Modelling the wider socio-economic costs of problematic opioid use in the UK

BACKGROUND: Opioid dependence imposes substantial harm, not only to individuals suffering from this chronic relapsing disease, but also to public health and safety. This comes with significant socioeconomic costs. Quantifying these costs is necessary for policy and decision makers weighing interventions to reduce opioid dependence. This study aimed to develop an economic model to estimate the wider socioeconomic costs per problematic drug user (PDU) on and off treatment in the United Kingdom.
METHODS: A costing model was developed to calculate the wider socioeconomic costs of PDUs on and off treatment. Model inputs included dependency prevalence, PDU demographic data, and frequency and cost estimates of opioid dependence-related events. Data were sourced from local databases, published literature, and Local Authority in England. Costs were stratified according to the payer liable and the sector in which costs were incurred.
RESULTS: The annual cost per PDU was substantially higher for PDUs not in treatment. The government bore a large portion of the costs for PDUs in treatment, most of these costs were productivity loss. For PDUs not in treatment, families and communities bore the most costs. The healthcare and criminal justice sectors experienced moderate costs. The criminal justice sector, however, experienced substantially more cost for PDUs not in treatment, while for the healthcare sector there was little difference in cost for PDUs in treatment versus not in treatment.
CONCLUSIONS: The model quantifies savings associated with getting PDUs on treatment and maintains previous findings that doing so reduces costs to society and heavily reduces financial burden on families and communities. Substantially larger savings occur outside healthcare – a sector that faces heavy treatment costs, and thus has a monetary counterincentive to implementation. Therefore, wide-perspective policy is necessary to launch and sustain interventions that make treatment more attractive, increase treatment retention and improve access.