OBJECTIVES: The opioid epidemic in the United States (US) has claimed over 47,000 lives in 2017. However, there is a dearth of literature on the economic impact that opioid-users place on the healthcare system. We sought to investigate the impact of opioid (narcotic) users compared to non-narcotic users on healthcare resources and expenditures using the 2017 Medical Expenditure Panel Survey (MEPS).

METHODS: We used the full consolidated household and prescription files from the 2017 MEPS and their associated survey weights. Narcotic users were defined as responders who reported being prescribed any opioid prescription in 2017. We evaluated the total, prescription, outpatient, inpatient, and emergency department expenditures including the number of outpatient, inpatient, and emergency department visits. Generalized linear models using gamma family and log link were constructed to estimate the marginal effects adjusted for age, race, ethnicity, marital status, region, and poverty status between narcotic and non-narcotic users.

RESULTS: There was a weighted total of 235,845,150 adult respondents eligible for analysis; 5.2% of the total population reported having at least one narcotic prescribed. Narcotic users were older (56 versus 47 years, P<0.001), mostly White (83% versus 77%, P<0.001), and mostly non-Hispanic (91% versus 83%, P<0.001). The marginal effects in total expenditures ($11,321; 95%CI: $8,948-$13,694), prescription expenditures ($2,037; 95%CI: $1,477-$2,598), outpatient expenditures ($1,105; 95%CI: $744-$1,466), emergency department expenditures ($413; 95%CI: $285-$540), and inpatient expenditures ($4,742; 95%CI: $2,952-$6,531) were greater in the narcotic group compared to the non-narcotic group. Narcotic users also had higher resource uses in terms of prescriptions (+13.9; 95%CI: 12.0-15.9), outpatient visits (+7.6; 95%CI: 6.5-8.7), emergency department visits (+0.4; 95%CI: 0.3-0.4), and inpatient nights (+0.9; 95%CI: 0.6-1.3).

CONCLUSIONS: Narcotic users had greater resource use and expenditures compared to non-narcotic users. Understanding the economic impact of narcotic users may influence policies on additional care such as psychosocial services and post-overdose care.