A substance use cost calculator for US employers with an emphasis on prescription pain medication misuse.
Open accessAbstract
OBJECTIVE: Substance use disorders are among the most common and costly health conditions affecting Americans. Despite estimates of national costs exceeding $400 billion annually, individual companies may not see how substance use impacts their bottom lines through lost productivity and absenteeism, turnover, health care expenses, disability, and workers' compensation. METHODS: Data on employed adults (18 years and older) from 3 years (2012 to 2014) of the National Survey on Drug Use and Health Public Use Data Files were analyzed. RESULTS: The results offer employers an authoritative, free, epidemiologically grounded, and easy-to-use tool that gives specific information about how alcohol, prescription pain medication misuse, and illicit drug use is likely impacting workplaces like theirs. CONCLUSION: Employers have detailed reports of the cost of substance use that can be used to improve workplace policies and health benefits.
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The estimated cost of any SUD diagnosis includes people with multiple SUD diagnoses and may be more meaningful than individual SUD type results.
“The estimated cost of any SUD diagnosis ($15 640 per affected enrollee and $35.3 billion in the ESI population) includes people with multiple SUD diagnoses and may be more meaningful than individual SUD type results; survey data suggest 40% of workers with illicit drug use disorders had comorbid alcohol use disorder.5”
From Medical Costs of Substance Use Disorders in the US Employer-Sponsored Insurance Population (2023) · cites this paper as [5]
The Results section, under “Comorbid Substance Use” (page unavailable), reports that workers with SUDs often have more than one disorder, including that four in 10 workers with an illicit drug use disorder also had an alcohol use disorder. This supports the concern about overlapping diagnoses, but the paper does not establish that an ESI-population cost estimate for any SUD is more meaningful than estimates by SUD type. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPrevious estimates of SUD medical costs among US employees relied on workers' self-reported health care utilization.
“Previous estimates of SUD medical costs among US employees are well described but relied on workers’ self-reported health care utilization.5”
From Medical Costs of Substance Use Disorders in the US Employer-Sponsored Insurance Population (2023) · cites this paper as [5]
Survey data suggest 40% of workers with illicit drug use disorders had comorbid alcohol use disorder.
“survey data suggest 40% of workers with illicit drug use disorders had comorbid alcohol use disorder.5”
From Medical Costs of Substance Use Disorders in the US Employer-Sponsored Insurance Population (2023) · cites this paper as [5]
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Cites
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“About 60% of people with substance use disorders (SUDs) are currently employed [41].”
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“Most people who use alcohol and other drugs, both legal and illegal, are employed (1) and 60% of people with substance use disorders (SUDs) have been found to be currently employed (2).”
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“In the United States, the annual cost of pain is estimated at $ 635 billion [4].”
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“The full methodology has been reported elsewhere.(25,26) Workplace substance use cost and savings are determined by employee size, industry, and state.”
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“…workers ’ substance misuse can adversely impact organizational health, reduce workplace safety, and increase organizational costs, making employee substance misuse a signi fi cant organizational concern for employers (Burke, 2019; de Oliveira et al., 2020; Goplerud et al., 2017; Sorge et al., 2020).”
BackgroundLê, A. B., & Rosen, J. D. (2021) · NEW SOLUTIONS A Journal of Environmental and Occupational Health Policy · doi:10.1177/10482911211039880 · Cited by 11 · see citing works
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“Similarly, in the United States, the annual national bill for substance use disorder and its related effects is >US $740 billion, and approximately 900,000 people die of alcohol abuse [6-8].”
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“Globally, construction workers are experiencing heightened levels of workplace stress [1], leading to increased absenteeism [2], growing opioid dependence [3], and a surge in suicide rates [4].”
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“One study found that 68% of adults who reported past-month prescription pain medication misuse are in the workforce, and those industries with younger, male-dominated workers reported two to three times higher rates of misuse when compared with the nation’s general workforce.(8) The relationship between alcohol use an…”
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“Three studies describe employerfocused calculators estimating health impacts on health care costs and worker productivity.(7,9,10) Like the present study, the researchers intended their calculator to educate and invite the user to take action.”
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“It is an urgent public health concern with devastating effects that not only may persist across generations, but also cause a significant economic burden [4], estimated as more than $700 billion annually in the US [5].”
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“Substance use disorders among employees are related to workplace outcomes such as workers’ health, productivity, and market performance (Goplerud et al., 2017; Comer, 2013; Frone, 2008; Bush & Autry, 2002).”
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“7 Prior studies suggest that opioid abuse significantly impairs employee health, decreasing employees’ abilities to discharge their work responsibilities (Ruetsch, 2010; Goplerud et al., 2017).”
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“People in recovery who attain stable employment are less likely to return to using opioids and other substances.(23)”
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“The time off for mental health or drug and alcohol rehabilitation could be beneficial to both the employee and employer as prior studies have found that treatment for substance use disorders improves productivity (Goplerud et al., 2017; Slaymaker & Owen, 2006 as cited in Frone & Bamberger, 2024).”
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“This situation has been inferentially drawn upon to explain the high suicide rates (Sussell et al., 2023), an alcohol and substance abuse rate that’s nearly double the national average (Goplerud et al., 2017), and an elevated risk of developing chronic health conditions (Ringen et al., 2014).”
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“Goplerud et al 29 used 3 years of data from the National Survey of Drug Use and Health and found that people with substance use disorders missed 14.8 days a year, which is similar to our findings for opioid users.”
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Enhancing employee retention in construction: role of workforce sustainability attributes
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“The average turnover rate across all industries is estimated to be around 21–22% of the annual salary to recruit and retrain for a vacant position (Goplerud et al. 2017).”
Workplace Drug Testing: SAMHSA and Non-SAMHSA Drugs
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What should managers do about opioid use at work?
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“Suicide remains a key leading reason for preventable death among the U. S. working-age population, and both mental health and substance use pose significant risks to the workforce in terms of disability, burnout and chronic disease burden (1–3) as well as proving costly to employers (4, 5).”
- Authors
- Goplerud, E., Hodge, S., & Benham, T.
- Affiliations
- National Safety Council (US)
- Corresponding author
- Goplerud, Eric
- ORCID
- Hodge, Sarah
- Venue
- Journal of Occupational & Environmental Medicine
- Published
- 2017-11
- Volume
- 59
- Issue
- 11
- Pages
- 1063-1071
- ISSN
- 1076-2752 (ISSN-L)
- PMC
- PMC5671784
- OpenAlex
- W2757594278
- Cited by
- 60
- References
- 19
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 6 · 2023: 14 · 2022: 12 · 2021: 7 · 2020: 7 · 2019: 4 · 2018: 3
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of Occupational and Environmental Medicine (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Keywords
- alcohol abuse, illicit drug use, workplace productivity loss, absenteeism, employee turnover, workers' compensation, occupational health policy, health benefits
- MeSH terms
- Absenteeism, Driving Under the Influence, Adolescent, Adult, Ambulatory Care, Analgesics, Anxiety, Depression, Emergency Service, Hospital, Female, Health Resources, Health Surveys, Hospitalization, Humans, Industry, Male, Middle Aged, Personnel Turnover, Smoking, Stress, Psychological, United States, Comorbidity, Prevalence, Health Care Costs, Workplace, Sick Leave, Substance-Related Disorders, Alcohol-Related Disorders, Prescription Drugs, Young Adult
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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