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Opioid abuse not only produces social and human tragedy, but it also imposes massive financial burdens on society. When individuals fall into addiction, the costs ripple through healthcare systems, criminal justice, productivity, and public budgets.
However, evidence shows that investing in prevention and treatment is not only more humane, but far cheaper in the long run than the default response of incarceration and reactive medical care.
The economic toll of drug and substance abuse in the United States is enormous. As of 2017, the total cost of opioid use disorder (OUD), overdose deaths, healthcare, criminal justice involvement, and lost productivity was estimated around $1.02 trillion. That figure includes tremendous expenditures on healthcare, addiction treatment, criminal justice operations, and most importantly, the societal cost of lost lives and reduced quality of life.
Given this massive burden, how we respond to addiction – either via prevention and treatment or via punishment and incarceration – makes a huge difference to the economy and taxpayers.
Research consistently shows that prevention and treatment programs are cost-effective, offering substantial returns for each dollar invested. According to global estimates, “every single US $ invested in effective treatment of substance use disorders can return to societies between $4 and $12.”
Outpatient or community-based treatment typically costs a few thousand dollars per year. Residential or more intensive programs remain cheaper than incarceration; when health-care savings and reductions in crime, theft, and emergency costs are included, the return on investment grows even more.
By contrast, incarcerating individuals, particularly for drug-related offences, is extremely expensive. For example, in California, the cost of incarcerating a person is over $127,800 per year, per inmate.
More broadly across the United States, median annual costs per prisoner can reach about $65,000, with some states exceeding $100,000 per inmate per year.
In contrast, effective treatment often costs between $1,800 and $6,800 per person per year, according to analyses of substance-abuse treatment cost-effectiveness.
Furthermore, studies of diversion and drug-treatment programs for nonviolent offenders have shown real cost savings: one evaluation found that diverting offenders to treatment instead of prison saved about $2,300 per offender over 30 months, even after accounting for increased spending in treatment, healthcare, and community supervision.
In addition to the direct financial burden, according to the Centers for Disease Control and Prevention (CDC), incarceration does little to treat underlying addiction.
Many incarcerated individuals lack access to effective substance-use disorder (SUD) treatment. As a result, they are at high risk of relapse or re-offending, which implies repeated costs to society – an inefficient, costly cycle.
Addiction often leads to emergency medical treatment, hospitalization, overdose interventions, and long-term health complications. These costs, though variable, contribute significantly to the overall economic burden of opioid abuse.
For example, in 2017, of the $1.02 trillion cost, a large portion came from healthcare and treatment for OUD and overdose. When people undergo treatment and recovery rather than cycling through overdose, emergency care, or repeated incarcerations, these medical costs drop, improving public health outcomes and reducing overall spending.
Viewed solely through a financial lens, the evidence strongly supports prevention and treatment over incarceration. Prevention is inexpensive and yields high returns; treatment is often a fraction of the cost of imprisonment.
Diversion programs and community-based treatment not only save taxpayer money but also increase the chance that individuals can rejoin the workforce and contribute positively to society.
Moreover, investment in prevention can reduce the number of individuals who enter the criminal justice system, shrink prison populations, and lower the burden on courts, jails, and prisons.
Treatment decreases drug-related crime and lowers emergency medical costs.
The choice between treating addiction as a health issue or a criminal issue is not only a moral decision, it is a deeply economic one. The data and research indicate that prevention and treatment are far more cost-effective than incarceration.
For individuals, families, communities, and taxpayers, investing in treatment and prevention yields stronger health, safer communities, restored lives, and major savings across criminal justice, health care, and social welfare systems.
Given the tremendous economic, as well as human costs of substance abuse, the argument for prevention and treatment becomes overwhelmingly compelling.
This article was written as part of a program to educate youth and others about Alameda County’s opioid crisis, prevention and treatment options. The program is funded by the Alameda County Behavioral Health Department and the grant is administered by Three Valleys Community Foundation.
