Substance Use Disorders Cost US Economy $93 Billion in Lost Productivity in 2023
A new analysis reveals that substance use disorders imposed a staggering $92.65 billion economic burden on the United States in 2023, stemming from diminished workforce participation and reduced output both at work and within households. The findings, published in the American Journal of Preventive Medicine, underscore the urgent need for expanded prevention and treatment initiatives to mitigate both the human and financial costs of these disorders.
The study, analyzed in 2025, provides a more comprehensive assessment of the economic impact than previous analyses by factoring in often-overlooked elements like presenteeism – being physically present at work but functioning at a reduced capacity – and declines in household productivity, encompassing tasks like cooking and cleaning.
“Substance use disorders can impair cognitive and behavioral functioning, resulting in productivity losses,” explained a team of investigators from the Centers for Disease Control and Prevention. “While medical costs and premature deaths associated with substance use disorders have been well documented, the impact of productivity losses on workers, families, and employers due to illness remains less visible and are often underestimated.”
Researchers utilized data from the National Survey on Drug Use and Health (NSDUH) to estimate the financial consequences of substance use disorders among adults aged 18 and older. The breakdown of the $92.65 billion in total productivity losses is as follows:
- Inability to work: $45.25 billion
- Absenteeism: $25.65 billion
- Presenteeism: $12.06 billion
- Household productivity loss: $9.68 billion
The economic toll was not evenly distributed, with males accounting for $61.19 billion in losses and females contributing $31.45 billion.
According to the study’s authors, these productivity losses are comparable to the direct healthcare expenditures associated with substance use disorders, highlighting the far-reaching economic consequences of these conditions. The largest contributors to the overall cost were the inability to work and absenteeism, demonstrating that the economic harms extend significantly beyond medical bills.
The analysis also revealed the substantial impact of presenteeism (13%) and household productivity losses (10%). This suggests that interventions focused on improving the functioning of individuals with substance use disorders, rather than solely on attendance, could yield significant economic benefits.
“Effective prevention and treatment of substance use disorders require integrated, ethically grounded approaches that address both individual risk factors and broader social determinants through coordinated efforts across health, social, and justice systems,” the researchers concluded. “At a time when employers and policymakers are weighing investments in treatment access, workplace supports, and prevention, our results highlight the potential returns on such investments beyond health care savings.”
Further information about the study, “Productivity Losses From Substance Use Disorder in the U.S. in 2023,” can be found in the American Journal of Preventive Medicine (DOI: 10.1016/j.amepre.2025.108102).
