Substance use disorder (SUD) and suicide are two of the most serious public health crises in the United States. Together, they cause tremendous human suffering—and carry a staggering financial cost. Understanding the true scope of these burdens is the first step toward building smarter, more equitable prevention strategies.

The Cost of Substance Use Disorder

Substance use disorder affects millions of Americans and drains enormous resources from families, employers, and communities. The economic burden spans healthcare costs, lost productivity, and criminal justice spending. Florence et al. (2021) found that opioid use disorder and fatal overdoses alone cost the United States approximately $1.5 trillion in 2020—capturing both medical expenses and the value of lives cut short. That figure reflects just one category of substance misuse. When alcohol and other drugs are included, total annual costs climb well above $700 billion. Fardone et al. (2023) reviewed two decades of evidence and found that SUD treatment consistently delivers strong economic returns, with reductions in criminal activity producing the largest savings. Still, gaps in funding, access, and culturally responsive care continue to limit the impact of available treatments. SUD also creates long-term harm beyond finances: children in affected households face higher risks of trauma, neglect, and intergenerational substance use, creating cycles that are difficult to break without sustained community investment.

The Cost of Suicide

Suicide is the most extreme and preventable outcome of untreated mental health crisis. Peterson et al. (2024) estimated the total economic cost of suicide and nonfatal self-harm in the United States at an average of $510 billion per year between 2015 and 2020—most of it tied to the loss of human life and productivity. Working-age adults between 25 and 64 accounted for nearly 75% of that cost. Sheppard et al. (2022) confirmed that the economic toll of suicide extends well beyond emergency care costs, with the majority of losses coming from reduced productivity and early death. Disparities make this burden worse: Stone et al. (2025) found that suicide rates vary significantly by race, ethnicity, and age group, with American Indian and Alaska Native populations and middle-aged adults facing the highest rates. These are not just numbers—they represent communities that are underserved and underprotected. Research shows that every dollar invested in suicide prevention can return four to six dollars in saved costs (Sheppard et al., 2022).

Why This Matters for Prevention

These numbers make a clear case: SUD and suicide are not just personal struggles—they are public health emergencies with massive societal consequences. Addressing them requires investment in evidence-based treatment, equitable access to care, and upstream prevention that targets poverty, trauma, and systemic inequality. Prevention saves lives and saves money. The question is whether we are willing to act with the urgency these crises demand.

References

Florence, C., Luo, F., & Rice, K. (2021). The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017. Drug and Alcohol Dependence, 218, 108350. https://doi.org/10.1016/j.drugalcdep.2020.108350

Fardone, E., Montoya, I. D., Schackman, B. R., & McCollister, K. E. (2023). Economic benefits of substance use disorder treatment: A systematic literature review of economic evaluation studies from 2003 to 2021. Journal of Substance Use and Addiction Treatment, 152, 209084. https://doi.org/10.1016/j.josat.2023.209084

Peterson, C., Xu, L., & Grosse, S. D. (2024). Economic cost of U.S. suicide and nonfatal self-harm. American Journal of Preventive Medicine, 66(6), 1011–1018. https://doi.org/10.1016/j.amepre.2024.02.010

Sheppard, K., Mace, G., Langley, R., Mercer Kollar, L. M., & Rostad, W. L. (2022). The economic toll of suicide and nonfatal self-harm in the United States. Injury Prevention, 28(2), 133–138. https://doi.org/10.1136/injuryprev-2021-044566

Stone, D. M., Cammack, A. L., & Carbone, E. G. (2025). Notes from the field: Differences in suicide rates, by race and ethnicity and age group — United States, 2018–2023. Morbidity and Mortality Weekly Report, 74, 550–553. https://doi.org/10.15585/mmwr.mm7432a4

Note: If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline, available 24/7.