Janelle Irwin Taylor
Costs related to opioid use disorder (OUD) can reach nearly $1 trillion per year when factoring in health insurance and uninsured costs, substance use treatment, lost productivity at both work and home and criminal justice.
That estimate is from a secondary research report by Avalere Health, a strategic health care partner that works through advisory, medical, and marketing teams to ensure support, treatment and overall care for every patient. The report found total annual costs related to OUD to be $934 billion nationwide, with most of that, $438 billion, coming from lost employer productivity, followed by employee productivity, at $248 billion.
OUD costs $111 billion annually in health insurance and uninsured costs, as well as $73 billion in lost household productivity. Other costs include criminal justice ($52 billion) and substance use treatment ($12 billion).
But with treatment, those costs can be tamed, the report found. Treatments including behavioral therapy alone save as much as $144,000 per case, while adding additional treatments increases overall cost savings to as much as $295,000 per case when combined with long-acting injectable buprenorphine. Combining behavioral therapy with methadone or sublingual buprenorphine saves as much as $271,000 per OUD case.
Those numbers are significant considering that in 2022, approximately 6.1 million people in the U.S. reported having an OUD, according to the report. OUD is defined as chronic opioid use that causes clinically significant distress or impairment.
The report further found that “appropriate treatment decreases rates of financially motivated and violent crimes.” That’s likely because, as those with OUD become less dependent on the drug, they no longer have the drive to obtain the funds necessary to purchase it.
Yet, “despite the well-established benefits of OUD treatment, individuals with OUD face significant barriers to treatment,” the report notes.
“Barriers to care include physicians’ stigmatizing attitudes and reluctance to treat OUD, inadequate provider training, geographic distances between patients and treatment settings, and social stigma associated with accessing treatment,” the report reads.
In Florida, the report found that OUD costs state and local governments between $200 and $299 per capita, a figure that places the Sunshine State in line with about half the nation. OUD per capita costs are less in Arkansas, California, Georgia, Kansas, Louisiana, Minnesota, Nebraska, South Dakota, Texas, and Wyoming. West Virginia posts the highest cost of OUD, at least $500 per capita. Connecticut, Kentucky, Maine, Massachusetts, Nevada, New Hampshire, New Jersey, Ohio, and Pennsylvania all have costs to state and local governments ranging from $400 to $499 per capita.
Previous research has attempted to quantify the opioid crisis, with the Council of Economic Advisers estimating it cost the U.S. $504 billion in 2015. According to the report, another study found a cost of more than $1 trillion in 2017, while a subsequent study reported a $1.5 trillion price tag in 2020. To put that into perspective, the report notes that the Centers for Disease Control and Prevention estimated the economic toll of heart disease and stroke at $254 billion in health care costs and $168 billion in lost productivity, far more than even the most conservative of the previous estimates on OUD costs.
Report researchers and authors looked at targeted literature to model overall costs and treatment savings associated with OUD at the state and national levels, focusing on outpatient care and involving several stakeholders, including government, private business, individuals and households, society at large, and OUD patients.
The research and report writing team includes Margaret Scott as the principal, research scientist Tim Collins, Senior Associate Gina Krupp, Associate Amanda Sitkowski, Managing Director Michael Ciarametaro, and Associate Principal Chani Seals.
