What Opioid Abuse Is Costing America

Dollar destruction.

Unless you have been hiding in a remote cabin for more than a decade, you know that opioids have been taking hundreds of thousands of lives in America. While other news may be claiming the headlines, this tragedy keeps playing out in the background. Month after month and year after year, opioid overdoses keep claiming our loved ones, neighbors and community members.

This chart from the Centers for Disease Control and Prevention (CDC) shows the devastation. The brown line shows the number of deaths from synthetic opioids. That category includes fentanyl and a small quantity of tramadol deaths. The black line shows the number of deaths from all opioids, including prescription painkillers, heroin, and methadone.

CDC - Drug overdose deaths by drugs
Image courtesy of cdc.gov

The line has flattened out in the last couple of years but there are no signs of it making any significant improvements.

Note: Each little circle on the graph shows the estimated number of drug overdose deaths for a prior 12-month period. The line shows the actual number of reports that have been received by the CDC. So in January 2023, there had been 82,706 reported deaths from opioids in the prior 12 months. The CDC estimates that when all reports finally come in, the final number will be 83,973. That is the difference between the line (reported value) and the little circles (estimated value).

The Personal and Emotional Losses

Every month that this epidemic of opioid abuse and addiction continues to rage, it costs America deeply. Before we talk about the financial costs of this situation, let’s talk about the personal and emotional losses.

Every year, there are at least 100 thousand families who will never recover from their broken hearts. They saw the potential in the loving child, parent, sibling or dear friend who was taken from them. Sometimes it was an outcome the family had been dreading for years. Sometimes it was a complete shock because the family didn’t know about the drugs. As a result, marriages sometimes break up. Children suffer neglect or abuse. Siblings may themselves descend into drug abuse despite everything they have seen because they are unable to process the loss.

America as a nation and all the communities affected by these deaths lose the creativity, imagination and possibilities of these individuals. If they could have broken free of their addictions and recovered the ability to live positive, productive lives again, who knows what they might have contributed?

Financial Losses: Losses to Employers and the Economy

Lack of employment

According to the CDC, 70% of those individuals with a substance use disorder are employed. That totals 13.6 million people. One-quarter of these people are suffering severe damage from their addictions. Almost a quarter suffer moderate harm. To some degree or another, these people are working impaired. They may be unable to deliver their best work. They may have more sick days, accidents or preoccupation while trying to be functional. There is a financial loss to companies when these employees do not get the help they need to overcome their addictions.

Financial Losses: Costs of Justice and Incarceration

Once addiction takes over a person’s life, it becomes more likely that they will lose their job. At that point, many will be forced to resort to criminal acts to be able to live and continue to access drugs. According to the National Institute on Drug Abuse:

“The substantial prison population in the United States is strongly connected to drug-related offenses. While the exact rates of inmates with substance use disorders (SUDs) is difficult to measure, some research shows that an estimated 65% percent of the United States prison population has an active SUD…”

The substantial prison population in the United States is strongly connected to drug-related offenses. While the exact rates of inmates with substance use disorders (SUDs) is difficult to measure, some research shows that an estimated 65% percent of the United States prison population has an active SUD. Another 20% percent did not meet the official criteria for an SUD, but were under the influence of drugs or alcohol at the time of their crime.

Therefore it is obvious that drug abuse and addiction greatly contribute to our costs of justice and incarceration.

Financial Losses: Healthcare and Emergency Rescue

Hospital ER

When a person overdoses at home, on the street or at work, emergency medical services are summoned to try to save the person’s life. According to the National Emergency Medical Services Information System, there are more than 200,000 EMS calls each year in which a person did not lose their life to opioids. The total costs of 200,000 EMS calls would be astronomical. Since more than 80,000 lives are lost due to opioid overdoses, emergency medical costs for those overdoses would contribute to even higher costs.

Some of those who survive overdoses will be hospitalized. Those without insurance or funds will be treated at public cost. According to the Substance Abuse and Mental Health Services Administration, more than 1.4 million people were admitted to publicly-funded drug treatment services. Again, the cost of treating 1.4 million individuals for addiction would be astronomical.

More than one-quarter of those in treatment stated that their primary drug of abuse was one of the opioid drugs.

The Total Losses

A Congressional report recently totaled the costs just from opioids, not including the cost of other drugs such as cocaine, methamphetamine, cannabis, synthetic drugs or alcohol.

The cost of opioid use and addiction alone
cost the country more than $1 trillion.

This means that every man, woman and child in America is paying more than $3,000, one way or another, for this problem. Add to that the cost of cocaine, meth, alcohol and other drugs. Drug addiction in America is a phenomenally expensive problem.

Just three years earlier, the White House Council of Economic Advisers calculated the cost of opioids at $700 billion, which reveals how quickly these costs can increase.

For Comparison: Arizona’s Costs

Arizona also calculates the state’s cost for opioid overdoses. In just this one state, opioid overdoses are racking up a price tag of more than $2 billion.

Again, these are just the financial losses. Since December 2019, the number of lives lost to all drugs has increased from 71,000 per twelve months to 93,000 in December 2020, 109,000 in December 2021 and 110,000 in December 2021. That’s close to 400,000 lives lost in four years to all types of drugs. As usual, illicit synthetic opioids are causing the greatest number of deaths.

Solving the Problem

If America is to overcome this problem, it must be addressed on many fronts. There must be substance abuse treatment that really works to free people from the trap they are in. There must be sufficient law enforcement efforts to remove drugs from our communities and prosecute those who traffic those drugs. Both young and old Americans must be educated on the dangers they face if they begin to drink excessively or use drugs.

In 2001, we were losing 6.8 lives for every 100,000 Americans. By 2021, the rate of loss per 100,000 Americans had increased to 32.4. That’s nearly a five-fold increase in less than a generation.

No matter what crises clamor for our attention, we must not forget those who lose their happy lives, careers, families or even their lives due to drug abuse and addiction. It is possible to recover from addiction as the recoveries of millions have shown us.


  • “Provisional Drug Overdose Death Counts.” CDC, 2023. CDC
  • “Workplace Supported Recovery: New NIOSH Research Addresses an Evolving Crisis.” CDC, 2022. CDC
  • “Criminal Justice DrugFacts.” NIDA, 2020. NIDA
  • “Non-Fatal Opioid Overdose Surveillance Dashboard.” NEMSIS, 2023 NEMSIS
  • “Treatment Episode Data Set, 2020.” SAMHSA, 2021. SAMHSA
  • “Overdose deaths cost US $1 trillion annually, bipartisan report finds.” ABC News, 2022. ABC News
  • “Opioid Overdoses Surveillance Report, Arizona, 2020-2021.” Arizona Department of Health Services, 2022. ADHS


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.