The societal cost of heroin use disorder in the United States

• Published in: PloS one 2017-05, Vol.12 (5), p.e0177323-e0177323
• Main Authors: Jiang, Ruixuan, Lee, Inyoung, Lee, Todd A, Pickard, A Simon
• Format: Article
• Language: English
• Subjects: Absenteeism; Acquired immune deficiency syndrome; Addictions; Adults; Age; AIDS; Alcoholic beverages; Antiviral agents; Biology and Life Sciences; Branches; Chronic illnesses; Coronary artery disease; Cost analysis; Cost of Illness; Costs; Crime; Data processing; Death; Diabetes; Diabetes mellitus; Disease control; Disease prevention; Drug abuse; Drugs; Economic analysis; Economic aspects; Economic impact; Economics; Formulations; Health risks; Heart; Heart diseases; Hepatitis; Hepatitis B; Hepatitis C; Hepatology; Heroin; Heroin Dependence - economics; Heroin Dependence - epidemiology; Heroin habit; HIV; Human immunodeficiency virus; Humans; Impact analysis; Imprisonment; Incidence; Infectious diseases; Injection; Mathematical analysis; Mathematical models; Medical research; Medicine and Health Sciences; Mortality; Narcotics; Neonatal abstinence syndrome; Neonates; Overdose; Pain; People and places; Pharmaceutical sciences; Pharmacoeconomics; Pharmacology; Pharmacy; Population studies; Populations; Prevention; Prisons; Productivity; Public health; Risk; Sensitivity analysis; Sexually transmitted diseases; Social aspects; Social Sciences; Society; STD; Stroke; Studies; Substance abuse treatment; Tuberculosis; United States - epidemiology; Viruses; Websites
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0177323

Heroin use in the United States has reached epidemic proportions. The objective of this paper is to estimate the annual societal cost of heroin use disorder in the United States in 2015 US dollars. An analytic model was created that included incarceration and crime; treatment for heroin use disorder; chronic infectious diseases (HIV, Hepatitis B, Hepatitis C, and Tuberculosis) and their treatments; treatment of neonatal abstinence syndrome; lost productivity; and death by heroin overdose. Using literature-based estimates to populate the model, the cost of heroin use disorder was estimated to be $51.2 billion in 2015 US dollars ($50,799 per heroin user). One-way sensitivity analyses showed that overall cost estimates were sensitive to the number of heroin users, cost of HCV treatment, and cost of incarcerating heroin users. 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.