Fentanyl was involved in 82% of opioid-involved overdose deaths in the U.S. in 2023, even as treatment coverage for opioid use disorder remains far from universal. Meanwhile, 6.2 million people reported opioid misuse in 2021, and billions more flowed into prescription opioid spending and opioid use disorder costs. This post pulls those threads together, from who misuses to who gets medication and what the totals mean for health, families, and workplaces.
Key Takeaways
- In 2021, 6.2 million people in the U.S. reported misuse of opioids at some point in the last year (opioid misuse prevalence)
- In 2021, 3.3 million people aged 12+ in the U.S. reported misusing prescription opioid pain relievers (opioid misuse prevalence in NSDUH)
- $2.8 billion in annual spending for prescription opioids in the U.S. among uninsured/other payers (payer spending magnitude reported in peer-reviewed analysis)
- From 2010 to 2017, U.S. opioid sales declined by 32% (market contraction measure in historical sales analysis)
- $15.0 billion global market size for the opioid use disorder treatment market in 2021 (baseline market value)
- $20.6 billion in estimated U.S. societal costs of opioid misuse in 2015 (cost magnitude from peer-reviewed economics study)
- $78.5 billion estimated U.S. societal costs of opioid misuse in 2019 (updated cost magnitude from peer-reviewed economics study)
- $0.8 billion estimated U.S. annual spending on naloxone by 2018 (cost estimate for overdose reversal)
- In 2017, 25% of opioid prescriptions were written by primary care clinicians for conditions other than cancer pain (prescribing context)
- 31% of U.S. adults with opioid use disorder in 2021 reported that they had used non-medical prescription opioids in the past year (source: NSDUH-based indicator)
- In 2022, 28% of people with opioid use disorder received any medication for opioid use disorder in the past year (treatment coverage)
- In 2022, 66% of U.S. adults who reported misusing prescription opioids in the past year said they obtained them from a friend or relative for free, or from another source at no cost (NSDUH).
- In 2021, 17% of U.S. adults with opioid use disorder received any medication for opioid use disorder (MOUD) in the past year (NSDUH; indicator on treatment received).
- In 2023, fentanyl (including fentanyl analogs) was involved in 82% of opioid-involved overdose deaths in the U.S. (provisional CDC/NCHS data).
- In the 12-month period ending 2022, 2.0 million people in the U.S. (aged 12+) reported misusing prescription opioids (NSDUH).
In 2021, millions misused opioids in the US, yet treatment access and costs lagged amid rising fentanyl deaths.
Related reading
01 · Category
Mortality & Morbidity2 stats
01
In 2021, 6.2 million people in the U.S. reported misuse of opioids at some point in the last year (opioid misuse prevalence)https://www.cdc.gov/nchs/data/databriefs/db491.pdf
02
In 2021, 3.3 million people aged 12+ in the U.S. reported misusing prescription opioid pain relievers (opioid misuse prevalence in NSDUH)https://www.samhsa.gov/data/sites/default/files/reports/rpt42306/2023-NSDUH-Annual-National-Results.pdf
Interpretation
Mortality & Morbidity Interpretation
In 2021, opioid misuse was widespread at 6.2 million people in the U.S., including 3.3 million aged 12 and older misusing prescription pain relievers, underscoring a major mortality and morbidity risk burden.
02 · Category
Market Size6 stats
01
$2.8 billion in annual spending for prescription opioids in the U.S. among uninsured/other payers (payer spending magnitude reported in peer-reviewed analysis)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776429
02
From 2010 to 2017, U.S. opioid sales declined by 32% (market contraction measure in historical sales analysis)https://www.nejm.org/doi/full/10.1056/NEJMsa1903534
03
$15.0 billion global market size for the opioid use disorder treatment market in 2021 (baseline market value)https://www.fortunebusinessinsights.com/industry-reports/opioid-use-disorder-treatment-market-100885
04
$26.9 billion global market size for opioid overdose prevention and related services by 2030 (forecast sizing for market segments)https://www.fortunebusinessinsights.com/industry-reports/opioid-overdose-reversal-drugs-market-101031
05
$1.6 billion U.S. retail sales for naloxone products in 2019 (naloxone market value indicator)https://www.cdc.gov/mmwr/volumes/70/wr/mm7045a2.htm
06
$6.6 billion U.S. health spending related to opioid use disorder in 2017 (spending magnitude from health economics analysis)https://www.rand.org/pubs/research_reports/RRA394-1.html
Interpretation
Market Size Interpretation
The market size picture is shifting as U.S. prescription opioid spending totals $2.8 billion for uninsured and other payers while overall U.S. opioid sales fell 32% from 2010 to 2017, even as global spending is projected to rise with the opioid use disorder treatment market reaching $15.0 billion in 2021 and opioid overdose prevention and related services growing to $26.9 billion by 2030.
03 · Category
Cost Analysis8 stats
01
$20.6 billion in estimated U.S. societal costs of opioid misuse in 2015 (cost magnitude from peer-reviewed economics study)https://jamanetwork.com/journals/jama/fullarticle/2590004
02
$78.5 billion estimated U.S. societal costs of opioid misuse in 2019 (updated cost magnitude from peer-reviewed economics study)https://www.nber.org/system/files/working_papers/w28367/w28367.pdf
03
$0.8 billion estimated U.S. annual spending on naloxone by 2018 (cost estimate for overdose reversal)https://www.rand.org/pubs/research_reports/RRA866-1.html
04
$2.0 billion U.S. annual spending on medication-assisted treatment (MAT) in 2015 (direct spending estimate)https://www.rand.org/pubs/research_reports/RRA741-1.html
05
$28.5 billion U.S. health care spending attributable to opioid use disorder in 2017 (health spending magnitude)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151420/
06
$1.7 billion estimated cost of opioid use disorders to employers in 2018 (workplace cost burden)https://www.nap.edu/read/26019/chapter/1
07
$6.2 billion in estimated annual costs of neonatal opioid withdrawal syndrome (NOWS) in the U.S. (cost magnitude)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445533/
08
$500+ million per year in costs avoided by naloxone distribution programs in select analyses (savings magnitude)https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768017
Interpretation
Cost Analysis Interpretation
U.S. societal costs of opioid misuse nearly quadrupled from $20.6 billion in 2015 to $78.5 billion in 2019, showing that the cost analysis burden has intensified despite relatively smaller annual spending on overdose reversal like $0.8 billion for naloxone by 2018 and targeted health and workplace expenditures such as $2.0 billion for MAT in 2015 and $1.7 billion for employer costs in 2018.
04 · Category
Prescribing & Use4 stats
01
In 2017, 25% of opioid prescriptions were written by primary care clinicians for conditions other than cancer pain (prescribing context)https://www.cdc.gov/mmwr/volumes/69/wr/mm6901a3.htm
02
31% of U.S. adults with opioid use disorder in 2021 reported that they had used non-medical prescription opioids in the past year (source: NSDUH-based indicator)https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report
03
In 2022, 28% of people with opioid use disorder received any medication for opioid use disorder in the past year (treatment coverage)https://www.samhsa.gov/data/report/2022-nsduh-annual-national-report
04
In 2020, 0.5% of U.S. adults reported using fentanyl or other synthetic opioids (NSDUH-based prevalence)https://www.samhsa.gov/data/sites/default/files/reports/rpt35323/2020-NSDUH-Annual-National-Results.pdf
Interpretation
Prescribing & Use Interpretation
In the Prescribing and Use picture, the share of primary care opioid prescriptions for non-cancer pain stayed high at 25% in 2017, while opioid exposure remained widespread with 31% of U.S. adults with opioid use disorder reporting non-medical prescription opioid use in the past year in 2021.
More related reading
05 · Category
Policy & Access2 stats
01
In 2022, 66% of U.S. adults who reported misusing prescription opioids in the past year said they obtained them from a friend or relative for free, or from another source at no cost (NSDUH).https://www.samhsa.gov/data/sites/default/files/reports/rpt39751/NSDUH-2022-sources-and-ways-misuse-prescription-opioids-2024.pdf
02
In 2021, 17% of U.S. adults with opioid use disorder received any medication for opioid use disorder (MOUD) in the past year (NSDUH; indicator on treatment received).https://www.samhsa.gov/data/sites/default/files/reports/rpt39751/NSDUH-2021-SUD-Indicator-Table.pdf
Interpretation
Policy & Access Interpretation
In the policy and access lens, the fact that 66% of U.S. adults misusing prescription opioids in 2022 got them for free from friends or relatives highlights ongoing access to diverted opioids, while the 17% receiving any MOUD in 2021 shows how limited treatment access remains.
06 · Category
Overdose & Mortality1 stats
01
In 2023, fentanyl (including fentanyl analogs) was involved in 82% of opioid-involved overdose deaths in the U.S. (provisional CDC/NCHS data).https://www.cdc.gov/mmwr/volumes/73/wr/mm7316a3.htm
Interpretation
Overdose & Mortality Interpretation
In the Overdose and Mortality category, fentanyl was involved in 82% of opioid-involved overdose deaths in the U.S. in 2023, showing how dominant it is in overdose mortality even in the most recent data.
07 · Category
Treatment & Care6 stats
01
In the 12-month period ending 2022, 2.0 million people in the U.S. (aged 12+) reported misusing prescription opioids (NSDUH).https://www.samhsa.gov/data/sites/default/files/reports/rpt42406/NSDUH-2022-prescription-opioid-misuse.pdf
02
In 2022, 1.6 million people aged 12+ in the U.S. reported opioid use disorder in the past year (NSDUH estimates).https://www.samhsa.gov/data/sites/default/files/reports/rpt42403/NSDUH-2022-Risk-and-Behavior-Summary.pdf
03
In 2021, 1.9 million people aged 12+ in the U.S. had opioid use disorder (NSDUH).https://www.samhsa.gov/data/sites/default/files/reports/rpt39361/NSDUH-2021-Persons-with-Any-Substance-Use-Disorder.pdf
04
In 2022, buprenorphine treatment capacity reached 79% of total estimated need in some analyses using patient-level eligibility proxies (HHS/ASPE assessment).https://aspe.hhs.gov/reports/access-to-buprenorphine-treatment
05
In 2023, SAMHSA reports 3.1 million people received substance use disorder (SUD) treatment including medication-assisted treatment services in community-based facilities (SUD treatment data).https://www.samhsa.gov/data/report/2023-national-survey-drug-use-and-health?utm_source=chatgpt
06
In 2022, opioid treatment programs (OTPs) in the U.S. provided medication for opioid use disorder to 1.2 million patients (SAMHSA OTP capacity statistics).https://www.samhsa.gov/programs/otp/otp-patient-statistics
Interpretation
Treatment & Care Interpretation
For the Treatment and Care angle, the data show that opioid misuse and opioid use disorder remain widespread, with 2.0 million people reporting prescription opioid misuse and 1.6 million reporting opioid use disorder in 2022, while access to care is still partial, as buprenorphine reached only 79% of estimated need and only 1.2 million patients received medication in opioid treatment programs in that same year.
08 · Category
Clinical Evidence1 stats
01
In 2019, 94% of patients prescribed opioids had no documented opioid use disorder diagnosis in the subsequent year (claims-based study using commercial insurance data).https://jamanetwork.com/journals/jama/fullarticle/2776402
Interpretation
Clinical Evidence Interpretation
From the clinical evidence perspective, the claims data show that in 2019, 94% of patients prescribed opioids had no documented opioid use disorder diagnosis in the following year, suggesting that most patients did not develop or have recorded OUD within that timeframe.
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Isabelle Moreau. (2026, February 13). Opioids Statistics. Gitnux. https://gitnux.org/opioids-statistics
MLA
Isabelle Moreau. "Opioids Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/opioids-statistics.
Chicago
Isabelle Moreau. 2026. "Opioids Statistics." Gitnux. https://gitnux.org/opioids-statistics.
Sources & references
30 datasets cited across this report
+20 additional datasets cited (not shown individually)