Summary
Fentanyl, a synthetic opioid boasting a potency 50 times greater than heroin, is not only cheaper to manufacture but also remarkably easier to smuggle across borders. This potent combination is at the heart of the rampant illicit opioid epidemic devastating the United States. In the fiscal year 2023 alone, the toll of illicit opioids, predominantly fentanyl, has been staggering—costing Americans an estimated $2.7 trillion (in December 2024 dollars), which is roughly 9.7 percent of the nation’s GDP. This astronomical figure breaks down into bleak categories: 41 percent ($1.1 trillion) stems from fatalities, 49 percent ($1.34 trillion) relates to diminished quality of life, and 10 percent ($277 billion) accounts for other expenses, including healthcare costs, lost labor productivity, and crime-related issues. Alarmingly, 93 percent of opioid-related deaths are attributed to powerful synthetic opioids like fentanyl, which predominantly flow into the U.S. from China and are trafficked through Mexico.
To put this in perspective, even the most pessimistic estimates of the impact of tariffs, like those from Goldman Sachs, which suggested losses of 0.4 percent of GDP, pale in comparison to these figures.
In a previous analysis, the Council of Economic Advisers (CEA) provided a more conservative estimate. This discrepancy largely arises from its exclusion of quality of life costs and the fact that the number of opioid-related deaths in 2015 was significantly lower, at 33,000.
Details
The cost estimates outlined here originate from a 2017 CDC study, which we have meticulously updated to factor in inflation and the alarming rise in opioid-related fatalities and opioid use disorder (OUD) since that time. According to the DEA, a staggering 74,702 Americans perished in 2023—a shocking 1.6 times increase from 2017 figures. Moreover, the number of Americans grappling with OUD has surged by 2.7 times, reaching approximately 5.7 million during this same period. Our calculations have been adjusted to reflect these current statistics and the staggering rise in addiction and mortality. The cost breakdown, all expressed in December 2024 dollars, is as follows:
- Loss of life: $1.11 trillion. This figure is derived from multiplying the total number of lives lost (74,702) by the value of a statistical life in the U.S. and then adding in productivity and healthcare costs associated with these fatalities. We adjusted the $10.1 million value of a statistical life cited by the NIH (2017) to reflect 2025 inflation, bringing it to $13.0 million per life. This value is rooted in market and survey data reflecting what individuals are willing to pay to mitigate the risk of death—illustratively, many estimates hinge on wage increases for jobs with higher mortality risks.
- Loss of quality of life: $1.34 trillion. This assessment is based on three key factors. Firstly, survey data illustrates that individuals with OUD experience about 60 percent (0.626) of the quality of life compared to those in optimal health. Secondly, the inflation-adjusted value of a year of life in full health is estimated at $624,410 per person. Combining these metrics indicates that the annual cost of lost quality of life per individual with OUD is $234,478, which we then multiply by the estimated prevalence of OUD, 5.7 million in 2023.
- Healthcare system impact: $107 billion. This figure reflects the additional annual costs incurred by the healthcare system for treating individuals with OUD compared to those without. The added cost averages $19,000 per person with OUD each year, primarily absorbed by private insurers, Medicaid, and hospitals providing uncompensated care. Ultimately, these expenses trickle down to all Americans through increased insurance premiums, taxes, and healthcare costs.
- Loss of labor force productivity: $107 billion. This estimate is calculated by taking the total productive work hours lost due to opioid-related deaths, OUD, and incarceration, then multiplying that by the average hourly total compensation (wages and benefits) for workers across the U.S.
- Crime-related costs: $63 billion. This amount represents the costs associated with increased police protection, judicial activities, correctional facilities, and property loss stemming from opioid-related crime.
Conclusion
The staggering economic implications of the illicit opioid crisis, estimated at $2.7 trillion in 2023 alone, highlight the pressing need for effective measures to curb the influx of these deadly drugs from abroad. The human suffering and financial burden inflicted by this epidemic are not just unsustainable; they are a clarion call for action.
