云南省药物滥用的社会成本调查

目的:对云南省2003年药物滥用的社会成本进行评估,期望研究结果能为我国制定有关药物滥用的防治策略提供可借鉴的依据。方法:在分层抽样的基础上,结合定性和定量研究的方法,调查了20个省级与药物滥用防治相关的部门和机构、9个国际、国内非政府组织、5个调查点的150余个相关机构和部门、301名吸毒者及77个吸毒者家庭,对云南省在2003年1a中因海洛因类物质滥用所耗费的个人、家庭和社会的资本和资源进行了综合评估。结果:以云南省登记在册的现有吸毒者数估算,因吸毒所导致的社会总成本达18.72亿元,而若以吸毒人群规模估计数估算则高达26.18-56.10亿元,占同年云南省国民生产总值的0.08%,其中公共成本占17.74%,个人成本占82.26%。公共成本中公安系统的投入最大,占85.54%,其次为教育和卫生,分别占5.72%和4.52%;同时,公共成本中又以被调查机构的日常运作经费为主,在药物滥用的治疗、预防和研究等方面投入则较低。吸毒者的个人投入73.40%用于购买毒品。结论:药物滥用的社会成本大小一定程度上可以反映出该社会的药物滥用状况以及政府对药物滥用问题的关注程度;云南省药物滥用防治资源配置不尽合理,在预防、治疗、康复、研究等干预性投入和技术性投入方面明显不足,尤其在教育、传媒、社区干预方面投入较低。建议,针对现行的药物滥用防治策略进行全面的成本效益评估,找到成本效益高的项目进行推广,从而有利于有效地合理分配资源,降低公共成本。

SOCIAL COST SURVEY ON DRUG ABUSE IN YUNNAN PROVINCE

Objective:To provide evidence-based reference for developing strategy on drug abuse prevention and control by studying social cost on drug abuse in Yunnan Province in 2003.Methods:Based on the sampling at different levels,with the integration of the quantitative and qualitative survey,we investigated 20 provincial departments and institutes related to drug abuse control,9 domestic and international NGOs,more than 150 related institutes in 5 survey sites,301 drug addicts and 77 families affected by drug abuse.After the investigation,we finally made a comprehensive analysis on the capital and resources of individual,family and society consumed by heroin abuse in 2003 in Yunnan.Results:Based on the number of the existing drug users registered in Yunnan Province,it is estimated that the social cost caused by drug abuse was 1.872 billion RMB.If based on the estimated population size of drug users,the social cost resulting from drug abuse would go up to 2.618-5.610 billion RMB,which accounted for 0.08% of GNP of Yunnan in the same year and meant that the average per capita burden for the citizen of Yunnan was 7.58 RMB.Among the social cost,public cost accounted for 17.74% and individual cost accounted for 82.26%.Among the public cost,public security cost the most which accounted for 85.54%,the next were education(5.72%)and public health(4.52%).However,the cost for drug abuse rehabilitation and research was relatively low.74.40% of the individual input of drug users was for purchasing drugs.Conclusion:To some extent,the scale of the social cost resulting from drug abuse can reflect the drug abuse situation of the society and the attached attention by government to the problem;the resource distribution for drug abuse control in Yunnan is not quite reasonable.The input for intervention such as prevention,treatment,rehabilitation and research as well as the technical input is obviously deficient,especially for the input in education,publicity and community intervention.So it is suggested that we should conduct an overall cost-effect evaluation on the existing drug abuse control strategy and popularize the high cost-effect project in order to distribute resources reasonably and efficiently and reduce the public cost.