Research project DR/98 (Research action DR)
Context
The use of psychoactive substances and gambling behavior generate substantial social costs through health problems, traffic accidents, and crime. In 2016, the first SOCOST study estimated these costs in Belgium for legal and illegal drugs. However, it revealed important limitations, including gaps in data availability and methodological inconsistencies. It also highlighted the need for a more sustainable and integrated monitoring framework to structurally map these societal burdens. The SOCOST 2 project responds to this need and is aligned with the Belgian national burden of disease study (BeBOD), coordinated by Sciensano, which provides a robust platform for routinely monitoring health impacts and their economic consequences.
Overall objectives and research questions
The main objective of SOCOST 2 is to assess the social costs (health-, traffic-, and crime-related) of psychoactive substances and (online) gambling in Belgium. This translates into three core questions:
1. What is the prevalence of use and misuse of tobacco, alcohol, illicit drugs, psychoactive pharmaceuticals, and (online) gambling in the Belgian population?
2. Which diseases, accidents, and crimes are associated with them, and with what relative risks?
3. What is the magnitude of the direct and indirect costs, and how can these be systematically integrated into the national burden of disease monitoring?
Methodology
The project is structured around five work packages. WP1 maps Belgian data sources (such as the Health Interview Survey) and develops methods to correct for survey bias, in order to better estimate the true prevalence of substance use and gambling. It also conducts a scoping review to determine relative risks and sets up an open access repository. WP2 calculates social costs, distinguishing between direct costs (health expenditures, healthcare use, crime- and traffic-related costs) and indirect costs (productivity losses due to illness or premature death). Data sources include BHIS, HISLink, and IMA. Analyses apply causal inference and comparative risk assessment to quantify both overall and disease-specific burdens. WP3 covers coordination and reporting, WP4 data management, and WP5 valorization, dissemination, and policy translation.
Interdisciplinarity
SOCOST 2 is carried out by a consortium that combines expertise in epidemiology, public health, and health economics, with additional collaboration on crime and traffic. UGent (health economics) and Sciensano (epidemiology and BeBOD) are the core partners. Their complementary expertise ensures both methodological rigor and policy relevance, building on previous successful collaborations.
Potential impact
Scientifically, SOCOST 2 contributes to the international knowledge base on social cost studies through an innovative, locally anchored application. Societally and politically, the project delivers up-to-date, reliable, and transparent estimates that can be directly applied within federal action plans on alcohol, tobacco, drugs, and gambling, as well as the inter-federal strategy for an integrated drug policy. These results support evidence-based policymaking and foster efficient allocation of resources for prevention and care. Moreover, the project enhances the visibility and usability of Belgian health data and contributes to international initiatives such as the European Burden of Disease Network.
Expected results
In the short term, SOCOST 2 will deliver:
- a methodological framework and open access databases with relative risks,
- technical reports and at least two scientific publications on cost estimates,
- integration of the results into the Belgian national burden of disease study,
- stakeholder communication through workshops and a follow-up committee.
In the medium term, additional peer-reviewed publications and conference contributions are foreseen, alongside policy-oriented outputs such as policy briefs and co-created recommendations with federal and regional actors. Together, these efforts will lead to a sustainable monitoring instrument that benefits science, policy, and society.
