Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United States

Abstract

The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future.

Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone

“…Frequencies of dual diagnosis comorbidities (having an Axis 1 mental illness with a concurrent substance disorder) were very high in both study populations (80% to 91%, respectively). The densities and patterns of dual diagnoses comorbidities, and racial/age demographics of patients with opioid use disorders found in the present study were also consistent with several urban clinical samples and large scale epidemiological surveys,2, 7, 8, 21, 22, 23, 24, 25 indicating the present findings are likely generalizable to many addiction treatment settings. Notably, the rates of comorbid alcohol use disorders among patients with opioid use disorders found in our sample (41%) were comparable to recent population data showing that 58% of patients with opioid use disorders have 12‐month prevalence rates of alcohol abuse or dependence 25…”

“…In a population of mentally ill‐addicted patients at risk for “Adverse Selection” phenomena,14 PDMP monitoring showed that addiction and dual diagnosis treatment involving INTX objectively produced a significant decrease in exposure to prescribed opioids. This decrement was likely accompanied, to some extent that we did not measure, by reductions in costs associated with doctor's visits, medical diagnostic tests, pharmacy costs, and diversion of prescription drugs that often accompany iatrogenic opioid prescribing 7, 30, 31. These findings thus suggest a remarkable, if indirect effect of addiction treatment, beyond individual patients, on the practices of outside physicians and health care systems that may inadvertently be contributing to addictions and overdose deaths.…”

“…Although the health, economic, and social consequences of the prescription opioid epidemic are broad,7, 8 people with mental illness and non‐opioid addictions show disproportionate risk of suffering serious complications of increased access to prescription opioids 9, 10, 11, 12. Pre‐existing mental illness is major risk factor for acquisition of opioid use disorders, and non‐medical opioid use that escalates to addiction is a risk factor for onset of mental illness 13.…”

Preoperative Opioid Misuse is Associated With Increased Morbidity and Mortality After Elective Orthopaedic Surgery

“…As a result, more than 16,000 deaths per year and USD 55 billion of increased costs have been attributed to overuse of opioids [7,29]. During the last one to two decades, there has been a dramatic increase in preoperative use of opioid medications in patients undergoing elective orthopaedic surgery [14,56].…”

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

“…[12] Societal costs of abuse of prescription opioid analgesics in the USA were estimated to be $55.7 billion in 2007. [13] A recent comprehensive review of the clinical and economic burden of abuse of prescription opioid analgesics in the USA found individuals who abused prescription opioid analgesics to be more likely than non-abusers to utilize medical services, such as emergency department visits, physician outpatient visits and inpatient hospital stays. [14] Mean annual excess health-care costs for abusers of prescription opioid analgesics compared with non-abusers ranged from US$14,054 to US$20,546 for those with private insurance and from US$5874 to US$15,183 for those with Medicaid.…”