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This was supposed to have been a big week in the massive federal opioid case. Then a last-minute settlement meant the first big trial was called off. The judge overseeing the litigation has been pushing for a global settlement that would resolve thousands of lawsuits. At one point, there was even a dollar figure floated for what some of the drug makers and distributors might pay out - $48 billion. It sounds like a lot of money, but as NPR's Selena Simmons-Duffin reports, it doesn't come close to accounting for the full cost of the opioid epidemic, let alone what it might cost to fix it.
SELENA SIMMONS-DUFFIN, BYLINE: Before we get into putting cold hard dollar figures on the opioid crisis, it's worth remembering there's a profound human cost that these numbers can't capture - 130 deaths every single day, lives thrown into chaos, families torn apart. You can't put a dollar figure on those things, but let's talk about the economic impact because that's part of the reckoning that's underway right now in the courts. How much did this epidemic cost society last year? To answer that question, I called this guy.
STODDARD DAVENPORT: My name is Stoddard Davenport, and I'm a health care management consultant with Milliman.
SIMMONS-DUFFIN: That's an actuarial firm. He just finished a report quantifying the costs of the opioid crisis. The biggest contributor - overdose deaths. Most of those dying are between 25 and 55 years old.
DAVENPORT: The mortality costs - the grand majority is composed of lost lifetime earnings from early mortality.
SIMMONS-DUFFIN: That ended up costing $73 billion last year. The next biggest amount comes from health care costs - first of all, from overdoses or other extra health care costs for someone with opioid use disorder compared to someone who's not addicted. But the report also accounted for the increased health costs for people living with someone who's addicted.
DAVENPORT: Your overall circumstances that drive your health are a little bit more complicated when you've got somebody in the household with an opioid use disorder.
SIMMONS-DUFFIN: If you add infants who are born dependent on opioids, the total health care costs of the epidemic in 2018 were $60 billion. But there's more - costs for criminal justice, Child and Family Assistance and lost productivity, specifically...
DAVENPORT: Reduced labor, forced participation and absenteeism, incarceration, short-term disability, long-term disability and worker's compensation.
SIMMONS-DUFFIN: All of that adds another 45 billion. Put this all together, and you get this. Last year the opioid epidemic cost $179 billion. It's worth noting in the lawsuits now being hashed out in federal court, thousands of cities and counties are going to drug makers and distributors and saying, you contributed to this crisis. We're dealing with the costs. But many of the costs added up here are being borne privately by families, employers, insurance companies.
DAVENPORT: It's around 30% falling on federal, state and local governments and then the rest sort of to the private sector and then, of course, to individuals.
SIMMONS-DUFFIN: Another point - these are just the costs now with the epidemic as it exists now. Putting numbers on what it's going to cost to fix or abate it is another story.
CHRISTOPHER RUHM: The notion of abatement is that we want to deal with the problem that exists but also to begin to remedy it.
SIMMONS-DUFFIN: Christopher Ruhm is a professor of public policy and economics at the University of Virginia. He worked for several years on a 30-year abatement plan for Oklahoma, part of that state's case against Johnson & Johnson currently being appealed. What does a government that wants to fix the opioid crisis have to spend money on?
RUHM: Treatment costs for individuals who are currently opioid-addicted, physician education efforts - for example, to reduce inappropriate prescribing.
SIMMONS-DUFFIN: And more. For Oklahoma, Ruhm estimated treatment, prevention, education, surveillance for one year would cost 836 million. Of course, Oklahoma is one state. If you scale those numbers up for the whole country, it looks more like $69 billion for one year.
RUHM: I'm not saying that's an appropriate calculation in the sense that, you know, things could be different in Oklahoma from other places.
SIMMONS-DUFFIN: Still, this gives you a rough idea as society starts to take stock of what this epidemic is costing already, how much it will cost to try to fix it and who should ultimately pay.
Selena Simmons-Duffin, NPR News.
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