The Financial Costs of the Opioid Epidemic

A new CDC report delivers a state-by-state economic breakdown that has the potential to trigger a more targeted response

By Jenny Diedrich

May 4, 2021

Alarm bells sounded when the Centers for Disease Control and Prevention (CDC) released a report earlier this year stating that the total financial cost of the opioid epidemic in 2017 was $1.02 trillion. A new CDC report that breaks down the 2017 snapshot by states adds more context to the picture, creating an opportunity for a targeted response.

“[The] estimated costs of opioid use disorder [OUD] and fatal opioid overdose and their per capita costs at the state level can assist federal and state decision makers in understanding the magnitude of opioid use disorder and fatal opioid overdose in their jurisdictions,” the report reads. “Federal and state public health agencies can use these data to help guide decisions regarding research, prevention and response activities, and resource allocation.”

Or as Courtney Hunter, vice president of state policy for the addiction nonprofit Shatterproof, puts it: “The states have massive control over programs and services that will impact people with OUD. There’s an important corollary between the dollars coming out of the state level and this snapshot.”

Actionable information on how individual states have been affected economically can assist with resource allocation as soon as 2022. An infusion of state-based dollars is expected through increased federal State Opioid Response grants and opioid settlement dollars from litigation against opioid manufacturers, distributors and pharmacies.

The states have massive control over programs and services that will impact people with OUD. There’s an important corollary between the dollars coming out of the state level and this snapshot.”—Courtney Hunter, vice president of state policy for Shatterproof

Opioid Financial Costs by States

The CDC’s report analyzes the economic costs of opioid use disorder (OUD) and fatal opioid overdose in 38 states and the District of Columbia. Generally, the highest per capita combined costs (OUD-fatal opioid overdose) were in states in the Ohio Valley and in New England. Specifically, West Virginia got absolutely walloped, with the heftiest per capita combined cost ($7,247) of any state measured. In a May 2 article in The Wall Street Journal, Tim Craft, who heads a ministry in West Virginia that assists with addiction, said, “Painkillers became so easy to get [in the state], it almost became cultural.”

After West Virginia, the states with the biggest per capita combined price tags were: Ohio ($6,226), New Hampshire ($5,953), Kentucky ($5,491), Massachusetts ($5,381), Maine ($5,099), Maryland ($4,884) and Connecticut ($4,800).

Figures were lower in states in the West, Midwest and South. Hawaii had the lowest per capita combined cost ($1,204) of all states, followed by Minnesota ($1,509), California ($1,566), Wyoming ($1,701), Texas ($1,736), Iowa ($1,952), Georgia ($1,992) and Mississippi ($2,199).

Do Opioid Financial Costs Provide a Full Picture?

Hard as it might be to swallow, the CDC report, based on statistics from 2017, likely paints a relatively rosy picture. Today’s economic figures are almost certain to be far larger. In fact, another recent CDC report estimates that there were more than 87,000 overdose deaths in the 12-month period ending in September 2020. That’s the highest one-year total since the opioid epidemic took hold in the early 1990s.

“The scope in the landscape of the drug crisis is completely different than it was four years ago. That’s how quickly it’s changing,” Shatterproof’s Hunter says. “Because this is 2017 data, the toll now is greater. The past year had the highest number on record—almost 90,000 who died of drug overdoses. I suspect that will continue to grow with fentanyl lacing everything. The toll that fentanyl has taken is significant and very concerning.”

opioid epidemic
Beating the opioid epidemic depends on viewing addiction as a whole.

The key to ending the opioid epidemic, says Hunter, is to view it through a wider lens. Measuring the broader toll of addiction, rather than focusing on specific substances such as opioids, is critical because many people with substance use disorder (SUD) are using more than one substance.

“We really should be pushing our federal agencies to look at addiction [overall],” Hunter says. “What is the toll of addiction, not opioid use disorder? I suspect that opioids have fueled the crisis, but it is an addiction epidemic and not just an opioid epidemic.”

Top photo: Jp Valery; bottom photo: Michael Longmire