Productivity losses from fatal drug overdoses in the United States

Drug overdose remains a major public health challenge in the United States, yet contemporary national estimates of productivity losses from fatal drug overdoses are limited. This study estimated total and per-decedent life-years and productivity losses from fatal drug overdoses among U.S. adults in 2023.

Drug overdose deaths were identified using 2023 National Vital Statistics System mortality file. Life-years lost were calculated by age and sex using U.S. life tables. Productivity losses were estimated from a societal perspective using human capital approach, valuing lost productivity as present value of expected lifetime productivity. Life-years and productivity losses were estimated for all overdose deaths, as well as opioid- and stimulant-involved overdose deaths.

In 2023, 103,936 overdose deaths occurred among U.S. adults, resulting in 3.79 million life-years lost and $194.51 billion in productivity losses. Opioid-involved overdoses resulted in 78,436 deaths, 2.95 million life-years lost, and $154.12 billion in productivity losses, and stimulant-involved overdoses accounted for 59,531 deaths, 2.13 million life-years lost, and $110.12 billion in productivity losses. Males accounted for most overdose deaths and associated losses. On average, 36.43 life-years were lost per overdose death, and per-decedent losses were greatest for opioid-involved overdoses (37.67 years). Synthetic opioids other than methadone (primarily illegally made fentanyl), psychostimulants, and cocaine were leading contributors to life-years and productivity losses.

Fatal drug overdose imposes a substantial economic burden through lost life-years and productivity. Intervention efforts, particularly those addressing illegally made fentanyl, cocaine, and psychostimulants could potentially save lives and yield economic benefits.