Societal Cost of Heroin Skyrockets

Megan Brooks

June 14, 2017

The societal cost of heroin use in the United States in dollars was more than $51 billion in 2015, according to a new analysis.

"The annual cost of heroin use disorder to society in the United States emphasizes the need for sustained investment in healthcare and non-healthcare related strategies that reduce the likelihood of abuse and provide care and support for users to overcome the disorder," the authors write.

The study, led pharmacoeconomists Simon Pickard, PhD, and Ruixuan Jiang, PharmD, University of Illinois at Chicago, was published online May 30 in PLOS ONE.

Heroin use in the United States has reached epidemic proportions. From 2000 to 2013, the number of heroin users doubled, rising from 1 per 1000 individuals to 2 per 1000 individuals. According to the World Drug Report 2016, published by the United Nations Office on Drugs and Crime, heroin use has reached the highest level in 20 years in the United States and is the deadliest drug worldwide.

Heroin-related overdose deaths have more than quadrupled since 2010. From 2014 to 2015, heroin overdose death rates jumped about 21%, with almost 13,000 people dying in 2015, according to the Centers for Disease Control and Prevention.

Dr Pickard, Dr Ruixuan, and colleagues created a cost-analytic model to gauge how heroin use affects society. Their analysis incorporated several variables, including the number of imprisoned heroin users and their crimes; treatment costs of heroin abuse; chronic infectious diseases contracted through heroin abuse (HIV infection, hepatitis B and C infection, and tuberculosis) and cost of treatments; the cost of treating neonatal abstinence syndrome; lost productivity at work; and heroin overdose deaths.

They found that heroin users are less productive than others, owing to several factors, including premature death; spending more time away from work because of treatment for drug dependence and for drug-related hospitalizations; and having high rates of work absenteeism and unemployment.

On average, the societal cost per heroin user per year is $50,799. With an estimated 1 million active heroin users in the United States, the total societal cost is about $51 billion a year, the authors say.

The cost per heroin user is far higher than for patients with other chronic illnesses, such as chronic obstructive pulmonary disease ($2567 per patient in 2015, or $38.5 billion for 15 million patients) and diabetes ($11,148 per patient in 2015, or $248.59 billion for 22.3 million patients), they note.

Heroin use disorder "exacts a tremendous cost to society," and this study "provides important evidence to inform policy on combating the heroin epidemic," the authors say.

"Without meaningful public health efforts, the number of heroin users is likely to continue to grow; the downstream effects of heroin use, such as the spread of infectious diseases and increased incarceration due to actions associated with heroin use, compounded by their associated costs would continue to increase the societal burden of heroin use disorder," they conclude.

The study had no commercial funding. The authors have disclosed no relevant financial relationships.

PLoS One. Published online May 30, 2017. Full text

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