Productivity Losses From Substance Use Disorder in the U.S. in 2023.

INTRODUCTION: Information on morbidity-related productivity losses attributable to substance use disorder is limited. This study estimates morbidity-related productivity losses attributable to substance use disorder among U.S. adults aged ≥18 years in 2023. METHODS: Morbidity-related productivity losses attributable to substance use disorder were estimated using the human capital approach. Using a regression-based approach, the 2021-2023 National Survey on Drug Use and Health data, along with other data and published literature, were used to estimate the cost of absenteeism, presenteeism, household productivity loss, and inability to work attributable to substance use disorder. All costs were estimated for 2023, and all analyses were conducted in 2025. RESULTS: Total morbidity-related productivity loss attributable to substance use disorder among U.S. adults was estimated to be $92.65 billion (95% prediction interval=$57.90, $136.48 billion) in 2023. Inability to work cost accounted for $45.25 billion (95% prediction interval=$28.29, $65.88 billion), followed by absenteeism cost of $25.65 billion (95% prediction interval=$15.11, $39.93 billion), presenteeism cost of $12.06 billion (95% prediction interval=$9.26, $15.41 billion), and cost of household productivity loss of $9.68 billion (95% prediction interval=$5.25, $15.26 billion). CONCLUSIONS: Total morbidity-related productivity losses attributable to substance use disorder in the U.S. are substantial, amounting to $92.65 billion in 2023. Given that these estimates depend on the prevalence of substance use disorder and the amount of lost productive time, evidence-based prevention efforts and policies addressing them can help reduce these losses.