The Economic Consequences of Opioid Addiction in America

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TOP 10 STATES: TOTAL HEALTH CARE COSTS FROM OPIOID ABUSE 6 WASHINGTON $977 million MICHIGAN $830 million 9 NEW YORK $1,256 million 3 7 5 8 PENNSYLVANIA $874 million CALIFORNIA $4,263 million 1 10 ARIZONA $699 million 2 TEXAS $1,964 million ILLINOIS $887 million OHIO $1,076 million 4 FLORIDA $1,247 million TOP 10 STATES: PER-CAPITA HEALTH CARE COSTS FROM OPIOID ABUSE 2 WASHINGTON $138 OREGON $155 1 9 IDAHO $96 4 COLORADO $111 8 10 3 7 RHODE ISLAND $103 DELAWARE $117 5 INDIANA $99 D.C. $95 CALIFORNIA $110 6 ARIZONA $104 2
BACKGROUND Opioid abuse is at the pinnacle of prescription drug abuse in the United States. According to the National Institute on Drug Abuse, 2.1 million Americans had a substance abuse disorder involving prescription opioids in 2012; opioid overdose deaths more than tripled between 1990 and 2010; and between 2004 and 2008, emergency room visits related to opioid abuse more than doubled (Volkow 2014). The majority of people who abuse opioids (55 percent) are given them by a friend or relative (CDC 2011). See Chart 1 for a breakdown of sources of prescription opioids that end up being abused. CHART 1: SOURCE OF ABUSED PRESCRIPTION PAINKILLERS 11.4% 7.1% 17.3% 4.4% 4.8% 55.0% Obtained free from a friend or relative Prescribed by one doctor Bought from friend or relative Other source Took from friend or relative without asking Got from drug dealer or stranger DATA AND METHODOLOGY Recently published research estimates that aggregate health care costs in the United States attributable to opioid abuse totaled $25 billion in 2007 (Birnbaum et al. 2011). We constructed a model to allocate this estimate by state. To provide an accurate state-by-state breakdown of the total health care cost associated with opioid abuse, it is important to account for three factors that can vary substantially from state to state: 1) population, 2) cost of health care, and 3) the rate of opioid abuse. In constructing the model, we incorporated state population data from the U.S. Census Bureau (2014). For the cost of health care, we used hospital adjusted expenses per inpatient day (Kaiser Family Foundation 2014). We chose this as a proxy for the cost of health care in a state because the majority of health care spending associated with opioid abuse is attributable to inpatient care (White et al. 2011). Finally, for opioid abuse rates, we used the percentage of nonmedical use of prescription pain relievers by people 12 or older, as reported in the National Survey on Drug Use and Health (SAMHSA 2013). Incorporating these three factors in the model ensures that the total cost is distributed proportionally across states according to the relevant variations. It should be noted that the state-by-state estimates are conservative for several reasons. The national estimate of health care costs attributable to opioid abuse is itself conservative, as described by Birnbaum et al. (2011). In addition, this estimate relates to 2007, and the opioid epidemic has worsened substantially since then (Volkow 2014). Source: CDC 2011. 3
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Economic Burden of Opioid Epidemic
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Page 146 and 147: Combatting the Opioid Epidemic 2019
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