The DOI matches its Crossref record; 33 of the 38 references it cites were found in a registry or an index; 11 of the 22 sources its claims cite were checked for support.
The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017
Open accessAbstract
Background The United States (U.S.) is experiencing an ongoing opioid crisis. Economic burden estimates that describe the impact of the crisis are needed when considering federal and state resources devoted to addressing overdoses. In this study, we estimate the societal costs for opioid use disorder and fatal overdose from all opioids in 2017. Methods We estimated costs of fatal overdose from all opioids and opioid use disorder based on the incidence of overdose deaths and the prevalence of past-year opioid use disorder for 2017. Incidence of fatal opioid overdose was obtained from the National Vital Statistics System; prevalence of past-year opioid use disorder was estimated from the National Survey of Drug Use and Health. Costs were estimated for health care, criminal justice and lost productivity. Costs for the reduced quality of life for opioid use disorder and life lost due to fatal opioid overdose were valued using U.S. Department of Health and Human Services guidelines for valuing reductions in morbidity and mortality. Results Costs for opioid use disorder and fatal opioid overdose in 2017 were estimated to be $1.02 trillion. The majority of the economic burden is due to reduced quality of life from opioid use disorder and the value of life lost due to fatal opioid overdose. Conclusions These estimates can assist decision makers in understanding the magnitude of opioid use disorder and fatal overdose. Knowing the magnitude and distribution of the economic burden can inform public policy, clinical practice, research, and prevention and response activities.
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Claims the paper makes
19 Own result · 13 Own method · 6 Own interpretation · 5 Supported · 5 Sources not found · 3 Partly supported · 2 Supported so far · 1 Couldn’t confirm · 1 No full text of the sources · 1 Not checked yet · accuracy not yet measured
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, the population requiring treatment has been estimated to be much larger than the current treatment capacity (Jones et al., 2015).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
What the sources say
- Supportedcites Jones et al., 2015 sourceExperimental — accuracy not yet measured
The Discussion reports that, in the United States in 2012, treatment need exceeded even maximum potential opioid agonist medication-assisted treatment capacity by nearly 1 million people. This directly supports the citing sentence’s comparison, though the paper measures capacity specifically for this form of treatment. (LLM, conf=0.93)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Naloxone distribution programs have been shown to reduce opioid mortality rates (Walley et al., 2013).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
What the sources say
- Supportedcites Walley et al., 2013 source
The Discussion (‘What this study adds’) states that opioid overdose death rates were lower in communities where overdose education and naloxone distribution was implemented than in communities where it was not. The paper describes this as observational evidence, rather than proof from a randomized trial. (LLM, conf=0.92)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“This is a change from previously published estimates, where a large share of costs was attributable to opioid use disorder (Birnbaum et al., 2011; Florence et al., 2016; Rice et al., 2014).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
What the sources say
- Not checked — no full text of the sourcecites Birnbaum et al., 2011 source
- Supportedcites Florence et al., 2016 source
The Results section reports that almost two-thirds of the estimated $78.5 billion in prescription-opioid-related costs were for health care, substance abuse treatment, and lost productivity in nonfatal cases. The paper estimates those nonfatal costs using the prevalence of opioid abuse and dependence, supporting the claim that a large share was attributable to OUD. (LLM, conf=0.91)
- Not checked — no full text of the sourcecites Rice et al., 2014 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“These HRQOL weights are based on a survey of 1,178 participants from the US population to assess the reduction in quality of life based on whether or not a person with opioid use disorder was currently using opioids either by injection or prescription opioid misuse”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Valuation of Lost Quality of Life and Life Lost
What the sources say
- Partly supportedcites Wittenberg et al., 2016 sourceExperimental — accuracy not yet measured
The Results report 1,178 respondents in the individual-focused survey, which assessed opioid-misuse health states. But the survey had 2,054 respondents overall, and the Methods (Study design) say responses from the 876-person spouse-spillover version also supplemented the individual utility data. Thus 1,178 is not the full survey sample underlying the weights. Page numbers are unavailable in our copy. (LLM, conf=0.88)
plainn = 1,178- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Using and alternative source of health care cost data has the smallest impact on the estimates (from $1,020.7 billion to $1,020.9 billion).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Costs for opioid use disorder and fatal opioid overdose in 2017 were estimated to be $1.02 trillion.”
- Also stated in: § Results · hedged
“The overall economic burden totaled approximately $1,020.7 billion (95% PI $967.2 to $1,075.7 billion) in 2017.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Abstract > Results:
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The sum of health care, criminal justice, lost productivity, and HRQOL/VSL valuations captures the total societal economic burden of OUD and fatal opioid overdose.
- Also stated in: § Results · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Slightly more than one-half of the cost is associated with fatal overdoses.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Lost productivity, for individuals with opioid use disorder ($23.5 billion) and fatal opioid overdose ($68.7 billion), together accounts for over $92 billion.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Lost productivity, for individuals with opioid use disorder ($23.5 billion) and fatal opioid overdose ($68.7 billion), together accounts for over $92 billion.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By far the largest components of the overall economic burden, however, are the value of reduced quality of life from opioid use disorder ($390.0 billion) and life lost to opioid overdose ($480.7 billion).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The general-purpose VSL and VSLY values from HHS guidelines reflect the U.S. population's willingness to pay to prevent opioid overdose deaths and morbidity.
- It may state two separate claims as one. 16
- Probably not a substantial claim. 15
- The quote only partly states this claim. 1
Every source the paper cites for this claim was checked and supports it.
In the paper
“Mandatory provider review of prescription drug monitoring programs before prescribing opioids and laws that govern the ownership and operation of pain clinics have been shown to reduce the amount of opioids prescribed and prescription overdose death rates (Dowell et al., 2016).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
What the sources say
- Supportedcites Dowell et al., 2016 source
The Abstract reports that combined implementation of mandatory PDMP review and pain clinic laws reduced opioid amounts prescribed by 8 percent and prescription opioid overdose death rates by 12 percent. The Study Data and Methods section describes pain clinic laws as governing clinic ownership and operation. The Discussion cautions that the study could not determine which policy drove the observed changes; the citing sentence attributes the result to the policies together. (LLM, conf=0.93)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“We also only value lost HRQL for individuals with opioid use disorder. There is likely a substantial reduction in quality of life for friends and family members who care for loved with use disorder, and lose loved ones to overdose (Wittenberg et al., 2016).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
What the sources say
- Partly supportedcites Wittenberg et al., 2016 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The original source study used a matched case-control design to estimate the impact of opioid use disorder diagnoses on health care spending.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Health Care Costs
What the sources say
- Supportedcites Florence et al., 2016 source
The Methods > Health Care Costs section explicitly says the study used a matched case-control design to estimate the impact of opioid abuse diagnoses on health care spending. It also describes comparing costs for patients diagnosed with abuse or dependence against matched comparison patients. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Finally, previous research has shown that both fatal opioid overdose (Ruhm, 2017) and opioid use disorder (Barocas et al., 2018) is likely undercounted in the data sources we used.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Sensitivity Analysis
What the sources say
- Not checked — no full text of the sourcecites Ruhm, 2017 source
- Supportedcites Barocas et al., 2018 source
Barocas et al. is cited for the OUD portion of the sentence, not the fatal-overdose portion. The Discussion reports that fewer than 50% of people with OUD were known to the health care system and that estimates based only on known cases were nearly half the capture–recapture estimates. Page numbers are not supplied in our copy. (LLM, conf=0.93)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Opioid use disorder can be undercounted because the NSDUH surveys the noninstitutionalized population, which will exclude incarcerated persons. The homeless population will also likely be missed by household-based surveys.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Sensitivity Analysis
What the sources say
- Partly supportedcites Barocas et al., 2018 sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) says survey-based approaches can underreport OUD and reports prevalence estimates higher than national estimates. It does not say that NSDUH excludes incarcerated people or that household surveys likely miss homeless people; searches for those survey-population claims found no supporting passage. (LLM, conf=0.83)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Both of these populations have been shown to have high rates of substance use disorder (Barocas et al., 2018).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Sensitivity Analysis
What the sources say
- Could not verifycites Barocas et al., 2018 sourceExperimental — accuracy not yet measured
The Methods describe identifying opioid use disorder in linked Massachusetts databases, and the Discussion reports prevalence by county and age group. Neither section reports substance use disorder rates specifically among incarcerated or homeless people; searches for “incarcerated” and “homeless” found no relevant passage. (LLM, conf=0.76)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
Every source the paper cites for this claim was checked and supports it.
In the paper
“Matching controlled for basic demographic variables, health status was matched based on the Charlson comorbidity index and health care costs prior to use disorder diagnosis, and regression models controlled for skewness in the expenditure data.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Health Care Costs
What the sources say
- Supportedcites Florence et al., 2016 source
The Methods > Health Care Costs section says propensity-score matching included age, sex, baseline health care costs, and the Charlson comorbidity index. It also says nonlinear regression models accounted for skewed health care expenditure data. The preceding Methods passage identifies the matching baseline as the six months before the diagnosis index date; page numbers are not available in our copy. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Slightly less than half of these costs were attributable to opioid use disorder ($471.0 billion (95% PI $417.8 to $525.7billion)).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The sum of health care, criminal justice, lost productivity, and HRQOL/VSL valuations captures the total societal economic burden of OUD and fatal opioid overdose.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our results are most sensitive to the choice of values for the VSL and VSLY. At the low estimate of a VSL/VSLY from the HHS guidelines, the overall economic burden is $556.0 billion, and at the high value of the VSL/VSLY, the overall burden is over $1,480.4 billion.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The general-purpose VSL and VSLY values from HHS guidelines reflect the U.S. population's willingness to pay to prevent opioid overdose deaths and morbidity.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“These costs are also only estimated for diagnosed cases of opioid use disorder in persons age 12+, so we do not estimate costs to other persons, such as in the case of neonatal abstinence syndrome.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Criminal justice costs were apportioned from government budget data and may not reflect the costs of all criminal justice activity related to opioids.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Medication-assisted treatment for opioid use disorder has been shown to reduce the rate of opioid misuse among patients with opioid use disorder and the rate of fatal opioid overdose (Mattick et al., 2009, 2014; Schwartz et al., 2013).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
What the sources say
- Not matchedcites Mattick et al., 2009, 2014
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites Schwartz et al., 2013 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Health care costs were estimated with a convenience sample of health insurers and public insurance beneficiaries and may not be representative of the U.S. population.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
hedged- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We then conducted a simulation with 10,000 replications and report a 95% prediction interval [PI] that is at the 2.5% and 97.5% cutoffs of the distribution of estimates in the simulation.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Sensitivity Analysis
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Calculation of the economic burden in this study uses data from a variety of sources, so it is not possible to directly estimate a traditional confidence interval for the estimates.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Sensitivity Analysis
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“This is a broader range of outcomes, and a more comprehensive estimate, than the most recent studies (Davenport et al., 2019).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
What the sources say
- Not matchedcites Davenport et al., 2019
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Many of the cost estimation methods used methods from a previous study, so the limitations of that study are also present in these results.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The resulting cost estimate is the increase in annual health care costs associated with opioid use disorder.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Health Care Costs
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This includes all opioid-related overdose deaths regardless of intent (intentional, unintentional, homicide, or undetermined).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Overview
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“However, the guidelines provide consensus estimates of a VSL, discounted to present value at a rate of 3%.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Valuation of Lost Quality of Life and Life Lost
What the sources say
- Not matchedcites Office of the Assistant Secretary for Planning and Evaluation, 2016
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Survey weights were used to estimate nationally representative population totals for cases of opioid use disorder.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Overview
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The NSDUH is a nationally representative sample of the U.S. civilian noninstitutionalized population ages 12 and older.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Overview
What the sources say
- Not matchedcites Center for Behavioral Health Statistics and Quality, 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite these limitations, these estimates provide an up-to-date understanding of the overall economic impact of the crisis.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We use these alternative measures as a sensitivity analysis, and not as our primary results, because both instruments lacks specificity to the condition being studied, and the populations studied were limited to subsets of the population of persons with opioid use disorder (e.g. only those who use heroin).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Sensitivity Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The guidelines recommend using measures of lost quality of life and the VSL that are specific to the outcome being analyzed, when feasible. The rationale for this is that the preferences of the U.S. population for reducing the risk of morbidity and mortality may differ by the cause and population affected.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Valuation of Lost Quality of Life and Life Lost
What the sources say
- Not matchedcites Office of the Assistant Secretary for Planning and Evaluation, 2016
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A primary limitation of our methodology is that we only measure the cost of opioid use disorder in a single year.”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“The survey collects detailed information on substance use, including a questionnaire that identifies opioid use disorder (opioid abuse or dependence) based on questions similar to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (American Psychiatric Association, 1994).”
§ The Economic Burden of Opioid Use Disorder and Fatal Opioid Overdose in the United States, 2017 > Methods > Overview
What the sources say
- Not matchedcites American Psychiatric Association, 1994
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
The paper relies on this without support.
The general-purpose VSL and VSLY values from HHS guidelines reflect the U.S. population's willingness to pay to prevent opioid overdose deaths and morbidity.
“We did not have a VSL value specific to the willingness to pay to prevent an opioid overdose death and instead used a general-purpose set of values based on results from studies that examined the value of risk reduction over a diverse set of risks.”
The paper relies on this without support.
The sum of health care, criminal justice, lost productivity, and HRQOL/VSL valuations captures the total societal economic burden of OUD and fatal opioid overdose.
“Our total valuation of economic burden of opioid use disorder and fatal overdose is therefore the sum of the HRQOL/VSL valuation, health care and substance use disorder treatment cost, criminal justice and lost productivity.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Cost per case of opioid use disorder ($221,219) was derived by dividing the total U.S. cost of opioid use disorder ($470,975 million) during 2017 by the number of opioid use disorder cases the same year (2.129 million) (3).”
From State-Level Economic Costs of Opioid Use Disorder and Fatal Opioid Overdose — United States, 2017 (2021) · cites this paper as [3]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Cost per case of fatal opioid overdose ($11.548 million) was derived by dividing the total cost of fatal opioid overdose ($549,691 million) by the number of fatal opioid overdose cases (47,600) (3).”
From State-Level Economic Costs of Opioid Use Disorder and Fatal Opioid Overdose — United States, 2017 (2021) · cites this paper as [3]
The cited source says what the claim attributes to it.
In the citing paper
“The economic cost of the U.S. opioid epidemic in 2017 was estimated at $1,021 billion, including cost of opioid use disorder estimated at $471 billion and cost of fatal opioid overdose estimated at $550 billion (3).”
From State-Level Economic Costs of Opioid Use Disorder and Fatal Opioid Overdose — United States, 2017 (2021) · cites this paper as [3]
Citations
Cites
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Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence
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Self-citationDiagnostic and Statistical Manual of Mental Disorders
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“Naloxone distribution programs have been shown to reduce opioid mortality rates (Walley et al., 2013).”
BackgroundNational and state treatment need and capacity for opioid agonist medication-assisted treatment
Jones, C. M., Campopiano, M., Baldwin, G., & McCance-Katz, E. (2015) · American Journal of Public Health · doi:10.2105/ajph.2015.302664 · Cited by 668 · cited 1×
“However, the population requiring treatment has been estimated to be much larger than the current treatment capacity (Jones et al., 2015).”
BackgroundSocietal costs of prescription opioid abuse, dependence, and misuse in the United States
Birnbaum, H. G., White, A. G., Schiller, M., Waldman, T., Cleveland, J. M., & Roland, C. L. (2011) · Pain Medicine · doi:10.1111/j.1526-4637.2011.01075.x · Cited by 644 · cited 2×
“This is a change from previously published estimates, where a large share of costs was attributable to opioid use disorder (Birnbaum et al., 2011; Florence et al., 2016; Rice et al., 2014).”
Background
Cited by
Sorted by citations
Items 201–300 of 504
Total cost of care associated with opioid use disorder treatment
Toseef, M. U., Durfee, J., Podewils, L. J., Blum, J., McEwen, D., Hanratty, R. L., & Everhart, R. M. (2022) · Preventive Medicine · doi:10.1016/j.ypmed.2022.107345 · Cited by 4
Curbing the Opioid Crisis: Optimal Dynamic Policies for Preventive and Mitigating Interventions
Ansari, S., Enayati, S., Akhavan‐Tabatabaei, R., & Kapp, J. M. (2024) · Decision Analysis · doi:10.1287/deca.2023.0084 · Cited by 5
Modulation of endogenous opioid signaling by inhibitors of puromycin sensitive aminopeptidase
Singh, R., Jiang, R., Williams, J. M., et al. (2024) · European Journal of Medicinal Chemistry · doi:10.1016/j.ejmech.2024.116604 · Cited by 4
Identification of Plasma Metabolites Responding to Oxycodone Exposure in Rats
Vu, T., Godbole, S. V., Carrette, L. L. G., Maturin, L., George, O., Saba, L. M., & Kechris, K. J. (2025) · Metabolites · doi:10.3390/metabo15020095 · Cited by 4
“Florence et al. estimated the overall economic burden of opioid use disorder and fatal opioid overdose in the US for 2017 to be $1.02 trillion, with major components attributed to the reduced quality of life and the value of life lost [2].”
InfluentialKnudsen, H. K., Andrews-Higgins, S., Back-Haddix, S., Lofwall, M. R., Fanucchi, L. C., & WALSH, S. L. (2025) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/s13011-025-00644-y · Cited by 4
“An estimated 42.4% of US adults know at least one person who has died by overdose [2], and opioid-related overdose mortality has large economic costs [3].”
InfluentialEffatpanah, M., Seyedmirzaei, H., Karami, H., Rasoulian, P., Mehrizi, R., Danandeh, K., Ghamkhar, L., Efatpanah, Z., & Nakhostin-Ansari, A. (2025) · Journal of Health Population and Nutrition · doi:10.1186/s41043-025-01029-4 · Cited by 5
“A 2017 study found that OUDs and fatal opioid overdoses were associated with costs amounting to $1.02 trillion in the US [7].”
InfluentialKatzman, J. G., Tomedi, L. E., Swift, R. Y., et al. (2021) · Military Medicine · doi:10.1093/milmed/usab010 · Cited by 4
Danielson, C. K., McCauley, J. L., Hinkley, J., Hahn, A. M., Moreland, A. D., López, C. M., Goodyear, M., Adams, Z. W., & McCart, M. (2023) · PubMed · Cited by 4
Opioid abuse and labor investment efficiency
Jia, J., & Li, Z. (2023) · International Review of Economics & Finance · doi:10.1016/j.iref.2023.08.012 · Cited by 4
Coffman, C. R., Leng, J. C., Ye, Y., Hunter, O. O., Walters, T. L., Wang, R. R., Wong, J. K., Mudumbai, S. C., & Mariano, E. R. (2023) · Seminars in Cardiothoracic and Vascular Anesthesia · doi:10.1177/10892532231200620 · Cited by 4
“47 48-50 High intraoperative opioid use has been associated with increased postoperative hyperalgesia 48 and development of opioid tolerance.”
BackgroundAre we missing the opioid consumption in low- and middle-income countries?
Correia, I. M. T., Meziat‐Filho, N., Furlan, A. D., et al. (2023) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2023-0086 · Cited by 4
Characterizing Information Seeking Events in Health-Related Social Discourse
Sharif, O., Basak, M., Parvin, T., Scharfstein, A., Bradham, A., Borodovsky, J. T., Lord, S., & Preum, S. M. (2024) · Proceedings of the AAAI Conference on Artificial Intelligence · doi:10.1609/aaai.v38i20.30241 · Cited by 7
Outcomes of Psychotherapy for Co-Morbid Pain and Substance Use Disorders: A Review of the Literature
Araque, S. J. M., Nguyen, L. T., & Nadal, C. N. (2024) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.1080/15360288.2024.2393842 · Cited by 4
“Similarly, the national economic burden was estimated to be $1.02 trillion for OUD and fatal opioid over-dose in 2017 (6).”
InfluentialOpioid Epidemic and Corporate InnovationPreprint
Chen, C., Huang, Q., Chang, S., et al. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4229228 · Cited by 4
Fields, M., Longley, J., Martinez, J. A., Weizman, S., & LaBelle, R. (2023) · Journal of Opioid Management · doi:10.5055/jom.2023.0798 · Cited by 3
Ebrahimi, A. H., Alesheikh, A. A., & Lotfata, A. (2025) · BMC Public Health · doi:10.1186/s12889-025-23375-y · Cited by 3
Vanhée, L., & Scarpa, S. (2025) · Drug and Alcohol Review · doi:10.1111/dar.70057 · Cited by 3
Greenwald, M. K., Demery‐Poulos, C., Moses, T. E. H., & Burmeister, M. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1714546 · Cited by 3
Garrison, K., Ellis, A. G., Curtice, T. G., Rosen, M. M., Sussman, M., Lee, J., & Lopez, A. (2025) · Journal of Medical Economics · doi:10.1080/13696998.2025.2595884 · Cited by 4
“Patients experiencing prescription opioid misuse have been shown to have reduced quality of life, including lower levels of general health, activities of daily living limitations, and higher rates of depression or anxiety compared to those without opioid misuse 16,17 .”
Ballreich, J. M., Jeyakumar, S., Garrison, K., Lopez, A., Cohen, B. G., Paffrath, A., Steel, P., & Rubin, J. L. (2025) · Journal of Medical Economics · doi:10.1080/13696998.2025.2602385 · Cited by 3
“A study from the CDC, which included the value of reduced quality of life and the value of statistical life lost, estimated the annual cost of the opioid epidemic to be $1.02 T in 2017; the Joint Economic Committee adapted this approach to estimate the burden to be $1.5 T in 2020 10,28 .”
InfluentialSmit, T., Mayorga, N. A., Rogers, A. H., Woods, S. P., Heggeness, L. F., Kauffman, B. Y., Garey, L., & Zvolensky, M. J. (2023) · Substance Use & Misuse · doi:10.1080/10826084.2023.2177969 · Cited by 3
“Specifically, the financial burden of opioid use disorder (e.g., emergency room visits due to opioid-related overdose, death, and consequent reduced employment contribution due to overdose) translates into $1.02 trillion per year (Florence et al., 2021).”
BackgroundInfluentialFisher, C. M., McDonald, V., Carroll, M. J., et al. (2024) · Social Work in Public Health · doi:10.1080/19371918.2024.2327576 · Cited by 3
“With over 68,000 opioid overdose deaths each year (Centers for Disease Control and Prevention, 2021a), the economic burden of opioid use disorder and overdoses in the U.S. is estimated at over one trillion dollars annually (Florence, Luo, & Rice, 2021).”
BackgroundRetrospective study investigating naloxone prescribing and cost in US Medicaid and Medicare patients
Manko, C. D., Ahmed, M. S., Harrison, L. R., Kodavatiganti, S. A., Lugo, N., Konadu, J. O., Khan, F., Massari, C. A., Sealey, T. K., Addison, M. E., et al. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-078592 · Cited by 3
Esparham, A., Mehri, A., Maher, W. A., & Khorgami, Z. (2024) · Surgical Endoscopy · doi:10.1007/s00464-024-11057-6 · Cited by 3
Avery-Desmarais, S. L., Schuler, M., Viveiros, J. D., et al. (2024) · Journal of Addictions Nursing · doi:10.1097/jan.0000000000000586 · Cited by 3
Spaderna, M., Belcher, A. M., Welsh, C., et al. (2025) · Health Affairs · doi:10.1377/hlthaff.2025.00339 · Cited by 3
Recent Innovations to Detect and Intervene to Prevent Opioid Overdose Deaths
Strang, J., Appiah‐Kusi, E., Chesney, E., Utrilla, M. G., Hayes, A., Lawn, W., & Tas, B. (2025) · British Journal of Hospital Medicine · doi:10.12968/hmed.2024.0941 · Cited by 3
German, D., Guţă, A., Denney, M. R., Evans, J., McMahon, M., Ashburn, K., Reiss, K., Kosinski, Z., & Genberg, B. L. (2025) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2025.105031 · Cited by 3
Stedman, M., Heald, A. H., Robinson, A., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-064723 · Cited by 3
Price, M. S., & Fryer, R. H. (2023) · PubMed Central · doi:10.1097/gox.0000000000004777 · Cited by 3
Gos, A., Steiner, J. H., Trübner, K., Ungewickell, J., Mawrin, C., Karnecki, K., Kaliszan, M., & Gos, T. (2023) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-023-01656-0 · Cited by 3
Morgan, J. K., Rawlins, C. R., Walther, S. K., Harvey, A., O'Donnell, A., Greene, M., & Schmidt, T. G. (2023) · JMIR Perioperative Medicine · doi:10.2196/50116 · Cited by 3
“Opioid misuse costs the Civilian Health and Medical Program of the Department of Veterans Affairs more than US $1.13 billion annually [6].”
BackgroundInfluentialCarter, J. S., Costa, C. C., Kearns, A. M., & Reichel, C. M. (2023) · Neuroendocrinology · doi:10.1159/000534647 · Cited by 3
“Differently, there was also a main effect of sex ( F [1, 37] = 16.02, p = 0.0003; Figure 4c).”
BackgroundMethodResultInfluentialA pilot study of virtual reality for inpatients with opioid use disorder
Greenwald, H. J., Berger, A. F., Wilson, R. L. H., Greenwald, D. J., Lannon, E., Johnson‐Smith, P., Bergman, B. G., & Wilens, T. E. (2024) · American Journal on Addictions · doi:10.1111/ajad.13526 · Cited by 3
Contemporary burden and trends of opioid-overdose mortality in New York State
Karaye, I. M., Gonzalez, J., Owens, S., Jalal, S., Sosa, S., Alexander, K., Thomas, M., Granger, G. G., Markowitz, W., & Kyriacou, C. M. (2024) · Preventive Medicine · doi:10.1016/j.ypmed.2024.108010 · Cited by 5
Review of Opioid Abuse-Deterrent Formulations: Impact and Barriers to Access
Webster, L. R., & Gudin, J. A. (2024) · Journal of Pain Research · doi:10.2147/jpr.s457982 · Cited by 3
Smartphone-based drug testing in the hands of patients with substance-use disorder—a usability study
Månflod, J., Gumbel, T., Winkvist, M., et al. (2024) · Frontiers in Digital Health · doi:10.3389/fdgth.2024.1394322 · Cited by 3
“Following a widespread citation on overdose dynamics (3), recently published indicators on overdose management (4), drug-related crime (5), and societal cost (6) continue to be alarming, to mention only three examples.”
BackgroundInfluentialPeck, K. R., Giannini, J., Badger, G. J., Cole, R., & Sigmon, S. C. (2024) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2024.112507 · Cited by 3
Impact of Physical Exercise on the Executive Function and Mental Health of Heroin Addicts
Fang, C., & Zheng, G.-H. (2024) · Exercise Science · doi:10.15857/ksep.2024.00402 · Cited by 5
Increasing competition, improving access, and lowering the cost of naloxone in California
Estus, E., Figueroa, R., Lee, H., et al. (2025) · Health Affairs Scholar · doi:10.1093/haschl/qxaf007 · Cited by 3
Babaei, A., Ebrahimi, H., Kouchaksaraei, T. S., Hamidi, S. M., Aliabad, M. K., Siahposht-Khachaki, A., & Ebrahimnejad, P. (2025) · Journal of drug targeting · doi:10.1080/1061186x.2025.2468758 · Cited by 3
“%) among all narcotics. the number of deaths due to opioid overdose has been increasing over the years. in the United states, it grew by 120% between 2010 and 2018. in 2016, 42,000 people died from opioid overdoses, and in 2017, the number rose to 47,600 [2,3].”
Fighting abuse with prescription tracking: mandatory drug monitoring and intimate partner violence
Dave, D., Erten, B., Hummel, D., Keskin, P., & Zhang, S. (2025) · Journal of Population Economics · doi:10.1007/s00148-025-01111-5 · Cited by 3
Gutta, S., Morgan, J. K., Hart, L., Abdo, A., Leib, A., Walther, S. K., & Herrine, G. (2022) · Psychology · doi:10.4236/psych.2022.133024 · Cited by 3
“Including reduced quality of life from opioid use disorder and the value of life lost due to fatal opioid overdose increases that estimate to be more than $1 trillion (Florence et al., 2021).”
BackgroundHassani, M., & Young, S. D. (2023) · Substance Use & Misuse · doi:10.1080/10826084.2023.2270583 · Cited by 3
“Opioid use disorder causes a lot of economic burden on the community and individuals (Florence et al., 2021), and stigma inhibits the prevention and treatment of opioid misuse (Corrigan & Nieweglowski, 2018; Garett & Young, 2022; McCradden et al., 2019).”
BackgroundSpillover Effects of the Opioid Epidemic on Labor and InnovationPreprint
Louca, C., Michaely, R., & Petmezas, D. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4299320 · Cited by 3
“Florence et al. (2021) estimate the costs for opioid use disorder and fatal opioid overdoses to the U.S. economy.”
BackgroundOviedo‐Joekes, E., Dobischok, S., Carvajal, J., Macdonald, S., McDermid, C., Klakowicz, P., Harrison, S., Lajeunesse, J., Chow, N., Brown, M., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-2570581/v1 · Cited by 3
Insurance Coverage and Provision of Opioid Treatment: Evidence from Medicare
Agniel, D. M., Cantor, J., Maclean, J. C., et al. (2023) · National Bureau of Economic Research · doi:10.3386/w31884 · Cited by 3
Shealey, J., Hall, E. W., Pigott, T., Rosmarin, L., Carter, A., Cade, C., Luisi, N., & Bradley, H. M. (2024) · medRxiv · doi:10.1101/2024.08.14.24310813 · Cited by 3
“In 2017, the economic burden of overdose and opioid use disorder (OUD) in the United States (U.S.) was estimated at $1.02 trillion, with more than 85% of costs attributable to the value of reduced quality of life and loss of life (Florence et al., 2021).”
BackgroundInfluentialPhilbin, S. E., Harris, A., Balbale, S. N., Bilaver, L., Beestrum, M., & McHugh, M. (2024) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2024.209600 · Cited by 2
A Risk-Structured Model of the Influence of Mental Health on Opioid Addiction
Newton, K. R., Luttrell, L. M., Blackwood, J. C., Montovan, K. J., & Goldwyn, E. E. (2025) · Bulletin of Mathematical Biology · doi:10.1007/s11538-025-01431-3 · Cited by 2
“TheCDCestimatesthatthetotalcostofopioiduse disorder(OUD)intheUnitedStateswasmorethan$1trillionin2017(Florenceetal.”
Gliedt, J. A., Gruttke, J., Jones, A., et al. (2025) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2025.2501054 · Cited by 2
“Opioid overdose deaths continue to rise over the last two decades [53,54] and costs associated with opioid use disorder and fatal opioid overdose are estimated at more than $1 trillion annually [55].”
Emergency Department-Initiated Interventions for Illicit Drug Overdose
Palumbo, R., Ahern, N. R., Mechling, B., & Bebawy, A. (2025) · Journal of Addictions Nursing · doi:10.1097/jan.0000000000000615 · Cited by 4
“Additional consequences of OD include significant physical, emotional, and socioeconomic burdens on individuals, and families, and have overwhelmed governmental systems and public resources (Busch et al., 2017; Florence, Luo, & Rice, 2021).”
Bridging Emergency and Prevention: A Systematic Review of Take-Home Naloxone Programs
Miller, L. (2025) · International Journal of Addiction Nursing · doi:10.1097/jan.0000000000000642 · Cited by 2
Abu-Zahra, M., Karakash, W. J., Kistler, N. M., et al. (2025) · The Spine Journal · doi:10.1016/j.spinee.2025.10.006 · Cited by 2
Xie, Q., Goldberg, S. B., Jacobson, N. A., Rakel, D. P., & Quanbeck, A. (2025) · Journal of Pain Research · doi:10.2147/jpr.s568016 · Cited by 4
Shealey, J., Hall, E. W., Pigott, T., Rosmarin, L., Carter, A., Cade, C., Crepaz, N., Buchacz, K. A., Rosenberg, E. S., Brookmeyer, K. A., et al. (2026) · Substance Use & Misuse · doi:10.1080/10826084.2025.2609295 · Cited by 2
“In 2017, the economic burden of overdose and opioid use disorder (OUD) in the United States (US) was estimated at $1.02 trillion, with more than 85% of costs attributable to the value of reduced quality of life and loss of life (Florence et al., 2021).”
InfluentialOkunogbe, A., Peltz, A., Danovitch, I., Ober, A. J., & Nuckols, T. K. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2026.11324 · Cited by 2
Greenwald, M. K., Ghosh, S., & Winston, J. R. (2022) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2022.101018 · Cited by 2
Community Coalitions' Perspectives on Engaging with Hospitals in Ohio to Address the Opioid Crisis
Walker, D. M., Shiu‐Yee, K., Chen, S., DePuccio, M. J., Jackson, R. D., & McAlearney, A. S. (2022) · Population Health Management · doi:10.1089/pop.2022.0174 · Cited by 2
Racial inequities in opioid use disorder management: can the anesthesiologist improve outcomes?
Alalade, E., & Willer, B. L. (2022) · International Anesthesiology Clinics · doi:10.1097/aia.0000000000000383 · Cited by 2
Anderson, H. D., Patterson, V., Wright, G. C., Rawlings, J. E., Moore, G. D., Utter, B., Taylor, J., Leonard, J., & Page, R. L., II (2022) · Journal of the American Pharmacists Association · doi:10.1016/j.japh.2022.11.009 · Cited by 2
Turpin, M. A. C., Rowland, K. C., Anugwom, C., Arocha, M., Carona, A., Gonzalez, B. I., Iskander, G., Snyder, S., Wilson, K., Kaye, A. D., et al. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-98814-8.00027-5 · Cited by 3
Fiscal Impacts of the Opioid Crisis on State and Local Governments
Bifulco, R., & Shybalkina, I. (2022) · The Annals of the American Academy of Political and Social Science · doi:10.1177/00027162221137171 · Cited by 2
“2016; Florence, Luo, and Rice 2021; Davenport, Weaver, and Caverly 2019). each of these base estimates of these costs on two factors: (1) the average increase in health care expenditures for an individual with a diagnosis of OuDs and (2) the number of individuals with OuDs.”
BackgroundMethodJoyce, V. R., Oliva, E. M., Garcia, C., Trafton, J., Asch, S., Wagner, T., Humphreys, K., Owens, D., & Bounthavong, M. (2023) · Addiction · doi:10.1111/add.16289 · Cited by 2
Quaye, A., Wampole, C., Riker, R. R., Seder, D. B., Sauer, W. J., Richard, J. M., Craig, W. Y., & Gagnon, D. J. (2023) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2023.209176 · Cited by 2
Opioid-Related Trends in Active Duty Service Members During the Coronavirus Disease 2019 Pandemic
Sorensen, I. S., Susi, A., Andreason, P., et al. (2023) · Military Medicine · doi:10.1093/milmed/usad245 · Cited by 2
Buprenorphine and Opioid Use Disorder Training: Graduate Nursing Curricula Recommendations
Meadows, L., Simonton, A. J., & Rolin, D. G. (2023) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20231206-01 · Cited by 2
Stone, B. M. (2024) · Substance Use & Misuse · doi:10.1080/10826084.2023.2280592 · Cited by 4
“…et al., 2013), community and familial distress (Hoffmann & Cerbone, 2002; Tyo & McCurry, 2020; Wilkens & Foote, 2019), economic hard-ships (Florence et al., 2021; Lund et al., 2019; Whiteford et al., 2016), and significant functional impairments (Harris et al., 2019; Henkel, 2011; Ramey &…”
Kyei, E. F., & Zhang, L. (2024) · Policy Politics & Nursing Practice · doi:10.1177/15271544241232588 · Cited by 2
“Additionally, the economic burden of substance use in the United States is substantial, with an estimated $740 billion annually, including healthcare expenses, lost productivity, and criminal justice costs (Florence et al., 2021).”
BackgroundBarnett, M. J., Clubbs, B. H., Woodyard, A., Wasem, V., Prinze, J., Tirupasur, A., Hosseini, S., Kim, M., Gallardo, F., Polich, N., et al. (2024) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2024.03.011 · Cited by 3
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“According to recent estimates, OUD-related reductions in quality of life, fatal overdoses, health care use, criminal justice involvement, and lost productivity cost the US economy $1.02 trillion in 2017 [11].”
InfluentialPharmacologic profile of ITI-333: a novel molecule for treatment of substance use disorders
Snyder, G. L., Li, P., Martin, T., Zhang, L., Yao, W., Zheng, H., Maguire, D. R., Gerak, L. R., Vanover, K. E., France, C. P., et al. (2024) · Psychopharmacology · doi:10.1007/s00213-024-06578-w · Cited by 2
“These include medications that lack abuse liability and other safety concerns commonly associated with opioid use (e.g., see Dufort & Samaan 2021 and Florence et al. 2021).”
BackgroundInfluentialOpioid Prescription Trends Among Sleep Surgeons in the United States
Saroya, J., Singh, A., Chang, J. L., et al. (2024) · The Laryngoscope · doi:10.1002/lary.31543 · Cited by 2
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“The New England region had some of the highest costs of opioid use disorders per capita (Luo et al., 2021).”
BackgroundInfluentialThe Opioid Crisis, Impact on Children, and Mitigation Strategies
Onigu-Otite, E., Shenoi, N., Moukaddam, N. J., & Shah, A. A. (2024) · Adolescent Psychiatry · doi:10.2174/0122106766296265240830050405 · Cited by 2
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“The reported cost for OUD and fatal opioid over-dose was estimated to be $1.02 trillion in 2017 (Florence et al., 2021).”
InfluentialGilpin, V. L., Smith, R. B., Birkett, J. W., & Davis, J. (2024) · Science & Justice · doi:10.1016/j.scijus.2024.10.004 · Cited by 2
Pain severity contributes to worse outcomes in opioid use disorder recovery than pain status
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“Beyond the human cost of opioid overdose, which is responsible for over 80,000 deaths annually in the U.S. Mattson et al., [27,35], annualized financial costs of fatal and non-fatal opioid overdoses are estimated to exceed $1 trillion [12].”
Sickle cell disease and opioid overdose outcomes in the United States: a nationwide analysis
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Race/ethnicity moderates the associations between lifetime psilocybin use and opioid use disorder
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“Healthcare costs in 2017 due to OUD were estimated at $31.3 billion, not including costs of OUD treatment services [1].”
InfluentialMericle, A. A., Masson, C. L., Zemore, S. E., Subbaraman, M. S., Khebzou, D., Schmidt, D., Kapiteni, K., & Jason, L. A. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1533082 · Cited by 2
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“The economic burden created by opioid addiction and fatal overdose in 2017 was USD 1020.7 billion (95% [Cl] USD 967.2 to USD 1075.7 billion), about half of which is related to OUDs alone [USD 471.0 billion (95% [CI] USD 417.8 to USD 525.7 billion)] [9].”
InfluentialHjaltadottir, B. E., Blöndal, A. B., & SÁÁ group (2025) · JMIR Research Protocols · doi:10.2196/72317 · Cited by 2
“The economic burden of opioid use disorder (OUD) is immense, estimated to be approximately US $1.02 trillion in 2017 when taking into account fatal opioid overdoses, increased health care costs, and loss of productivity [7].”
InfluentialBecker, S. J., Janssen, T., Souza, T., Hartzler, B. J., Rash, C. J., DiClemente-Bosco, K., & Garner, B. R. (2025) · Implementation Science · doi:10.1186/s13012-025-01473-0 · Cited by 2
“Notably, both the California Recovery Incentives Program [53, 54] and a new stepped-wedge trial [55] are using all the E-ATTC strategy components except for incentivization (i.e., didactic training + performance feedback + consulta-tion + facilitation).”
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Allostatic load in opioid use disorder: a scoping review protocol
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Advancing the Role of the Anesthesiologist in Perioperative Medicine
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The Opioid Crisis, Employee Health Capital, and Corporate Information Production
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Nation’s Response to the Substance Use Crisis
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Xu, J., Zakari, N. M. A., Hamadi, H. Y., Park, S., Haley, D. R., & Zhao, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18179127 · Cited by 2
“The total economic burden was estimated to be $1021 billion at the national level and $68,444 million in Florida alone in 2017 [10,11].”
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Halbout, B., Hutson, C., Agrawal, S., Springs, Z. A., & Ostlund, S. B. (2023) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2023.09.14.557822 · Cited by 1
Metadata
- Authors
- Florence, C., Luo, F., & Rice, K.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Florence, Curtis
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 218
- Pages
- 108350
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC8091480
- OpenAlex
- W3095492073
- Cited by
- 511
- References
- 38
- Citations by year
- 2026: 69 · 2025: 122 · 2024: 103 · 2023: 110 · 2022: 68 · 2021: 36
- FWCI
- 40.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- opioid use disorder, economic burden, social costs, health care costs, criminal justice costs, productivity loss, quality of life, opioid epidemic, public policy
- MeSH terms
- Opioid Epidemic, Opiate Overdose, Analgesics, Opioid, Criminal Law, Delivery of Health Care, Humans, Opioid-Related Disorders, Quality of Life, United States, Prevalence, Cost of Illness, Drug Overdose
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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