost analysis of the financial burdens of alcohol harm has not been carried out since 2014. Back then, a Department of Health commissioned analysis put the cost of alcohol harm at approximately €2.35 billion annually. This figure includes:
- Cost to the health care system €793m
- alcohol-related crime cost €686m
- alcohol-related road accidents cost €258m
- lost economic output due to alcohol €614m (€195 million due to absenteeism, €185 million due to accidents at work, €169 million due to suicide and €65 million due to premature mortality).
Since, then the OECD estimates that for Ireland the costs are of the order of about 1.9% of GDP which tallies with research cited by the World Health Organisation that in high income countries alcohol harm amounts to up 2.5% of GDP.
For Ireland that would equate to approximately €9.6bn-€12bn annually. Against that alcohol excise duties only raise €1.2 bn annually.
Read more about alcohol taxation and affordability here
Breakdown of costs
Alcohol causes multiple illnesses and deaths and in Ireland, 11% of the healthcare budget is being used for alcohol-related illnesses and injuries. However, there are other costs, including harm to others.
A comprehensive report by the Health Research Board outlines some of the main costs of alcohol consumption in Ireland. It should be noted that here also, the data is outdated.
The report finds that:
- The estimated cost to the health system in 2012 of dealing with inpatients with either a wholly or partially alcohol-attributable condition was €1.5 billion, which accounted for 11.0% of all public healthcare expenditure that year. The majority of these costs (77.4%) were associated with discharges with partially attributable alcohol conditions. This excludes the cost of emergency cases, GP visits, psychiatric admissions and alcohol treatment services.
- In 2013, alcohol-related discharges accounted for 160,211 bed days in public hospitals, that is 3.6% of all bed days that year; compared to 56,264 bed days or 1.7% of the total number of bed days in 1995.
- An estimated 5,315 people on the Live Register in November 2013 had lost their job due to alcohol use.
- The estimated cost of alcohol-related absenteeism from work was €41,290,805 in 2013. This does not include the costs associated with reduced productivity at work or the cost of alcohol-related injury at work.
Harm to others
Considering harm to others from alcohol use, in 2018 the HSE published a report The Untold Story: Harms experienced in the Irish population due to others’ drinking, found that:
- One in six carers (16%) reported that children, for whom they had parental responsibility, experienced harm because of someone else’s drinking.
- One in every two people (51%) reported experiencing harm due to strangers’ drinking in the past 12 months.
- Two in every five people (44%) reported experiencing negative consequences due to the drinking of people they know.
- Three in every five people (61%) reported having a known heavy drinker in their life.
- One in seven workers (14%) reported work-related problems due to co-workers’ drinking.
The total cost of these alcohol harms to others was estimated as €872.75 million.
International evidence
Since these reports in Ireland were published there is increasing evidence that the scale of the costs from alcohol harm to others is comparable to that of the cost of alcohol harm to the individual, that alcohol carries a much greater cost than other drugs and that the costs are increasing over the past two decades.
Australia
For example, in Australia, research published in 2022 found that for 2016, the amount expended on those impacted by drinkers and their drinking is equivalent to the same amount again for those who drink, bringing the total annual bill to about AUS$40 billion. This includes costs from alcohol-related violence, car accidents, child services, impacts on quality of life and damage to property.
Canada
In Canada in 2020 costs for substance use were calculated for healthcare costs, lost productivity costs, criminal justice costs or other direct costs. Alcohol carried by the far the greater burden.
The four substances associated with the largest costs were (in order):
- Alcohol, accounting for $19.7 billion or 40.1% of the total costs (net of assumed benefits);
- Tobacco, accounting for $11.2 billion or 22.7% of the total costs;
- Opioids, accounting for $7.1 billion or 14.4% of the total costs; and
- Cocaine, accounting for $4.2 billion or 8.5% of the total costs
England
The Institute of Alcohol Studies published in 2024 the first nationwide analysis of alcohol costs of its kind in over 20 years. While noting that the research was likely to be an underestimate, it found costs of £27.4 billion annually which showed that there has been over a 40% increase in the cost of harm from alcohol since last calculated using the same methodology in 2003. Costs were calculated for healthcare, criminal justice system, social services and wider costs to the economy such as lost productivity.
International comparisons of costs of Adverse Childhood Experiences
Growing up with parental problem alcohol use is a well recognised Adverse Childhodd Experience (ACE). An increasing number of studies are identifying associations between ACEs and ill health throughout the life course. A comprehensive study published in 2019 examined these costs across Europe and North America and found that the fallout from ACEs across the lifespan costs Ireland 2% of GDP.