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The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013

Florence, Curtis S. PhD; Zhou, Chao PhD; Luo, Feijun PhD; Xu, Likang MD

doi: 10.1097/MLR.0000000000000625
Original Article

Importance: It is important to understand the magnitude and distribution of the economic burden of prescription opioid overdose, abuse, and dependence to inform clinical practice, research, and other decision makers. Decision makers choosing approaches to address this epidemic need cost information to evaluate the cost effectiveness of their choices.

Objective: To estimate the economic burden of prescription opioid overdose, abuse, and dependence from a societal perspective.

Design, Setting, and Participants: Incidence of fatal prescription opioid overdose from the National Vital Statistics System, prevalence of abuse and dependence from the National Survey of Drug Use and Health. Fatal data are for the US population, nonfatal data are a nationally representative sample of the US civilian noninstitutionalized population ages 12 and older. Cost data are from various sources including health care claims data from the Truven Health MarketScan Research Databases, and cost of fatal cases from the WISQARS (Web-based Injury Statistics Query and Reporting System) cost module. Criminal justice costs were derived from the Justice Expenditure and Employment Extracts published by the Department of Justice. Estimates of lost productivity were based on a previously published study.

Exposure: Calendar year 2013.

Main Outcomes and Measures: Monetized burden of fatal overdose and abuse and dependence of prescription opioids.

Results: The total economic burden is estimated to be $78.5 billion. Over one third of this amount is due to increased health care and substance abuse treatment costs ($28.9 billion). Approximately one quarter of the cost is borne by the public sector in health care, substance abuse treatment, and criminal justice costs.

Conclusions and Relevance: 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.

National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

The authors declare no conflict of interest.

Reprints: Curtis S. Florence, PhD, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-62, Atlanta, GA 30341. E-mail: cflorence@cdc.gov.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.