Costs of Prescription Opioid Overdose, Abuse and Dependence Top $75 Billion Interview with:

Curtis Florence, PhD National Center for Injury Prevention and Control and Assistant professor, Department of Health Policy Management Rollins School of Public Health at Emory

Curtis Florence, PhD

Curtis Florence, PhD
National Center for Injury Prevention and Control and
Assistant professor, Department of Health Policy Management
Rollins School of Public Health
Emory What is the background for this study?

  • This study presents most recent CDC estimates of the economic burden of prescription opioid abuse, dependence and overdose in the United States.
  • In 2013, over 16,000 persons died of prescription opioid overdoses, and almost 2 million people met the diagnostic criteria for abuse and/or dependence. What are the main findings?
• The total cost of prescription opioid overdose, abuse, and dependence was estimated to be $78.5 billion in 2013.
• Over one third of this amount ($29 billion) was due to increased health care and substance abuse treatment costs.
• One-quarter of the costs were paid for by the public sector in health care, substance abuse treatment, and criminal justice costs. What should readers take away from your report?

  •  These estimates help quantify the magnitude of adverse health impacts associated with prescription opioids.
  •  In the ideal case, decision makers could use these estimates when weighing the benefits and risks of using opioids to treat pain, and evaluating prevention measures to reduce harmful use. However, at the present time a full accounting of both the benefits and costs of prescription opioid use is not available.
  • The results are also helpful in understanding the distribution of the economic burden. A large share of the cost is borne by the public sector, both through direct services from government agencies, but also through tax revenue that will be lost from reduced earnings. Also, the health care sector bears approximately one-third of the estimated costs. What recommendations do you have for future research as a result of this study?


  • Our economic burden estimates were based on the prevalence of abuse and dependence. Ideally, the economic burden of an adverse health outcome would be estimated by calculating the lifetime cost of the condition-that is, observing the condition from its onset until it ends. Then, the total value of preventing the condition from occurring would be known. At the present time though, information in the research literature about the natural history of opioid misuse does not allow for such a calculation, and surveillance systems are not in place to adequately measure the incidence of the condition in the population. Is there anything else you would like to add?


  • Prescription opioid abuse, dependence and overdose prevention strategies can save lives and reduce costs. CDC is working with communities and prescribers to prevent opioid misuse and overdose by tracking and monitoring the epidemic and helping states scale up effective programs. In addition, CDC developed the Guideline for Prescribing Opioids for Chronic Pain to help primary care doctors provide safer, more effective care for patients with chronic pain. Thank you for your contribution to the community.


Curtis S. Florence, Chao Zhou, Feijun Luo, Likang Xu. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013.Medical Care, 2016; 54 (10): 901 DOI:10.1097/MLR.0000000000000625

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Last Updated on September 15, 2016 by Marie Benz MD FAAD