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A Look At The Costs From The Opioid Epidemic


The opioid epidemic is expensive. There are the cost of treatment programs. There's the cost of overdose deaths. We've asked NPR's Selena Simmons-Duffin to help us understand the numbers.

Welcome to the program.


CORNISH: So give us more context. What's the data on the costs of the epidemic?

SIMMONS-DUFFIN: Well, you've heard the statistics about the epidemic as a whole, but they bear repeating. Around 70,000 people die every year from drug overdose deaths. That's more than the Americans killed in the Vietnam War. Almost 1 in every 3 people in the U.S. knows someone with an opioid addiction according to an NPR/Ipsos poll from earlier this year.

And there are a lot of expenses associated with the epidemic, not just because treatment for people with addiction is expensive, but because of all sorts of other costs to society. There are direct costs as you mentioned, but then there are also costs like foster care and criminal justice and the cost to special education, the cost of emergency room visits when somebody overdoses. It's extremely expensive. And you can even think about the lost productivity from people who have opiate addictions and the costs of lost wages. If you add all of that up, one estimate last year put the cost to the country overall at over a trillion dollars since the early 2000s, and that's not even looking forward at what it's going to cost in the future.

CORNISH: So $1 trillion is one estimate of what the epidemic has cost so far. What about the cost of actually trying to fix it?

SIMMONS-DUFFIN: Earlier this week, as an example, Oklahoma had a judgment in its own legal case against a drugmaker - that was Johnson and Johnson. In that case, the judge put the cost of abating the crisis in Oklahoma for one year at $570 million. And that's Oklahoma. That's not a very populous state. And to mitigate the crisis, we need to fund programs for much longer than one year. Addiction is often talked about as a chronic condition. And for each individual affected, they might require long-term care.

And then there's the question of how this money would be distributed and whether it would actually go to these expensive efforts.

CORNISH: Right. There have been people who look to the tobacco settlements that the states made in the late '90s and say look; that was an example of what not to do. Why?

SIMMONS-DUFFIN: Well, yes, I think that's the closest analogue we have to this litigation and the money that could come to states if a settlement is reached here. In that case, it was about $200 billion over 25 years. And there are a lot of criticisms now that the money was used for all sorts of things that had nothing to do with smoking cessation, which was kind of the idea with the settlement.

A lot of experts in addiction treatment and advocates are worried there would be nothing preventing states from putting money in their general fund and using them for roads and schools and whatever else they think needs more money. And if it were earmarked for opioid treatment and related programs, the infrastructure to use this money on evidence-based treatment and get it to the people who need it is really not there right now.

CORNISH: One more thing about this - we've been talking about the amount that drugmakers might end up paying. Could taxpayers end up bearing some of the costs as well?

SIMMONS-DUFFIN: Yes. Basically, yes. The taxpayers will probably be paying for the costs of mitigating this crisis. And there's bipartisan legislation out there - it's called the CARE Act, the Comprehensive Addiction Resources Emergency Act of 2019 - that would provide $100 billion for the opioid crisis over 10 years. And that would be coming from taxpayers if something like that were to pass. Community groups that are dealing with the epidemic now say they're desperate for substantial and sustainable funding, which a law like that would provide.

There is this sense that drugmakers played a role in creating this mess and they should pay to clean it up. One public health researcher I talked to today said listen; taxpayers are already paying for the opioid crisis. It's here. It would be cheaper and better for society in all sorts of other ways to fund programs to try to fix the crisis rather than just keep paying for the waste that is costing us already.

CORNISH: That's NPR's Selena Simmons-Duffin.

Selena, thank you.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.