The economic burden of opioid-related poisoning in the United States

Pain Med. 2013 Oct;14(10):1534-47. doi: 10.1111/pme.12183. Epub 2013 Jul 10.


Objective: To estimate the yearly economic burden of opioid-related poisoning in the United States.

Background: Rates of opioid poisoning and related mortality have increased substantially over the past decade. Although previous studies have measured the costs of misuse and abuse, costs related specifically to opioid poisoning have not been quantified. This study quantifies the economic burden of opioid poisoning in the United States to help evaluate the economic case for efforts to reverse or prevent opioid poisoning and its associated morbidity and mortality.

Methods: Mean costs and prevalence estimates were estimated using publically available datasets. A societal perspective was assumed and accordingly estimated direct medical and productivity costs. Direct medical costs included treatment for opioid poisoning in the emergency department (ED) and inpatient settings, along with emergency transport and drug costs. Productivity costs were estimated using the human capital method and included lost wages due to mortality and absenteeism costs from ED visits and hospitalizations. All costs were inflated to 2011 U.S. dollars.

Results: In 2009, total costs were estimated at approximately $20.4 billion with indirect costs constituting 89% of the total. Direct medical costs were approximately $2.2 billion. ED costs and inpatient costs were estimated to be $800 million and $1.3 billion, respectively. Absenteeism costs were $335 million and lost future earnings due to mortality were $18.2 billion.

Conclusion: Opioid-related poisoning causes a substantial burden to the United States each year. Costs related to mortality account for the majority of costs. Interventions designed to prevent or reverse opioid-related poisoning can have significant impacts on cost, especially where death is prevented.

Keywords: Costs; Heroin; Opiate; Opioid; Overdose; Poisoning.

MeSH terms

  • Analgesics, Opioid / poisoning*
  • Health Care Costs*
  • Humans
  • Opioid-Related Disorders / economics*
  • Opioid-Related Disorders / epidemiology
  • Prevalence
  • United States


  • Analgesics, Opioid