Modelling the wider socio‐economic costs of opioid dependence in the UK

BACKGROUND AND AIMS: Opioid dependence poses large costs to society, and associated deaths are rising in the United Kingdom (UK) and Europe. Opioid dependence treatment programs combining opioid agonist therapy with psychosocial interventions have been shown to improve treatment retention compared with agonist therapy alone. This study estimated the wider societal costs of opioid dependence within different sectors and according to different cost bearers within the UK and evaluated how the costs differ depending on whether people with opioid dependence are in treatment. METHODS: This prevalence-based cost-of-illness modelling study used secondary data from peer-reviewed journals as well as official reports to develop a costing model estimating the annual wider socio-economic costs of people with opioid dependence in treatment and not in treatment in the UK. There were an estimated 364 161 people with opioid dependence in the UK, and of these, approximately 47% (170 969) were in treatment. Costs were calculated according to which of five sectors (healthcare, social care, economy, wider social and criminal justice) the costs were incurred, and according to a set of five cost bearers (government, employers, insurance companies, families/communities and the people with opioid dependence). The model incorporated approximately 160 cost and frequency parameters drawn from secondary sources. All costs were expressed in 2022 UK pounds sterling (GBP). RESULTS: The total annual costs of opioid dependence in the UK across the five sectors amounted to an estimated £71.4 billion. Of this, an estimated £49.4 billion was incurred by people with opioid dependence not in treatment. Annually, every person with opioid dependence successfully recruited or retained in treatment for a period of one year incurs an estimated £140 876 less in costs than those not in treatment. A small proportion, 2%, of this cost difference was seen within the healthcare sector, while 37% of the difference came in the form of relief for families and communities, 37% in the form of economic productivity and 23% in less cost for the criminal justice system. SUMMARY: The financial burden of opioid dependence extends beyond the healthcare sector, with substantial costs borne by families and communities, employers and the criminal justice system. Opioid dependence treatment can contribute to considerable societal cost reductions, particularly for families and communities. The healthcare sector experiences a small proportion of these reductions and thus may lack the necessary incentive for implementing innovative and inclusive treatment programs.