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Am J Manag Care. 2019 Jul;25(13 Suppl):S270-S276.
As the opioid epidemic has drawn increased attention, many researchers are attempting to estimate the financial burden of opioid misuse. These estimates have become particularly relevant as state and local governments have begun to take legal action against pharmaceutical manufacturers, distributors, and others who are identified as being potentially responsible for the worsening epidemic. An important category of costs includes those related to the effect of opioid misuse on labor market outcomes and productivity. Most published estimates of opioid-attributable productivity losses estimate the financial burden borne by society, failing to distinguish between costs internalized by individuals and those that spill over to third parties, such as state and federal governments. This article provides an overview and a conceptual framework for 2 types of labor market-related costs borne by state and federal governments that typically have not been incorporated into existing estimates, which may represent important categories of expenditures. Because detailed estimates of lost tax revenue are available elsewhere, this article focuses largely on whether, and how, to incorporate opioid-related expenses incurred by means-tested government programs into more general estimates of the economic harm created by the opioid epidemic.
随着阿片类药物滥用问题日益受到关注，许多研究人员试图估算阿片类药物滥用造成的经济负担。随着州和地方政府开始对制药商、分销商和其他被认为可能对日益恶化的阿片类药物流行负有责任的人采取法律行动，这些估算变得尤为重要。成本的一个重要类别包括与阿片类药物滥用对劳动力市场结果和生产力的影响相关的成本。大多数已公布的与阿片类药物相关的生产力损失估计数都估算了社会承担的经济负担，而没有区分个人内化的成本和溢出到第三方（如州和联邦政府）的成本。本文概述了州和联邦政府承担的 2 类通常未纳入现有估计数的与劳动力市场相关的成本，并提供了一个概念框架，这些成本可能代表着重要的支出类别。由于其他地方提供了详细的税收损失估计数，本文主要集中讨论如何将针对经济状况调查的政府计划中因阿片类药物而产生的相关费用纳入更广泛的阿片类药物流行造成的经济危害的估计数。
