Summary
Fentanyl, a synthetic opioid 50 times more potent than heroin, is cheaper to produce and easier to smuggle across borders, fueling the illicit opioid epidemic in the United States with devastating consequences. In 2023 alone, illicit opioids, primarily fentanyl, cost Americans an estimated $2.7 trillion (in December 2024 dollars), equivalent to 9.7 percent of GDP. Of this total cost, 41 percent ($1.1 trillion) is attributed to deaths, 49 percent ($1.34 trillion) to lost quality of life, and 10 percent ($277 billion) to other costs such as healthcare, reduced labor productivity, and crime-related expenses. Alarmingly, 93 percent of opioid deaths are caused by powerful synthetic opioids like fentanyl, which typically originate in China and are trafficked through Mexico.
This number dwarfs even pessimistic estimates of the effects of tariffs, like that of Goldman Sachs, who estimated losses of 0.4 percent of GDP.
The CEA previously studied this issue and came up with a smaller number. The primary reasons are because it did not include the cost of reduced quality of life and because the number of deaths in 2015 was 33,000.
Details
Our cost estimates are based on a 2017 CDC study which we have updated to account for inflation and the sharp rise in opioid deaths and opioid use disorder (OUD) since then. According to the DEA, an estimated 74,702 Americans died in 2023, a staggering 1.6 times more than in 2017. Additionally, the number of Americans living with OUD increased by 2.7 times to 5.7 million during the same period. We have adjusted the calculations to reflect current prices as well as the alarming rise in opioid addiction and deaths. We scale up the loss of life estimates based on the increase in fatalities, while we scale up the other estimates to reflect the increase in the prevalence of those living with OUD. The breakdown of the cost estimates, all expressed in December 2024 dollars, is as follows:
- Loss of life: $1.11 trillion. This estimate is calculated by multiplying the number of lives lost (74,702) by the value of statistical life in the United States and then adding productivity and healthcare costs that arise due to opioid fatalities. We inflation adjusted the $10.1 million value of a statistical life number provided by NIH (2017) to 2025 dollars ($13.0 million per life). The value of a loss of life is based on market and survey based evidence on what amount of money people are willing to forgo to change the probability of death. For example, many estimates rely on the value of life implied by the increase in wages required for people to take jobs with higher mortality risk.
- Loss of quality of life: $1.34 trillion. This estimate is the product of three factors. First is a survey-based measure for the loss in quality of life for individuals with opioid use disorder (OUD) compared to those in full health. The measure shows that life with OUD has about 60 percent (0.626) of the quality of life of those in full health. Second is a measure of how much Americans value a year of life in full health. Adjusted for inflation, this value is estimated at $624,410 per person per year. Together these values imply that the lost quality of life costs $234,478 per year for each person living with OUD. We then multiply this value by the prevalence of OUD, estimated to be 5.7 million in 2023.
- Healthcare system: $107 billion. This estimate represents the additional annual costs incurred by the healthcare system for treating individuals with opioid use disorder (OUD) relative to the average annual costs of treating those without OUD. This amounts to $19,000 additional dollars per year per person with OUD. These costs were primarily borne by private insurers, Medicaid, and hospitals providing uncompensated care. Ultimately, these costs are passed on to all Americans through higher insurance premiums, taxes, and healthcare expenses.
- Loss of labor force productivity: $107 billion. This estimate is calculated by multiplying the number of productive work hours lost due to opioid-related deaths, OUD, and incarceration by the average hourly total compensation (wages and benefits) for American workers.
- Crime-related: $63 billion. This figure represents the sum of costs incurred for additional police protection, judicial activities, correctional facilities, and property loss resulting from opioid-related crime.
Conclusion
The enormous economic cost of the illicit opioid epidemic to Americans, estimated at $2.7 trillion in 2023 alone, underscores the urgent need to control the flow of lethal drugs pouring in from foreign countries. The human suffering and financial burden inflicted by this epidemic are unsustainable.