Howard G. Birnbaum

Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United States

OBJECTIVES The objective of this study was to estimate the societal costs of prescription opioid abuse, dependence, and misuse in the United States. METHODS Costs were grouped into three categories: health care, workplace, and criminal justice. Costs were estimated by 1) quantity method, which multiplies the number of opioid abuse patients by cost per opioid abuse patient; and 2) apportionment method, which begins with overall costs of drug abuse per component and apportions the share associated with prescription opioid abuse based on relative prevalence of prescription opioid to overall drug abuse. Excess health care costs per patient were based on claims data analysis of privately insured and Medicaid beneficiaries. Other data/information were derived from publicly available survey and other secondary sources. RESULTS Total US societal costs of prescription opioid abuse were estimated at

The prevalence and effects of adult attention deficit/hyperactivity disorder on work performance in a nationally representative sample of workers.

55.7 billion in 2007 (USD in 2009). Workplace costs accounted for

Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R)

25.6 billion (46%), health care costs accounted for

The Prevalence and Correlates of Nonaffective Psychosis in the National Comorbidity Survey Replication (NCS-R)

25.0 billion (45%), and criminal justice costs accounted for

AGE DIFFERENCES IN THE PREVALENCE AND CO-MORBIDITY OF DSM-IV MAJOR DEPRESSIVE EPISODES : RESULTS FROM THE WHO WORLD MENTAL HEALTH SURVEY INITIATIVE

5.1 billion (9%). Workplace costs were driven by lost earnings from premature death (

Costs of attention deficit–hyperactivity disorder (ADHD) in the US: excess costs of persons with ADHD and their family members in 2000

11.2 billion) and reduced compensation/lost employment (

Attention-Deficit/Hyperactivity Disorder: Increased Costs for Patients and Their Families

7.9 billion). Health care costs consisted primarily of excess medical and prescription costs (

Depression and work productivity : The comparative costs of treatment versus nontreatment

23.7 billion). Criminal justice costs were largely comprised of correctional facility (

Employees With Fibromyalgia : Medical Comorbidity, Healthcare Costs, and Work Loss

2.3 billion) and police costs (

Foundations of Opioid Risk Management

1.5 billion). CONCLUSIONS   The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future.