2011-05-13 Ingvar Nilsson ( i.nilsson@seeab.se )

1. Is rehabilitation a short run cost or a long term social investment with an extreme high rate of return? 2011-05-13 Ingvar Nilsson (i.nilsson@seeab.se)

2. ”When I leave prison with a plastic bag with all my belongings in one hand, a few dollars in my pocket . No social contacts outside the drug community, no job, no housing, no incomeHow long do you think I will manage”?

3. A mathematical summury

4. Some statements • Drug addiction is expensive, very expensive • You can put a price on it • Most of the costs are invisible • You can calculate the economic benefits of • Prevention • Rehabilitation

5. An economist´s point of view • An economist is a person who know the price of everything and the vaule of nothing • On the other hand • Money talks!!!

6. IT ALL STARTED 32 YEARS AGOHow much does drug addiction cost the Swedish society?

7. IT ALL STARTED 32 YEARS AGOIT´S TOO EXPENSIVE

8. IT´S TOO EXPENSIVE!!!BUT WHAT IS TOO EXPENSIVE???Socioeconomic accounting

9. The economics of marginalizationmake visible the long run economic effects of marginalizationin order tosee the benefits of prevention and rehabilitation

10. Euros & kronor • 1 EURO = 10 KRONOR • The figures are swedish • The principles are universal • The method is translatable

12. Questions to ask • What does addiction cost • What are the economic effects of prevention and rehabilitation • What are the rates of success? • How succesful do you have to be in order to be profitable?

13. Let´s start with some resultasthen look at the methodology

14. The price tag of business as usual Anual costs

15. The metadone program in Stockholm • 600 clients • Annual cost 63 Mkr • Annual cost/client approx 100.000 Kr • Levels of succes • No succes at all • Partially free from crugs, still criminal • Partially free from drugs, no criminality • Free from drugs, no job • Free from drugs, job • Question; is this a profitable project?

16. SOCIOECONOMIC ANUAL INCOME STATEMENT METHADONE PROGRAM 600 CLIENTS PROFIT PROFIT PER PERSON

18. Total profit for a period of 20 years, SEK

19. If you could reinvest the profits!!!

21. THE PREVENTIVE PERSPECTIVEThe road to hell....When does it start???Normally very early!!!

23. ADHD – average annualcost 1-19 years www.seeab.se www.socioekonomi.se

24. NO lack of resources Buthowdoweusethem? www.seeab.se www.socioekonomi.se

25. ADHD best case & worst case Costsyear 1-19 Non- prevention Late High cost Prevention Early Low cost

26. Nobodysees the wholepattern Nobodysees the long term effects Non- prevention Late High cost Prevention Early Low cost

27. The situation at the age of 33the non - intervention perspective

29. 30 ADHD GROWN UP´S CRIMINAL AND DRUG ADDICTION

33. Three paths to follow Stop looking at the top of the iceberg – start looking from a holistic point of view Stop thinking short term costs – start thinking long run social investment Stop thinking ”not my table” - start thinking about mutual cooperation

34. So how did we make this calculations???

35. BASTA – a social enterprise • 1991 – I have seen the light - St Patrigiano • 1994 start • 60 former addicts (mostly ”street level”) • 30-50 years old, 15-25 years as outsiders • A democratic company • Rehabilitation through ”good work” • Steady growth • Economically & socially succesfull • Developed working relations with local authorites

36. Peter managing partner at Basta, former addict for 20 years; are we a profitable company???

37. The socioeconomic perspective • An expansion of the perspective of business economics and agency economics • All relevant impacts must be considered • An expression of the overall view • Three steps • Identify • Quantify • Assess

38. Three aspects of the socioeconomic report • Income statement • Revenues minus costs • Difference between public and business perspectives • Difference between tunnel vision and overall view • Investment calculation • What happens long-term • A short-term cost may be a long-term investment • A social investment perspective • Key figures statement • What happens if we compare

39. PROSECUTOR TRUSTEE NURSE COUNSELLOR DOCTOR DEBT COUNSELLOR Prison & Probation Service CUSTODIAN COUNSELLOR CASEWORKER SOC. INS. Psychiatric care POLICE Support MENTAL HEALTH WORKER CORRECTIONAL OFFICER SOCIAL WORKER IFO PSYCHOTHERAPIST EMP. SERVICE COUNSELLOR OCC. THERAPIST ATTORNEY PSYCHOLOGIST BAILIFF HOUSING COMPANY PHYSIOTHERAPIST JUDGE DOCTOR AID ASSESSMENT Somatic care People with addictions HOUSING SUPPORT NURSE DISTRICT NURSE Housing MANAGE HOUSING NURSE, DETOX RESIDENTIAL TREATMENT CENTRE HOME HELP Dependency care GUIDANCE EMP OSA GUIDANCE RSMH ALCOHOL THERAPIST Employment INDIVIDUAL/ FAMILY SERVICES Social life & context Family & social network VOCATIONAL GUIDANCE Addiction care TREAT- MENT CENTRE GUIDANCE COUNSELLOR HOME VISITS SOC CHILD/ADOLESCENT HOUSING SUPPORT POLICE CHILD PSYCHIATRY SOCIAL WORKER PO

40. Chain Crime Fraud Police investigation Claims adjustment Shoplifting Loss of property Property damage Receiving stolen goods Car theft Time/Prod loss victims Burglary Apprehension Peddling (drugs/alcohol) Sources of income Smuggling What does the drug really cost? Prostitution

41. i.nilsson@seeab.se Theft – stolen goods – dealer process 200 kr to the dealer for amfetamin

42. i.nilsson@seeab.se Drug adiction and the legal system Supervision- Board Supervision Crime Suspended sentence Appeal Court of appeal Apprehension Contract treatment Community service Detention Counsel for Conviction Injured party Intensive supervision Investigation Released Questioning Probation Main proceedings Prosecutor Dismissed Minimum security (open) local prison Arrest Attorney Minimum security (open) national prison Remand prison examination Forensic psychiatric PPS Transport Indictment Locked local prison Detention Locked national prison Detention Preliminary investigation/ Criminal investigation High security prison Detention order proceedings Personal case study

43. Drug adiction and financial support Waiting periods Investigation Sickness compensation Doctor Sickness benefit Rehab- Illness Investigation compensation Poor Economic Investigation finances assistance Unemployment benefit No Investigation Activity compensation job Public sheltered compensation (OSA) Wage subsidy Tax revenues Legal Paid work Production value Illegal

44. Peter once more; are there not many people getting a job from my criminality and drug addiction?

45. Addicts at Vägen Ut and Basta as indirect employers Per Person Enterprise Total Total Legal system Municipality/County Council Other sector Total Is there a drug industrial complex???? 26.000 ADICTS IN SWEDEN, EVERY ONE CREATES 2.3 FULL TIME JOBS THIS GIVES A TOTAL NUMBER OF 59.800 FULL TIME JOBS OR MORE THAN 1% OF THE LABOUR FORCE

46. Costs for drug adiction the full picture?

47. The price tag of business as usual 26.000 adicts - annual costs around 40.000 millions kronor

48. SOCIOECONOMIC REPORT, INCOME STATEMENT, BASTA 2005

50. Socioeconomic report, Basta, 2005. Payoff time for rehab investment