The Economic Toll of Substance Use Disorders in America: $93 Billion and Counting
A groundbreaking study published in the American Journal of Preventive Medicine on December 8 has revealed the staggering economic impact of substance use disorders (SUDs) in the United States. According to researchers at the CDC’s Division of Injury Prevention, SUDs cost the American economy nearly $93 billion in 2023 alone. This enormous figure represents a combination of missed workdays, reduced productivity on the job, and lost household productivity. The study’s authors emphasized that implementing public health strategies to address SUD prevalence could significantly reduce these economic losses and provide substantial cost savings for the nation. This research sheds new light on the hidden economic burden of addiction beyond the more commonly discussed health and social consequences.
Substance use disorders encompass a range of conditions characterized by a person’s uncontrollable use of substances despite harmful consequences. While the recent news of declining drug overdose deaths in 2024 offers some hope, with the steepest year-over-year decline in five years, the prevalence of SUDs remains alarmingly high. According to the Substance Abuse and Mental Health Services Administration’s 2023 report, 48.5 million Americans aged 12 and above—representing over 17% of the population—struggle with a substance use disorder. Of these, more than 27 million specifically battle drug addiction. These statistics demonstrate that despite recent progress, SUDs continue to affect a significant portion of the American population, with far-reaching economic consequences that extend beyond individual suffering.
To arrive at their conclusions, CDC researchers analyzed data primarily from the National Survey on Drug Use and Health, focusing on adults 18 years and older diagnosed with SUDs. Their findings revealed that men accounted for a significantly larger portion of the economic impact ($61.19 billion) compared to women ($31.45 billion). Breaking down the $92.65 billion total loss, the researchers identified several key components: $45.25 billion stemmed from people unable to work due to their condition, $25.65 billion resulted from absenteeism, $12.06 billion came from presenteeism (working while unwell, resulting in reduced productivity), and $9.68 billion represented lost household productivity. These detailed figures help quantify the comprehensive economic impact of substance use disorders across different aspects of productivity.
The study also identified interesting age-related patterns in how SUDs affect productivity. Young adults aged 18-25 showed the highest rates of absenteeism, while those 65 and older demonstrated the highest rates of presenteeism and sick days. Perhaps most notably, adults between 50 and 64 years old had the highest proportion of individuals completely unable to work due to substance use disorders. As Brendan Saloner, a professor of health policy and management at Johns Hopkins University, pointed out, the population of people with SUDs is “large and diverse,” including both highly functional individuals who contribute fully to the economy and others whose substance use significantly limits their economic potential. He emphasized that the study helps quantify the debilitating effect of SUDs on collective productivity, while noting that it only accounts for impacts among the living—the economic value of lost lives would make the total impact substantially larger.
The economic impact of SUDs extends beyond individuals simply showing up to work impaired. Professor Saloner explained that substance use can cause a “long-term erosion of economic capability,” often pushing people out of the labor market entirely. Importantly, this is not solely about individual choices but also reflects systemic issues in our economy. For example, employer discrimination against people in recovery can prevent otherwise productive individuals from participating in the workforce. This perspective highlights how addressing SUDs requires not only individual-focused interventions but also broader policy and workplace culture changes to reduce stigma and create supportive environments for those in recovery.
Looking forward, the study authors suggest that policy efforts aimed at reducing the prevalence of SUDs could yield significant economic benefits. Professor Saloner proposed that extending new work requirements for Medicaid to those with SUDs might actually support recovery, as employment can provide personal and financial stability. Currently, individuals with SUDs are exempt from the new requirements being introduced by President Trump’s One Big Beautiful Bill Act. Saloner also advocated for greater investment in supported employment programs, which have proven effective but remain underutilized. These policy considerations demonstrate how addressing substance use disorders represents not only a public health imperative but also an economic opportunity. By implementing evidence-based approaches to prevention, treatment, and recovery support, the nation could reclaim a significant portion of the $93 billion currently lost to SUDs each year while improving countless lives in the process.
