<P> There is currently no consistent approach to measuring the economic impact of alcohol consumption . The economic burden such as direct, indirect, and intangible cost of diseases can be estimated through cost - of - illness studies . Direct costs are estimated through prevalence and incidence studies, while indirect costs are estimated through the human capital method, the demographic method, and the friction cost method . However it is difficult to accurately measure the economic impact due to differences in methodologies, cost items related to alcohol consumption, and measurement techniques . </P> <P> Alcohol dependence has a far reaching impact on health outcomes . A study conducted in Germany in 2016 found the economic burden for those dependent on alcohol was 50% higher than those who were not . In the study, over half of the economic cost was due to lost productivity, and only 6% was due to alcohol treatment programs . The economic cost was mostly borne by individuals between 30--49 years old . In another study conducted with data from eight European countries, 77% of alcohol dependent patients suffered from psychiatric and somatic co-morbidity, which in turn increased systematic healthcare and economic cost . Alcohol consumption can also affect the immune system and produce complications in people suffering from HIV, pneumonia, and tuberculosis . </P> <P> Indirect costs due to alcohol dependence are significant . The biggest indirect cost comes from lost productivity, followed by premature mortality . Men with alcohol dependence in the U.S. have lower labor force participation by 2.5%, lower earnings by 5.0%, and higher absenteeism by 0.5--1.2 days . Female binge drinkers have higher absenteeism by 0.4--0.9 days . Premature mortality is another large contributor to indirect costs of alcohol dependence . In 2004, 3.8% of global deaths were attributable to alcohol (6.3% for men and 1.1 for women). Those under 60 years old have much higher prevalence in global deaths attributable to alcohol at 5.3% . </P> <P> In general, indirect costs such as premature mortality due to alcohol dependence, loss of productivity due to absenteeism and presenteeism, and cost of property damage and enforcement, far exceed the direct health care and law enforcement costs . Aggregating the economic cost from all sources, the impact can range from 0.45%--5.44% of a country's gross domestic product (GDP). The wide range is due to inconsistency in measurement of economic burden, as researchers in some studies attributed possible positive effects from long term alcohol consumption . </P>

Select three possible impacts of alcohol abuse on the individual