Prescription opioid overdose, abuse, and dependence carries high costs for American society, with an estimated total economic burden of $78.5 billion, according to a study in the October issue of Medical Care.
Health care accounts for about one-third of costs attributable to the prescription opioid epidemic, while one-fourth of costs are borne by the public sector, according to the analysis by Curtis Florence, PhD, and colleagues of the National Center for Injury Prevention and Control. They hope their findings will help in understanding the economic impact of opioid overdose, abuse, and dependence, and in guiding strategies aimed at reducing the burden of the epidemic.
"More than 40 Americans die each day from overdoses involving prescription opioids. Families and communities continue to be devastated by the epidemic of prescription opioid overdoses." said CDC Director Tom Frieden, MD, MPH. "The rising cost of the epidemic is also a tremendous burden for the health care system."
Study Shows High Societal Costs of Opioid Epidemic
Using data from a wide range of sources, the researchers estimated the "monetized burden" of prescription opioid overdose, abuse, and dependence in the United States. Costs were analyzed from a societal perspective—including direct healthcare costs, costs related to loss productivity, and costs to the criminal justice system.
Based on the latest data, nearly two million Americans met criteria for prescription opioid abuse and dependence in 2013. In the same year, there were more than 16,000 deaths from prescription opioid overdose. Both figures were substantially higher than in 2007—the most recent previous year for which comprehensive estimates were available.
Aggregate costs for prescription opioid overdose, abuse, and dependence were estimated at over $78.5 billion (in 2013 dollars). Total spending for health care and substance abuse was over $28 billion, most of which ($26 billion) was covered by insurance.
In nonfatal cases, costs for lost productivity—including reduced productive hours and lost production for incarcerated individuals—were estimated at about $20 billion. Nearly two-thirds of the total economic burden was due to health care, substance abuse treatment, and lost productivity for nonfatal cases. Fatal overdoses—including costs related to healthcare and lost productivity—accounted for $21.5 billion.
Overall, nearly one-fourth of the aggregate economic burden was funded by public sources. That included costs funded by public insurance (Medicaid, Medicare, and veterans' programs) and other government sources for substance abuse treatment.
There were also $7.7 billion in criminal justice-related costs—nearly all borne directly by state and local governments. In addition, the authors note reduced tax revenues due to opioid-related productivity losses.
Dr. Florence and colleagues point out some important limitations of the data sources and methods used to estimate costs. The study can't measure all of the societal costs of the opioid epidemic—including the impact on quality of life for opioid-dependent people, or the pain and suffering of family members who have lost loved ones due to fatal overdose.
"The costs that we can identify, however, do help increase our understanding of the impact of the epidemic," the researchers conclude. "These estimates can assist decision makers in understanding the magnitude of adverse health outcomes associated with prescription opioid use such as overdose, abuse, and dependence."
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Curtis S. Florence et al. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013, Medical Care (2016). DOI: 10.1097/MLR.0000000000000625