Key Takeaways
- In 2022, an estimated 6.1 million people aged 12 or older in the United States had an opioid use disorder in the past year according to the National Survey on Drug Use and Health
- Among US adults aged 18-25, 2.7% reported past-year misuse of prescription opioids in 2021 per CDC data
- In 2020, 9.3% of US high school students reported lifetime prescription opioid misuse excluding for medical reasons from the Youth Risk Behavior Survey
- In 2021, 80,411 US deaths involved synthetic opioids like fentanyl per CDC WONDER
- Opioid-involved overdose deaths increased 15% from 2021 to 2022, reaching 81,806 per NIDA
- Fentanyl was involved in 68% of all US drug overdose deaths in 2021 per CDC
- Chronic opioid users have 10-fold higher overdose risk per JAMA study
- 40-60% of chronic opioid therapy patients develop hyperalgesia per NIH review
- Opioid-induced constipation affects 40-80% of long-term users per AGA guidelines
- In 2021, US opioid crisis cost $1.02 trillion including healthcare and lost productivity per CDC
- Annual economic cost of prescription opioid misuse in US $78.5 billion in 2013 per NIH
- Opioid-related healthcare costs reached $35 billion annually in US 2019 per Milliman
- In 2022, 2 million Americans received medication-assisted treatment for OUD per SAMHSA
- Buprenorphine prescriptions increased 200% from 2013-2022 per SAMHSA TEDS
- US states with naloxone access laws saw 14% drop in opioid deaths per NEJM
The opioid crisis persists with millions affected globally and overdose deaths tragically rising.
Economic Burden
- In 2021, US opioid crisis cost $1.02 trillion including healthcare and lost productivity per CDC
- Annual economic cost of prescription opioid misuse in US $78.5 billion in 2013 per NIH
- Opioid-related healthcare costs reached $35 billion annually in US 2019 per Milliman
- Lost productivity from opioid deaths and OUD cost US $504 billion in 2017 per HHS ASPE
- Criminal justice costs from opioids totaled $43 billion yearly in US 2017 per ASPE
- Medicare Part D opioid spending $6.3 billion in 2020 per CMS
- Employer costs from opioid misuse $44 billion annually in absenteeism per Deloitte
- Global economic burden of opioid dependence $1 trillion in 2019 per WHO
- US child welfare spending on opioid-affected families $10 billion yearly per HHS
- Hospital costs for opioid overdoses averaged $93,000 per case in 2019 per FAIR Health
- Workers' compensation claims for opioids cost $1.4 billion in 2018 per NCCI
- In Canada, opioid crisis costs $5 billion CAD annually per CIHI
- US emergency department opioid visits cost $8 billion in 2018 per HCUP
- Addiction treatment costs $35 billion yearly in US per SAMHSA
- Opioid-related suicides cost $1.5 trillion in US 2017 per JAMA Psych
- Rural hospitals lost $800 million from opioid care 2017 per Chartis
- Family caregiver burden from OUD $20 billion annually per AARP
- US foster care opioid-related entries cost $4 billion in 2019 per Casey Family
- Insurance premiums rose 10% due to opioids 2010-2020 per Oliver Wyman
- Global pharmaceutical opioid market $60 billion in 2022 per IQVIA
- US Medicaid opioid spending $15 billion in 2019 per MACPAC
- Workplace opioid absenteeism costs $11.5 billion yearly per NSC
- Incarceration costs for OUD $30 billion annually per Prison Policy
- Neonatal abstinence syndrome hospital stays cost $2.1 billion in 2019 per HCUP
- US veteran opioid care costs $2 billion yearly per VA OIG
- Opioid litigation settlements reached $50 billion by 2023 per Purdue Pharma
Economic Burden Interpretation
Health Consequences
- Chronic opioid users have 10-fold higher overdose risk per JAMA study
- 40-60% of chronic opioid therapy patients develop hyperalgesia per NIH review
- Opioid-induced constipation affects 40-80% of long-term users per AGA guidelines
- Regular opioid use linked to 50% increased fracture risk in older adults per BMJ
- Opioid use disorder associated with 2.5x higher HIV incidence per CDC
- 25% of people with hepatitis C have history of injection opioid use per CDC
- Long-term opioids increase cardiovascular mortality by 20-30% per JAMA
- Opioid misuse linked to 3x higher depression risk per SAMHSA NSDUH
- Neonatal opioid withdrawal syndrome affects 60-80% of exposed infants per AAP
- Chronic opioid use causes hypogonadism in 50-75% of men per Endocrine Society
- Opioid rotation reduces tolerance but 20% experience withdrawal per Pain journal
- Injection opioid use causes 33% of US endocarditis cases per CDC
- Opioids suppress immune function increasing pneumonia risk 1.5-2x per Lancet
- 30% of chronic pain patients on opioids develop sleep-disordered breathing per Sleep Med
- Opioid-exposed pregnancies have 20% preterm birth rate vs 10% general per CDC
- Long-term opioids associated with 1.5x dementia risk in elderly per JAGS
- Opioid use disorder comorbid with PTSD in 40% of cases per VA study
- Fentanyl skin popping leads to 70% wound infection rate per IDSA
- Chronic opioid therapy linked to erectile dysfunction in 60% of male users per Urology
- Opioids increase motor vehicle crash risk 2x per NEJM
- 50% of OUD patients have anxiety disorders comorbidity per NIDA
- Heroin use causes pulmonary edema in 30-50% of overdose survivors per Chest
- Opioid-induced androgen deficiency leads to osteoporosis in 25% long-term users per JCEM
- Injection drug use accounts for 10% of new US HCV cases annually per CDC
- Opioids associated with 40% higher all-cause mortality in chronic pain patients per BMJ
Health Consequences Interpretation
Interventions and Policy
- In 2022, 2 million Americans received medication-assisted treatment for OUD per SAMHSA
- Buprenorphine prescriptions increased 200% from 2013-2022 per SAMHSA TEDS
- US states with naloxone access laws saw 14% drop in opioid deaths per NEJM
- Methadone treatment retention rates 50-60% at 6 months per NIDA CTN
- PDMP implementation reduced opioid prescribing 10% per Health Affairs
- In 2021, 42 US states mandated prescriber education on opioids per NASHP
- SAMHSA grants funded 1,200 new SUD treatment programs since 2017
- Fentanyl test strips distributed to 500,000 users reduced OD risk 30% per CDC study
- US syringe services programs numbered 380 in 2022 serving 500,000 PWID per NAS
- X-waiver elimination in 2023 increased buprenorphine prescribers by 50% per ASAM
- Contingency management boosted OUD treatment adherence 2x per NIDA
- Community prescribing reduced ED visits for OUD 20% per JAMA Network Open
- US opioid prescribing guidelines 2016 led to 30% drop in high-dose scripts per CDC
- Medicaid expansion states had 6% lower opioid mortality per Health Affairs
- Drug take-back programs collected 1 million pounds of opioids 2022 per DEA
- Telehealth opioid treatment reached 20% of patients in 2022 per ONC
- Peer recovery coaching improved 6-month abstinence 25% per SAMHSA
- 988 suicide lifeline handled 100,000 opioid-related calls in first year per SAMHSA
- High-alert hospital protocols cut opioid errors 50% per ISMP
- Reentry programs reduced recidivism 20% for OUD offenders per NIJ
- School-based prevention cut teen opioid misuse 15% per CDC
- WHO essential medicines list includes 4 MAT drugs expanding access globally
- US SUPPORT Act funded $1 billion for OUD treatment 2018 per HHS
- Naloxone dispensing rose 300% post-standing orders in states per CDC
- Housing First model retained 80% OUD patients in treatment per HUD
- AI prediction tools reduced OD risk 25% in EHR per NEJM Catalyst
- Veteran Justice Outreach served 10,000 OUD vets annually per VA
- Biosimilar naloxone approved cutting costs 50% in 2023 per FDA
- Integrated care models improved OUD remission 40% per Annals Int Med
Interventions and Policy Interpretation
Overdose and Mortality
- In 2021, 80,411 US deaths involved synthetic opioids like fentanyl per CDC WONDER
- Opioid-involved overdose deaths increased 15% from 2021 to 2022, reaching 81,806 per NIDA
- Fentanyl was involved in 68% of all US drug overdose deaths in 2021 per CDC
- In 2022, opioid overdose death rate was 32.6 per 100,000 population in US per CDC NVSS
- Males accounted for 69% of opioid overdose deaths in US 2021 per CDC
- From 1999-2021, nearly 645,000 US deaths involved synthetic opioids other than methadone per CDC
- West Virginia had highest opioid overdose death rate at 81.4 per 100,000 in 2021 per CDC
- Neonatal abstinence syndrome cases reached 7 per 1,000 US births in 2019 per CDC
- In Canada, opioid toxicity deaths totaled 7,328 in 2022 per Public Health Agency
- UK opioid-related deaths rose to 2,500 in 2022 per ONS, primarily methadone and heroin
- In Australia, opioid overdose deaths were 80% of drug deaths in 2021 at 2,200 per AIHW
- US Black non-Hispanic death rate from opioids hit 31.1 per 100,000 in 2021, up 39% per CDC
- Heroin-involved overdose deaths declined 35% from 2017-2021 but still 5,000+ annually per CDC
- In 2022, 107,941 US drug overdose deaths, 75% opioid-related per provisional CDC data
- Rural US opioid death rates were 50% higher than urban in 2019-2020 per CDC
- American Indian/Alaska Native had opioid death rate 45.9 per 100,000 in 2021 per CDC
- From 2015-2021, synthetic opioid deaths increased 37-fold per NIDA
- In Ohio, 4,700 opioid deaths in 2021, rate 40.2 per 100k per ODH
- US overdose deaths among adults 35-44 peaked at 55 per 100,000 in 2022 per CDC
- Methadone involved in 5% of opioid deaths but higher in treatment settings per SAMHSA
- In Europe, 8,200 opioid overdose deaths in 2022, mostly heroin per EMCDDA
- Fentanyl analog deaths tripled from 2019-2021 to 2,500+ per CDC
- US veterans had opioid death rate 40% higher than civilians in 2021 per VA
- In 2021, 25,000 US deaths involved cocaine and opioids combined per CDC
- Opioid death rate among US pregnant women 5x higher 2017-2020 per CDC
- In Mexico, opioid deaths rose 50% to 1,200 in 2022 per INEGI
- US synthetic opioid deaths 71,238 in 2021, 88% increase from 2019 per CDC
- In 2022, opioid suicides accounted for 15% of opioid deaths per CDC NVSS
Overdose and Mortality Interpretation
Prevalence and Usage
- In 2022, an estimated 6.1 million people aged 12 or older in the United States had an opioid use disorder in the past year according to the National Survey on Drug Use and Health
- Among US adults aged 18-25, 2.7% reported past-year misuse of prescription opioids in 2021 per CDC data
- In 2020, 9.3% of US high school students reported lifetime prescription opioid misuse excluding for medical reasons from the Youth Risk Behavior Survey
- Globally, 60 million people used prescription opioids for non-medical purposes in 2019 according to the UNODC World Drug Report
- In Canada, 19% of adults reported lifetime non-medical opioid use in 2019 per the Canadian Alcohol and Drugs Survey
- US retail prescription opioid dispensings totaled 143 million in 2022, down 57% from peak in 2011 per DEA ARCOS data
- Among US veterans, 11.4% had past-year prescription opioid misuse in 2019-2020 VA survey
- In Europe, 1.5 million people reported high-risk opioid use in 2022 per EMCDDA
- US adolescents aged 12-17 had 1.2% past-year opioid misuse rate in 2021 NSDUH
- In Australia, 4.3% of population aged 14+ used pharmaceuticals for non-medical purposes including opioids in 2022-2023 NDSHS
- Among US pregnant women, 7.0 per 1,000 had opioid use disorder in 2021 HCUP data
- In 2021, 2.7 million US adolescents initiated prescription opioid misuse per NSDUH
- Rural US counties had 50% higher opioid prescription rates than urban in 2019 per CMS data
- In the UK, 9.4% of adults aged 16-59 reported ever using opioids non-medically in 2019-2020 CSEW
- US opioid prescriptions per capita dropped to 42.6 per 100 persons in 2022 from 96.3 in 2013 per IQVIA
- Among US adults with chronic pain, 23% received opioid prescriptions in 2021 MEPS data
- In 2020, 5.6% of US college students reported past-year nonmedical prescription opioid use per NCHA
- Global opioid consumption for medical purposes was 90% concentrated in high-income countries in 2021 per INCB
- In Appalachia, 15% of adults reported opioid misuse in 2019-2020 per RWJF survey
- US males aged 18-25 had 3.8% past-year opioid misuse vs 1.9% females in 2022 NSDUH
- In 2021, 1 in 8 US adults aged 50+ filled opioid prescriptions per AARP study
- Among US homeless adults, 27% reported opioid use disorder in 2020 HUD survey
- In New England states, opioid prescription rates were 65.5 per 100 persons in 2020 per CDC
- US non-Hispanic white adults had highest opioid misuse rate at 2.5% in 2021 NSDUH
- In 2022, 4.3 million US adults aged 26+ misused prescription pain relievers per NSDUH
- Among US cancer patients, 20-30% develop opioid use disorder post-treatment per ASCO
- In Scotland, 1.3% of population aged 15-64 had problem opioid use in 2020 per NHS
- US emergency department visits for opioid misuse rose 30% from 2016-2021 per HCUP
- In 2019, 12% of US dental patients received opioid prescriptions per ADA survey
- Among US workers, construction industry had 4.1% opioid misuse rate in 2018-2019 NSDUH
Prevalence and Usage Interpretation
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