OBJECTIVES: Opioid use disorder (OUD) is a chronic and relapsing medical illness associated with a high cost to individuals, families and society. We evaluated the current literature to identify evidence gaps and summarise published data on economic costs associated with OUD.
METHODS: A structured, comprehensive literature review was conducted to identify articles describing the burden and treatment landscape of OUD including: risk factors, patient characteristics and comorbidities, epidemiology, humanistic and economic burden, employment and crime, treatment options and current clinical guidelines. Global literature databases, guideline databases, regulatory and health technology assessment agency websites and relevant society guidelines were searched for data published between 2000–2015. Articles were not restricted by language. Eligible articles were those reporting on OUD (including opioid dependence and abuse) and providing data on ≥1 topic of interest.
RESULTS: A total of 2,234 records were screened; 202 articles met the selection criteria and were included in this literature review, 31 of which reported on economic burden. From these 31 articles, only one reported total economic burden associated with untreated opioid dependence as CAD$5,086 million/year (cost year: 1996). The remaining articles (Australia [7], UK [1], Canada [2], US [20]) focused on specific elements of economic burden, including costs of treatment programmes, criminal justice and use of prescription opioids. Of these, studies looking specifically at prescription opioid abuse, dependence and misuse, reported that the total societal cost was US$55.7 billion (2007) and US$78.5 billion (2013).
CONCLUSIONS: The literature reports a substantial economic burden associated with OUD. However, the majority of the evidence is from studies reporting on specific elements of cost, with limited direct and indirect cost data. Furthermore, the latest comprehensive data were reported approximately 20 years ago. Thus, the lack of recent global data is likely to result in underestimation of the current economic burden associated with OUD.
