While the numbers often blur together, the stark reality is that over 80,000 lives were lost to opioid overdoses in 2022 alone, a harrowing statistic that underscores a crisis touching every community, age group, and walk of American life.
Key Takeaways
- In 2021, an estimated 5.6 million people aged 12 or older (2.0%) had an opioid use disorder (OUD) in the past year according to the National Survey on Drug Use and Health
- Approximately 9.2 million people misused prescription pain relievers in 2021, representing 3.3% of those aged 12 or older
- Heroin use disorder affected about 828,000 people aged 12 or older in 2021
- Overdose deaths involving opioids reached 81,806 in 2022, a 22% increase from 2021
- Synthetic opioids like fentanyl were involved in 73,838 deaths in 2022
- From 1999-2022, over 645,000 opioid-involved overdose deaths occurred
- Opioid use disorder is diagnosed in males at twice the rate of females (4.5% vs 2.2%) in 2021
- Adults aged 18-25 had the highest past-year opioid misuse rate of 5.0% in 2021
- Non-Hispanic Whites had 3.5% past-year prescription opioid misuse in 2021, highest among races
- The economic cost of opioid crisis was $1.02 trillion in 2017 including healthcare and lost productivity
- Opioid misuse led to 495 million lost workdays in 2015, costing $13.2 billion in productivity
- Annual healthcare costs for opioid use disorder: $35.4 billion in 2017
- Only 11% of people with OUD receive medications for opioid use disorder (MOUD) annually
- Buprenorphine treatment capacity covers only 30% of OUD patients needing it in 2022
- Methadone is provided to 20% of OUD patients via 1,800+ OTPs nationwide
Opioid addiction is a widespread and deadly national crisis impacting millions of lives.
Demographics
- Opioid use disorder is diagnosed in males at twice the rate of females (4.5% vs 2.2%) in 2021
- Adults aged 18-25 had the highest past-year opioid misuse rate of 5.0% in 2021
- Non-Hispanic Whites had 3.5% past-year prescription opioid misuse in 2021, highest among races
- Rural residents had 25% higher opioid hospitalization rates than urban in 2016-2017
- Among American Indians/Alaska Natives, 4.9% misused opioids past-year in 2021
- Females comprised 47% of opioid overdose deaths but 56% of prescription opioid misusers in 2021
- Ages 26-34 group had opioid death rate of 45.2 per 100,000 in 2022, second highest
- In Appalachia, 15% of adults reported chronic pain leading to higher opioid use
- Veterans represent 9% of U.S. population but 11% of opioid prescriptions
- Low-income adults (<$25k) had 4.8% opioid misuse rate vs 2.1% high-income in 2021
- Hispanic/Latino past-year opioid misuse: 2.9% in 2021
- Construction industry workers: 12.6% past-year prescription opioid misuse in NSDUH
- Among those with depression, 10.2% had co-occurring opioid use disorder in 2019
- Pregnant women opioid misuse: 2.1% in first trimester per 2020 data
- Black adults had opioid hospitalization rate 1.5 times higher than Whites in 2019
- Ages 65+ represent 16% of population but 10% of opioid deaths in 2022
- LGBTQ+ individuals have 1.5 times higher odds of opioid misuse per 2021 surveys
- Uninsured adults had 5.2% opioid misuse rate vs 2.8% insured in 2021
- Mining industry: 14.1% past-year opioid misuse among workers
- Among chronic pain sufferers, 12% develop opioid use disorder, mostly middle-aged
- Females aged 18-25 had higher prescription opioid misuse (5.5%) than males (4.5%) in 2021
- In correctional populations, 65% of inmates meet opioid use disorder criteria upon entry
- Asian/Pacific Islanders lowest misuse rate at 1.2% past-year in 2021
- Healthcare professionals: 10-15% lifetime opioid misuse prevalence
- Disabled adults: 6.8% opioid misuse rate, twice the general population in 2021
- Midwest region highest opioid prescribing rate: 82.5 prescriptions per 100 persons in 2022
Demographics Interpretation
The opioid crisis paints a grimly predictable portrait of America, where your vulnerability is cruelly tailored by your zip code, your job, your trauma, and the systemic failures that ration healthcare, pain relief, and dignity along lines of poverty, race, and region.
Economic
- The economic cost of opioid crisis was $1.02 trillion in 2017 including healthcare and lost productivity
- Opioid misuse led to 495 million lost workdays in 2015, costing $13.2 billion in productivity
- Annual healthcare costs for opioid use disorder: $35.4 billion in 2017
- Criminal justice costs from opioid crisis: $72 billion annually as of 2020
- From 2001-2020, opioid crisis cost U.S. economy $2.55 trillion in inflation-adjusted dollars
- Lost productivity from premature opioid deaths: $504 billion from 2015-2020
- Opioid-related hospitalizations cost $15.7 billion in 2012, rising 153% since 2005
- Child welfare spending due to parental opioid misuse: $10.9 billion in 2019
- Emergency department visits for opioids cost $8.2 billion annually pre-COVID
- Medicare Part D spending on opioids: $4.5 billion in 2020 despite fewer prescriptions
- Workers' compensation claims for opioid dependence: 16% increase 2002-2016, costing billions
- Neonatal abstinence syndrome treatment costs average $3,500-$93,900 per infant in 2012 dollars
- Opioid crisis reduced U.S. GDP by 0.8% annually from 2015-2018
- Treatment costs for OUD: $15,000-$20,000 per person annually
- Illicit opioid market value estimated at $150 billion annually in U.S.
- Employer costs for opioid misuse: $44 billion in absenteeism and turnover in 2016
- Federal spending on opioid response: $42 billion from 2017-2026 per SUPPORT Act
- State-level opioid treatment spending: $7.5 billion in FY2020
- Lifetime economic cost per opioid overdose death: $1.02 million in 2017 dollars
- Opioid prescriptions led to $78.5 billion in excess healthcare spending 2015-2017
- Family members bear $25,000 average cost per addicted individual in caregiving
- Opioid crisis caused 1.1 million children to lose a parent 2011-2021, costing future earnings
- Insurance claims for OUD treatment rose 1,000% from 2010-2020
- Rural hospitals opioid-related losses: $4.8 billion from 2012-2019 closures
Economic Interpretation
America has discovered an appallingly inefficient way to burn a mountain of cash, where the invoice for our national despair comes due in trillions, paid in lost lives, stolen futures, and a staggering pile of receipts from the emergency room, the jail cell, and the empty workplace chair.
Mortality
- Overdose deaths involving opioids reached 81,806 in 2022, a 22% increase from 2021
- Synthetic opioids like fentanyl were involved in 73,838 deaths in 2022
- From 1999-2022, over 645,000 opioid-involved overdose deaths occurred
- Heroin-involved overdose deaths declined 35% from 2017 to 2022
- In 2022, opioid overdose death rate was 32.6 per 100,000 population
- Provisional data shows 112,000 drug overdose deaths in 2023, mostly opioids
- Males accounted for 69% of opioid overdose deaths in 2022
- Age-adjusted opioid overdose death rate for ages 35-44 was 51.5 per 100,000 in 2022
- Black non-Hispanic persons had opioid death rate of 41.6 per 100,000 in 2022, up 34% from 2021
- American Indian/Alaska Native death rate from opioids was 56.6 per 100,000 in 2022
- In 2022, 17 states had opioid overdose death rates over 40 per 100,000
- Fentanyl deaths increased 94% from 2019 to 2022 among adolescents
- Opioid-involved deaths with psychostimulants rose 20-fold from 2000-2022
- Neonatal abstinence syndrome cases linked to maternal opioid use: 7 per 1,000 births in 2019
- Opioid overdose deaths in rural areas were 50% higher than urban in 2017-2018
- COVID-19 pandemic saw 30% rise in opioid deaths from 2019-2020
- Methadone-involved deaths: 5,352 in 2022
- Oxycodone deaths: 13,762 in 2022 per CDC data
- From 2010-2022, opioid death rates tripled in ages 25-34 group
- 75% of 2022 opioid deaths involved illicitly manufactured fentanyls
- Opioid death rate among males aged 25-34: 77.3 per 100,000 in 2022
- Suicide by opioids accounted for 14% of drug poisoning suicides in 2021
- In West Virginia, opioid death rate was 81.4 per 100,000 in 2022, highest in US
- Youth opioid deaths (14-18) quadrupled from 2019-2022 to 459
- Polydrug opioid deaths (with cocaine) rose 40% in 2022
- Opioid deaths declined 3% in 2023 provisional data after peak
- Fentanyl deaths among females increased 26% from 2021-2022
- In 2022, 27,254 opioid deaths in ages 25-44 group
- Heroin deaths dropped to 3,984 in 2022 from peak of 15,469 in 2016
- Natural opioid deaths stable at around 15,000 annually since 2019
- Opioid deaths in pregnancy/postpartum: 8.3 per 100,000 live births 2018-2020
- Males aged 35-44 had 55.4 opioid deaths per 100,000 in 2022
- In 2021, males had 2.5 times higher opioid death rate than females (42.8 vs 17.0)
- Non-Hispanic White opioid death rate declined 8% from 2021-2022 to 30.7 per 100,000
- Ages 12-17 opioid death rate rose 181% from 2007-2017
- In 2022, opioid deaths cost 1.02 million years of potential life lost before age 65
- 40 states saw opioid death rate increases >20% from 2020-2021
- Black opioid death rate surpassed White in 2020 at 28.1 per 100,000
Mortality Interpretation
While we might have won the battle against heroin, we are catastrophically losing the war against fentanyl's synthetic siege, a grim shift quantified not just in rising, youth-skewing death tolls, but in the stark, inequitable suffering of Black, Indigenous, and rural communities.
Prevalence
- In 2021, an estimated 5.6 million people aged 12 or older (2.0%) had an opioid use disorder (OUD) in the past year according to the National Survey on Drug Use and Health
- Approximately 9.2 million people misused prescription pain relievers in 2021, representing 3.3% of those aged 12 or older
- Heroin use disorder affected about 828,000 people aged 12 or older in 2021
- From 2012 to 2021, the rate of past-year opioid misuse among adults aged 18-25 increased from 3.3% to 4.9%
- In 2020, 2.7% of pregnant women reported prescription opioid misuse during pregnancy
- Past-year misuse of opioids was reported by 3.3% of adolescents aged 12-17 in 2021
- Among adults aged 26 or older, 3.2% had past-year OUD in 2021
- In rural areas, opioid misuse rates were 4.1% compared to 3.0% in urban areas in 2019
- Past-month opioid misuse among high school students was 1.9% in 2021 per YRBS
- In 2022, 6% of U.S. adults reported lifetime prescription opioid misuse
- Lifetime heroin use among adults aged 18+ was 1.6% in 2019 NSDUH
- Opioid use disorder prevalence among veterans is 11.4% higher than civilians
- In Appalachia, 5.2% of adults reported past-year opioid misuse in 2018-2019
- Among American Indian/Alaska Native adults, opioid misuse was 4.8% in 2021
- Past-year prescription opioid misuse declined from 4.3% in 2015 to 3.3% in 2021
- In 2021, 2.7 million adolescents aged 12-17 misused opioids in the past year
- Opioid misuse among college students was 5.1% past-year in 2020 surveys
- In states with high prescribing rates, opioid misuse prevalence was 4.5% in 2019
- Past-year OUD among those with chronic pain was 8.7% in 2019
- In 2020, 3.4% of employed adults reported past-year opioid misuse
- Opioid misuse in the LGBTQ+ community was 4.2% past-year in 2021
- Among those with mental health disorders, opioid misuse was 7.1% in 2021
- In 2019, 1.2% of U.S. population had past-year heroin use disorder
- Fentanyl-involved misuse prevalence rose 20% from 2019-2021
- In correctional facilities, opioid use disorder affects 50% of inmates
- Past-year opioid misuse among older adults 65+ was 1.8% in 2021
- In 2022, 4.0% of young adults aged 18-25 had OUD
- Opioid misuse in construction workers was 5.3% past-year in 2019
- Among healthcare workers, opioid misuse prevalence is 2.9% lifetime
- In 2021, 3.5% of U.S. adults with disabilities reported opioid misuse
Prevalence Interpretation
What emerges from these sobering statistics is a grim portrait of a nation where this crisis—far from being a monolithic plague—is a hydra with distinct, tentacled heads, each whispering a different demographic’s name and revealing that from expectant mothers to veterans, rural towns to city centers, no community is left untouched by its shadow.
Treatment
- Only 11% of people with OUD receive medications for opioid use disorder (MOUD) annually
- Buprenorphine treatment capacity covers only 30% of OUD patients needing it in 2022
- Methadone is provided to 20% of OUD patients via 1,800+ OTPs nationwide
- Retention in medication-assisted treatment (MAT) averages 50% at 6 months for buprenorphine
- Naloxone distribution prevented an estimated 26,000 opioid overdoses from 1996-2014
- In 2021, 2.3 million people aged 12+ received substance use treatment, 40% for opioids
- Telehealth opioid treatment prescriptions increased 154% during COVID-19 2020
- Behavioral therapies combined with MAT increase abstinence rates by 50-70%
- Contingency management boosts treatment retention to 75% in opioid trials
- Only 1 in 5 rural counties have an OTP for methadone in 2022
- Naltrexone extended-release reduces relapse by 17% vs placebo in trials
- SAMHSA grants funded 1,200+ new MAT providers since 2017
- Overdose education and naloxone distribution (OEND) reduces overdose mortality by 46%
- In 2020, 48 states expanded Medicaid to cover MAT for OUD
- Residential treatment completion rate for OUD: 58% within 90 days per 2021 data
- Fentanyl test strips detect illicit fentanyl in 90% of samples in harm reduction programs
- Syringe services programs (SSPs) averted 10,000+ HIV cases worth $285 million savings 2005-2010
- Long-acting buprenorphine injections retain 40% more patients at 6 months vs daily
- Peer recovery coaching improves treatment engagement by 30% in OUD studies
- X-waiver removal in 2023 increased buprenorphine prescribers by 50% potential
- MAT reduces overdose risk by 50% during treatment and 38% post-treatment
- Cognitive behavioral therapy (CBT) reduces opioid misuse relapse by 40% in trials
- Emergency department-initiated buprenorphine increases treatment linkage by 67%
- Harm reduction programs reach 40% of people who inject drugs with services
- Vivitrol (naltrexone) used by 5% of OUD patients in treatment per 2021 claims
- Outpatient treatment accounts for 75% of OUD specialty care episodes in 2021
Treatment Interpretation
While we have the tools and evidence to turn the tide of the opioid crisis—from life-saving medications to transformative policies—our systemic failure to deploy them at scale means we are fighting this war with one hand tied behind our back, watching a preventable tragedy unfold in slow motion.
Sources & References
- Reference 1SAMHSAsamhsa.govVisit source
- Reference 2NIDAnida.nih.govVisit source
- Reference 3CDCcdc.govVisit source
- Reference 4KFFkff.orgVisit source
- Reference 5VAva.govVisit source
- Reference 6NCBIncbi.nlm.nih.govVisit source
- Reference 7NIHnih.govVisit source
- Reference 8BLSbls.govVisit source
- Reference 9JOURNALSjournals.lww.comVisit source
- Reference 10ASPEaspe.hhs.govVisit source
- Reference 11USCHAMBERuschamber.comVisit source
- Reference 12AAPaap.orgVisit source
- Reference 13HEALTHAFFAIRShealthaffairs.orgVisit source
- Reference 14BROOKINGSbrookings.eduVisit source
- Reference 15RANDrand.orgVisit source
- Reference 16SHRMshrm.orgVisit source
- Reference 17JAMANETWORKjamanetwork.comVisit source
- Reference 18RURALHEALTHruralhealth.usVisit source
- Reference 19RURALHEALTHINFOruralhealthinfo.orgVisit source
- Reference 20NEJMnejm.orgVisit source