A new study shows that in 2023, substance use disorders will result in nearly $93 billion in lost productivity in the United States due to absenteeism, reduced work performance, inability to work, and lost household productivity. The new analysis shown in American Journal of Preventive Medicinepublished by Elsevier, highlights the need for prevention and treatment strategies to reduce harm and cost.
“Substance use disorders can impair cognitive and behavioral functioning, resulting in productivity losses,” said the team of researchers from the Centers for Disease Control and Prevention. “While the medical costs and premature deaths associated with substance use disorders are well documented, the impact of lost productivity on workers, families and employers due to illness remains less visible and often underestimated.”
The researchers used recent national survey data—primarily from the National Survey on Drug Use and Health (NSDUH)—of adults 18 and older with substance use disorders to estimate the costs associated with absenteeism and incapacity for work, as well as two often overlooked factors: presenteeism (present but not productive at work), and household production (e.g., burden.
Analyzes show estimated productivity losses of $92.65 billion in total, or $3,703 per adult with a substance use disorder, in 2023 (analyzed in 2025). The distribution of these costs is as follows:
- Disability to work: $45.25 billion
- Absences: $25.65 billion
- Presentation: 12:06 billion dollars
- Household productivity loss: $9.68 billion
Of this total cost, men accounted for $61.19 billion and women for $31.45 billion.
The study’s authors note, “These costs are comparable to direct health care costs for substance use disorders, showing the broad economic impact of these disorders. The largest rates came from inability to work, followed by absenteeism, highlighting that the economic harms extend far beyond medical bills.”
The researchers also point to the impressive size of the share of costs associated with attendance (13%) and household productivity losses (10%), indicating that interventions aimed at improving employee functioning, not just engagement, could yield significant economic benefits.
The researchers conclude: “Effective prevention and treatment of substance use disorders requires comprehensive, ethically grounded approaches that address both individual risk factors and broader societal determinants through coordinated efforts across health, social and justice systems.
