purity has reached an all-time high, with the vast majority of resources spent on interdiction and law enforcement instead of public health. in the united states, the number of nonviolent drug offenders in prison exceeds by 100,000 the total incarcerated population in the eu, despite the fact that the eu has 100 million more citizens. despite drug legislation (or perhaps because of it), large, organized criminal drug cartels operate worldwide. advocates of decriminalization argue that drug prohibition makes drug dealing a lucrative business, leading to much of the associated criminal activity. some states in the u.s, as of late, have focused on facilitating safe use as opposed to eradicating it. for example, as of 2022, new jersey has made the effort to expand needle exchange programs throughout the state, passing a bill through legislature that gives control over decisions regarding these types of programs to the state’s department of health. this state level bill is not only significant for new jersey, as it could be used as a model for other states to possibly follow as well. this bill is partly a reaction to the issues occurring at local level city governments within the state of new jersey as of late. one example of this is in the atlantic city government which came under lawsuit after they halted the enactment of said programs within their city. this suit came a year before the passing of this bill, stemming from a local level decision to shut down related operations in atlantic city made in july that same year. this lawsuit highlights the feelings of new jersey residents, who had a great influence on this bill passing the legislature. these feelings were demonstrated in front of atlantic city city hall, where residents exclaimed their desire for these programs. all in all, the aforementioned bill was signed effectively into law just days after it passed legislature, by new jersey governor phil murphy. cost policymakers try to understand the relative costs of drug-related interventions. an appropriate drug policy relies on the assessment of drug-related public expenditure based on a classification system where costs are properly identified. labelled drug-related expenditures are defined as the direct planned spending that reflects the voluntary engagement of the state in the field of illicit drugs. direct public expenditures explicitly labeled as drug-related can be easily traced back by exhaustively reviewing official accountancy documents such as national budgets and year-end reports. unlabelled expenditure refers to unplanned spending and is estimated through modeling techniques, based on a top-down budgetary procedure. starting from overall aggregated expenditures, this procedure estimates the proportion causally attributable to substance abuse (unlabelled drug-related expenditure = overall expenditure × attributable proportion). for example, to estimate the prison drug-related expenditures in a given country, two elements would be necessary: the overall prison expenditures in the country for a given period, and the attributable proportion of inmates due to drug-related issues. the product of the two will give a rough estimate that can be compared across different countries. europe as part of the reporting exercise corresponding to 2005, the european monitoring centre for drugs and drug addiction's network of national focal points set up in the 27 european union (eu) the member states, norway, and the candidates' countries to the eu, were requested to identify labeled drug-related public expenditure, at the national level. this was reported by 10 countries categorized according to the functions of government, amounting to a total of eur 2.17 billion. overall, the highest proportion of this total came within the government functions of health (66%) (e.g. medical services), and public order and safety (pos) (20%) (e.g. police services, law courts, prisons). by country, the average share of gdp was 0.023% for health, and 0.013% for pos. however, these shares varied considerably across countries, ranging from 0.00033% in slovakia, up to 0.053% of gdp in ireland in the case of health, and from 0.003% in portugal, to 0.02% in the uk, in the case of pos; almost a 161-fold difference between the highest and the lowest countries for health, and a six-fold difference for pos. to respond to these findings and to make a comprehensive assessment of drug-related public expenditure across countries, this study compared health and pos spending and gdp in the 10 reporting countries. results suggest gdp to be a major determinant of the health and pos drug-related public expenditures of a country. labeled drug-related public expenditure showed a positive association with the gdp across the countries considered: r = 0.81 in the case of health, and r = 0.91 for pos. the percentage change in health and pos expenditures due to a one percent increase in gdp (the income elasticity of demand) was estimated to be 1.78% and 1.23% respectively. being highly income elastic, health and pos expenditures can be considered luxury goods; as a nation becomes wealthier it openly spends proportionately more on drug-related health and public order and safety interventions. united kingdom the uk home office estimated that the social and economic cost of drug abuse to the uk economy in terms of crime, absenteeism and sickness is in excess of £20 billion a year. however, the uk home office does not estimate what portion of those crimes are unintended consequences of drug prohibition (crimes to sustain expensive drug consumption, risky production and dangerous distribution), nor what is the cost of enforcement. those aspects are necessary for a full analysis of the economics of prohibition. united states yearcost(billions of dollars) 1992107 1993111 1994117 1995125 1996130 1997134 1998140 1999151 2000161 2001170 2002181 these figures represent overall economic costs, which can be divided in three major components: health costs, productivity losses and non-health direct expenditures. health-related costs were projected to total $16 billion in 2002. productivity losses were estimated at $128.6 billion. in contrast to the other costs of drug abuse (which involve direct expenditures for goods and services), this value reflects a loss of potential resources: work in the labor market and in household production that was never performed, but could reasonably be expected to have been performed absent the impact of drug abuse. included are estimated productivity losses due to premature death ($24.6 billion), drug abuse-related illness ($33.4 billion), incarceration ($39.0 billion), crime careers ($27.6 billion) and productivity losses of victims of crime ($1.8 billion). the non-health direct expenditures primarily concern costs associated with the criminal justice system and crime victim costs, but also include a modest level of expenses for administration of the social welfare system. the total for 2002 was estimated at $36.4 billion. the largest detailed component of these costs is for state and federal corrections at $14.2 billion, which is primarily for the operation of prisons. another $9.8 billion was spent on state and local police protection, followed by $6.2 billion for federal supply reduction initiatives. according to a report from the agency for healthcare research and quality (ahrq), medicaid was billed for a significantly higher number of hospitals stays for opioid drug overuse than medicare or private insurance in 1993. by 2012, the differences were diminished. over the same time, medicare had the most rapid growth in number of hospital stays. canada substance abuse takes a financial toll on canada's hospitals and the country as a whole. in the year 2011, around $267 million dollars of hospital services were attributed to dealing with substance abuse problems. the majority of these hospital costs in 2011 were related to issues with alcohol. additionally, in 2014, canada also allocated almost $45 million towards battling prescription drug abuse, extending into the year 2019. most of the financial decisions made on substance abuse in canada can be attributed to the research conducted by the canadian centre on substance abuse (ccsa) which conduct both extensive and specific reports. in fact, the ccsa is heavily responsible for identifying canada's heavy issues with substance abuse. some examples of reports by the ccsa include a 2013 report on drug use during pregnancy and a 2015 report on adolescents' use of cannabis. special populations immigrants and refugees immigrant and refugees have often been under great stress, physical trauma and depression and anxiety due to separation from loved ones often characterize the pre-migration and transit phases, followed by "cultural dissonance," language barriers, racism, discrimination, economic adversity, overcrowding, social isolation, and loss of status and difficulty obtaining work and fears of deportation are common. refugees frequently experience concerns about the health and safety of loved ones left behind and uncertainty regarding the possibility of returning to their country of origin. for some, substance abuse functions as a coping mechanism to attempt to deal with these stressors. immigrants and refugees may bring the substance use and abuse patterns and behaviors of their country of origin, or adopt the attitudes, behaviors, and norms regarding substance use and abuse that exist within the dominant culture into which they are entering. street children street children in many developing countries are a high-risk group for substance misuse, in particular solvent abuse. drawing on research in kenya, cottrell-boyce argues that "drug use amongst street children is primarily functional—dulling the senses against the hardships of life on the street—but can also provide a link to the support structure of the ‘street family’ peer group as a potent symbol of shared experience." musicians in order to maintain high-quality performance, some musicians take chemical substances. some musicians take drugs such as alcohol to deal with the stress of performing. as a group they have a higher rate of substance abuse. the most common chemical substance which is abused by pop musicians is cocaine, because of its neurological effects. stimulants like cocaine increase alertness and cause feelings of euphoria, and can therefore make the performer feel as though they in some ways ‘own the stage’. one way in which substance abuse is harmful for a performer (musicians especially) is if the substance being abused is aspirated. the lungs are an important organ used by singers, and addiction to cigarettes may seriously harm the quality of their performance. smoking harms the alveoli, which are responsible for absorbing oxygen. veterans substance abuse can be a factor that affects the physical and mental health of veterans. substance abuse may also harm personal and familial relationships, leading to financial difficulty. there is evidence to suggest that substance abuse disproportionately affects the homeless veteran population. a 2015 florida study, which compared causes of homelessness between veterans and non-veteran populations in a self-reporting questionnaire, found that 17.8% of the homeless veteran participants attributed their homelessness to alcohol and other drug-related problems compared to just 3.7% of the non-veteran homeless group. a 2003 study found that homelessness was correlated with access to support from family/friends and services. however, this correlation was not true when comparing homeless participants who had a current substance-use disorders. the u.s. department of veterans affairs provides a summary of treatment options for veterans with substance-use disorder. for treatments that do not involve medication, they offer therapeutic options that focus on finding outside support groups and “looking at how substance use problems may relate to other problems such as ptsd and depression”. sex and gender part of a series onsex differences in humans biology sexual differentiation disorders in research physiology medicine and health autoimmunity life expectancy mental disorders autism depression schizophrenia substance abuse suicide stroke care neuroscience and psychology aggression cognition emotional intelligence empathy intelligence memory narcissism neurosexism sexuality age disparity in relationships attraction desire fantasy jealousy sociology crime education in the u.s. gender inequality leadership religion social capital social support there are many sex differences in substance abuse. men and women express differences in the short- and long-term effects of substance abuse. these differences can be credited to sexual dimorphisms in the brain, endocrine and metabolic systems. social and environmental factors that tend to disproportionately affect women, such as child and elder care and the risk of exposure to violence, are also factors in the gender differences in substance abuse. women report having greater impairment in areas such as employment, family and social functioning when abusing substances but have a similar response to treatment. co-occurring psychiatric disorders are more common among women than men who abuse substances; women more frequently use substances to reduce the negative effects of these co-occurring disorders. substance abuse puts both men and women at higher risk for perpetration and victimization of sexual violence. men tend