OBJECTIVES: Prior research has estimated the burden of opioid abuse in the U.S. However, older data may not reflect recent trends in abuse prevalence and associated costs. This study provides updated estimates of the burden of opioid abuse. METHODS: Patients aged 12-64 diagnosed with opioid abuse/dependence (“abusers”) were selected from the Truven MarketScan medical and pharmacy claims database, 2009-2012. A 12-month follow-up period centered on the index date (i.e., first abuse diagnosis) was used to assess costs and was preceded by a 6-month baseline period. Patients were required to have continuous non-HMO coverage throughout the 18-month study period. Potential controls met similar inclusion criteria but were not diagnosed with abuse, with their index date based on a random medical claim. Abusers were matched 1:1 to controls based on index year, baseline healthcare costs, and propensity score to account for baseline differences. Per-patient healthcare costs of abusers and matched controls were compared to determine the excess annual healthcare costs of diagnosed abuse. Costs reflect payments from payers to providers in 2012USD. Prevalence of abuse was estimated as the proportion of abusers among those with ≥1 one month of eligibility in a given year. RESULTS: