A map of Virginia with the counties colored in shades of purple to cream.
A map showing the annual economic burden of the opioid epidemic in Virginia per person by locality. (Virginia Department of Health/VCU Center on Society and Health)

The opioid epidemic cost Virginians $5 billion in 2021, new data shows

Researchers from VCU and the Virginia Department of Health say at least six Virginians died of an opioid overdose every day on average, with more than 150,000 having an addiction.

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Last year, Virginia Commonwealth University’s Center on Society and Health collaborated with the Virginia Department of Health to calculate how much the opioid epidemic cost Virginians financially in 2020, including families, businesses and government agencies. New data collection methods introduced in 2021 now suggest that the prevalence and economic impact of opioid addiction was underestimated in previous reports.  

The data from 2021 revealed that nearly 150,000 people in Virginia had an opioid use disorder, 127% higher than 2020 estimates, with at least six Virginians dying of an opioid drug overdose every day on average. The calculator revealed that the overall cost of the epidemic in 2021 was more than $5 billion, which is 43% higher than 2020 estimates. On an individual level, the financial impact of the opioid epidemic amounted to $588 per Virginian on average.

“Opioid addiction has been an increasing issue in the United States for the last several years, and these shocking estimates underscore the tremendous financial cost of this epidemic, which has a devastating impact on individuals, their families and communities,” said Derek Chapman, Ph.D., interim director of the VCU Center on Society and Health. “A comprehensive strategy focusing on prevention, treatment and recovery is needed to reverse these troubling trends.”

The opioid cost calculator was first released in October 2022 and used data collected in 2020 by the National Survey on Drug Use and Health (NSDUH) and the Centers for Disease Control and Prevention. With this data, the research team developed analytical models to estimate productivity, health care costs and government losses from the opioid epidemic.

The increased reports of opioid use in 2021 were in part due to changes in the NSDUH’s survey methods to provide a more accurate estimate of the epidemic’s impact. In the 2020 survey, questions about substance use disorder were given only to individuals who abused prescription drugs, such as taking them for longer periods of time or in larger amounts than what was prescribed. However, even when prescription drugs are used as intended, people can still be at risk of developing addiction.

“Providers are careful to follow clinical recommendations for managing patient pain and consider many factors before prescribing opioids,” Chapman said. “However, a person could be taking their prescription drugs as prescribed and still experience symptoms of substance use disorder, such as feeling unable to stop taking opioids, having intense cravings, developing withdrawal symptoms or not being able to carry out responsibilities at work or home.”

To gain a more comprehensive understanding of the opioid epidemic, the 2021 survey asked any persons who took prescription drugs a series of questions to determine whether they had a substance use disorder.

“The majority of the increase in our estimates between 2020 and 2021 reflects a better ascertainment of the problem in the 2021 NSDUH survey compared to the 2020 survey methods. However, data from the Centers for Disease Control and Prevention shows that opioid deaths also increased by 17% between 2020 and 2021, so it is likely that opioid use disorder increased by at least that much,” Chapman noted.

A graphic showing the economic costs of the opioid addiction in Virginia
A graphic showing the economic costs of the opioid addiction in Virginia by sector and by payer. (Virginia Department of Health/VCU Center on Society and Health)

The cost calculator shows not only the overall cost of the epidemic in Virginia in total dollars but also provides breakdowns by sector (labor, health care, crime), payer (households, state/local government, federal government) and locality (counties and independent cities).

The majority of costs from the opioid epidemic were shouldered by Virginia families and businesses through lost labor (such as lost wages) due to missed work, incarceration or death from opioids. Federal, state and local governments were also financially impacted due to loss of income tax revenues, increased opioid-related health care costs and higher expenditures required within the criminal justice system, child and family services, and K-12 education.

The impact of the opioid epidemic varied among Virginia localities, with communities in Petersburg, Norton, Richmond City, Portsmouth, Hopewell, King and Queen County, Fredericksburg and Roanoke experiencing the greatest financial costs related to addiction.

The researchers hope the cost calculator helps raise awareness of the devastating impact of opioid addiction in Virginia and supports ongoing efforts by policymakers and community partners toward creating systemic change at state and local levels.

“This calculator shows the value of investing in measures for prevention, treatment and recovery from opioids, such as treating mental health disorders, continuing to carefully monitor opioid prescriptions and providing more resources for those with substance addiction,” Chapman said.

While the numbers mentioned in this study are important for understanding the economic consequences of opioid addiction in Virginia, there are other harmful effects that can’t be reduced to a dollar amount.

“The reduced quality of life from addiction and the emotional costs of losing loved ones to opioids are incalculable and add to the urgency of addressing this issue,” Chapman said. “You can’t put a price on being around for birthdays, graduations and time spent with family and friends.”

This project was funded through the CDC’s Overdose Data to Action initiative to prevent and reduce drug overdose deaths in Virginia through a series of surveillance and prevention strategies.