Opioid use disorder (OUD) costs the U.S. around $94.3 billion annually. To put that in perspective, that’s the same amount the President of the Philippines asked for to support its entire government budget in 2023.
The price tag per person among the 6.1 million people who have an OUD lands somewhere around $700,000 per case.
Most of this comes from governments and employers losing tax revenue to healthcare and justice system expenses. This is according to a new report from Washington, D.C.-based Avalere Health, a health care consulting firm. Almost 44% of the annual cost — $41.6 billion caught up in police, courts and corrections — is “a cost higher than Medicaid or substance use treatment,” an Avalere spokesperson said during a press call.
Every untreated case of OUD costs $119,000 when averaged across public and private stakeholders, law enforcement, Medicaid, lost productivity for employers, among other things.
However, when an individual receives robust addiction treatment, up to $295,000 can be saved per case, the Avalere report found.
Engaging in behavioral therapy alone was associated with a savings net of treatment cost of $144,000. When behavioral therapy is combined with methadone or transmucosal buprenorphine, the savings nearly double to $271,000. The largest cost savings per case stems from an individual receiving behavioral therapy in combination with MAT in the form of a long-acting injectable (LAI) like extended-release buprenorphine, leading to an estimated savings of $295,000 per case, according to the report.
“When considering savings across all stakeholders, including the patient burden to the individual with OUD, the savings associated with behavioral therapy plus LAI buprenorphine were greater than the next most cost-saving treatment option, even with the higher costs of LAI buprenorphine compared to other treatment options,” the Avalere report states. “All treatment options reduced costs relative to no treatment.”
The report found that across the board, not only does addiction treatment significantly decrease the overall cost burden and lead to savings, it also “decreases rates of financially motivated and violent crimes among individuals with OUD.”
Even amid the ongoing opioid crisis, the U.S. just experienced what the Drug Enforcement Administration (DEA) touted was “the largest 12-month reduction in drug overdose deaths ever recorded,” with reported drug overdose deaths falling 26% year over year, according to the CDC. Most drug overdose deaths during this timeframe — 69% — were attributed to synthetic opioids, particularly fentanyl, the DEA said.
While these deaths are declining in a way not seen in years, OUDs and related overdoses are still an ongoing issue, one the Trump administration is also chiefly focused on cutting down by taking a law and order approach to deter substances from entering the country.
“It’s hard to say what is contributing to that decline, but we do know that OUD is still a significant problem,” the Avalere spokesperson said.
Still, it is estimated that among individuals with substance use disorders, 94.7% do not receive treatment. For individuals with OUDs, only one in five received medication-assisted treatment (MAT) in 2021 and in 2022, among individuals who needed OUD treatment, 42.7% “did not perceive that they needed it” according to the CDC.
But barriers to treatment, ranging from physician and societal stigma, lack of provider training in medication for opioid use disorders (MOUDs), and the price of accessing treatment directly and indirectly continue to present hurdles toward increasing treatment access.
While cost savings, directly or indirectly, should seem appealing to treatment uptake, dismantling these barriers will require “a multi-pronged approach, including a variety of federal and state policies,” the report authors note.
