Why we need bolder action to combat the opioid epidemic
Although the opioid crisis in the US is gaining increased attention, the steps taken to date to combat it are insufficient. Our research suggests that much broader—and bolder—action is required.
The problems resulting from the opioid epidemic have gained increased recognition in the United States, and greater focus is being placed on preventing opioid use disorder (OUD). We are hopeful that, because of efforts already underway, the number of new people with OUD will soon start to decrease.
That does not mean, however, that the opioid epidemic will soon be over. Given the number of people already suffering from OUD (whether diagnosed or not), the rate of adverse outcomes is likely to rise. These outcomes include not only overdoses and deaths, but also unemployment, lost productivity, and exacerbations of behavioral health conditions. In addition, a growing number of children are being displaced and/or emotionally affected because of their parents’ opioid dependency.
This paper summarizes our core perspectives on the opioid crisis in the United States. These perspectives are based on investments McKinsey has made in both research and proprietary analytics. The research included an extensive review of publicly available literature and conversations with more than 100 stakeholders, including executives from public-sector organizations, payers, providers, pharmaceutical benefits managers, pharmaceutical and biotech companies, start-ups, and foundations.
The crisis is likely to worsen
Four primary factors lead us to believe that the effects of the opioid crisis will worsen over the next three to five years, even if the rate of new OUD cases slows considerably.
First, the prevalence of OUD is likely to be much higher than the figure commonly cited—two million people1 —because OUD is significantly underdiagnosed and underestimated. For example, it has been shown that many, if not most, patients who use opioids for more than a brief period develop some degree of dependency.2 However, in an analysis of data from one state’s Medicaid population, we found that only 18% of the members receiving high-dose opioids on a chronic basis (defined as greater than 120 MED per day for more than 180 days in the past year3 ) had been given a diagnosis of opioid dependence or abuse (Exhibit 1). This and other recent research suggests that the nationwide prevalence of OUD could be upward of four million to six million people.