Policing cannabis and drug related hospital admissions: Evidence from administrative records

Elaine Kelly,Imran Rasul

doi:10.1016/j.jpubeco.2014.01.008

Abstract

We evaluate the impact of a policing experiment that depenalized the possession of small quantities of cannabis in the London borough of Lambeth, on hospital admissions related to illicit drug use. To do so, we exploit administrative records on individual hospital admissions classified by ICD-10 diagnosis codes. These records allow the construction of a quarterly panel data set for London boroughs running from 1997 to 2009 to estimate the short and long run impacts of the depenalization policy unilaterally introduced in Lambeth between 2001 and 2002. We find that the depenalization of cannabis had significant longer term impacts on hospital admissions related to the use of hard drugs, raising hospital admission rates for men by between 40 and 100% of their pre-policy baseline levels. The impacts are concentrated among men in younger age cohorts. The dynamic impacts across cohorts vary in profile with some cohorts experiencing hospitalization rates remaining above pre-intervention levels three to four years after the depenalization policy is introduced. We combine these estimated impacts on hospitalization rates with estimates on how the policy impacted the severity of hospital admissions to provide a lower bound estimate of the public health cost of the depenalization policy.

Highlights

Illicit drug use generates substantial economic costs including those related to crime, ill-health, and diminished labor productivity
We evaluate the impact of a policing experiment that depenalized the possession of small quantities of cannabis in the London borough of Lambeth, on hospital admissions related to illicit drug use
Our analysis provides novel evidence on this relationship, at a time when many countries are debating moving towards more liberal policies towards illicit drugs markets, with the depenalization or decriminalization of cannabis possession as the most often suggested or implemented policy

Summary

Introduction

Illicit drug use generates substantial economic costs including those related to crime, ill-health, and diminished labor productivity. In 2002, the Oce for National Drug Control Policy estimated that illicit drugs cost the US economy $181 billion in total [Oce for National Drug Control Strategy, et al 2004]; for the UK, Gordon [2006] estimated the total cost of drug-related crime and health service use to be ¿15.4 billion in 2003/4 It is these social costs, coupled with the risks posed to drug users themselves, that have led governments throughout the world to try and regulate illicit drug markets. After forty-years of the USwar on drugs', the Obama administration has adopted a strategy that focuses more on prevention and treatment, and less on incarceration [Oce for National Drug Control Strategy, 2011], other federal agencies such as the Drug Enforcement Agency and the Oce for National Drug Control Policy remain more focused on traditional incarceration-based approaches Other countries such as the Netherlands, Australia and Portugal, have long adopted more liberal approaches that have depenalized or decriminalized the possession of some illicit drugs, most commonly cannabis, with many countries in Latin America currently debating similar moves

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