In 2021, the opioid epidemic had a significant economic impact on Virginia. It is estimated that the total cost of this problem reached $5 billion in 2021 alone. This financial burden has hurt everyone, including workers, families, businesses, and government agencies. It includes both money that was spent directly because of the epidemic and money that will be lost in the future.
Where the Money Went
Many of these costs are shouldered by Virginia's families and businesses. They lose out on money that won't be earned in the future due to people being affected by opioids. Federal, state, and local government agencies also pay a share of the costs. They provide health care and other services for people suffering from the opioid crisis. Additionally, government agencies miss out on money that would have come from taxes in the future. So, the costs of the opioid epidemic are spread across different parts of the community.
“Costs by Sector” and “Costs by Payer”
Looking at "Costs by Sector" and "Costs by Payer" helps us see the economic impact of the opioid crisis in Virginia. "Costs by Sector" shows how much is spent on lost labor, healthcare, crime-related costs and other services. (The category “Crime/Other” refers to criminal justice and other services, including help for children and families.) "Costs by Payer" shows who covers these costs, including households, state and local governments, and the federal government. These analyses help us see where the money goes and who pays for the cost.
Mapping the Economic Burden of the Opioid Epidemic
The impact of the opioid epidemic varies among Virginia localities. The map below displays each locality’s cost per person (total costs divided by the total population) for each sector.
Scroll over the map below to explore how the opioid crisis impacted counties and independent cities in Virginia. Select the tabs at the top of the map to change which sector or payer is being shown on the map.
By Locality (County or Independent City)
State of Virginia
Data Included:This map includes costs of lost labor, healthcare, and public services related to opioids for all 133 localities in Virginia, totalling $5.02 Billion in 2021. The data covers local, state, and federal governments, as well as household and private sector expenses. The map displays economic costs per person in dollars, considering the population size of each county and independent city.
Lighter Color: Counties and cities with lower economic costs per person, between $60 and $345, are shown in lighter colors.
Slightly Darker Color: Regions with moderately low economic costs per person, between $345 and $536, are displayed in slightly darker colors.
Darker Color: Areas with moderately high economic costs per person, between $536 and $790, are indicated in darker colors.
Darkest Color: Counties and cities with the highest economic costs per person, between $790 and $1.92K, are shown in the darkest color.
Clusters: The map shows two major clusters of localities with high total opioid costs per person: a broad swath entirely spanning southern Virginia, and another broad swath entirely spanning eastern Virginia. The highest total opioid costs per person are in the central portions of eastern and southern Virginia. In the western portion of central Virginia, we find a cluster of localities with low total opioid costs per person.
Outliers: In addition to those clusters, we find a group of outliers in northeastern Virginia, another in southeastern Virginia, and a third smaller group of outliers in the extreme southwest of Virginia, where localities with low total opioid costs per person differ from their surrounding areas.
Virginia is a state located in the southeastern region of the United States, with a population of 8.5 million residents.
Virginia's public health services are organized into health districts, with each district responsible for providing essential health programs and services to its residents.
The opioid cost per person in Virginia is $588. The total cost of opioids in the state of Virginia is $5,020,792,988.
Costs By Community: Per Person vs. Total
To grasp the opioid epidemic’s reach, it's helpful to investigate both the total cost and cost per person. The total cost presents a bigger picture view of the expenses. Cost per person reveals how the opioid epidemic affects people individually. Using both measures helps us fully understand how the epidemic affects different localities.
Read full explanation
Total cost means the total expenses resulting from the opioid epidemic in each place. The total cost encompasses both direct costs and lost income. Total cost includes lost labor and costs related to health care, crime, education, and households. Cost per person divides the total cost by the locality's population. In this way, it shows the average cost for each person living in a locality.
Calculating the total cost shows the varying scale of the opioid epidemic’s impact on localities. The total cost also highlights which places face higher expenses. Yet, it may not be fair to compare localities with very different population sizes. The total cost does not show the whole picture of the epidemic's relative severity. A smaller place may have a lower total cost because fewer people live there, but the cost per person may be very high.
Calculating the cost per person allows for a fairer comparison between localities. Population size helps us understand the epidemic's relative impact on individuals. Relying only on cost per person, though, may not show the full extent of the epidemic's seriousness. Some smaller localities may have a high cost per person, but the overall impact could be lower due to their smaller populations. We need to understand both relative impact and population size for full context.
The Connection Between Poverty and Opioid Use
Studies have shown a strong link between how much money a person has and their well-being. They find socioeconomic status matters more than lifestyle factors in predicting health.
Why? Being jobless, having less income and lower education, and living in poor housing can all cause stress. Such situations also isolate people from the support they need. When people lack the support they need, they are more likely to experience mental health problems. To cope, they may use substances such as opioids.
We use two ways to understand the economic conditions of localities in Virginia: Poverty Rate and Median Household Income.
Poverty Rate by Locality, Compared to State Poverty Average, 2021
Source: 2021 American Community Survey (ACS) 5-Year Estimates.
How We Measure Poverty Rates
To calculate the poverty rate of a county, we count how many people in each county have an income below a certain amount of money each year. Then we divide that number by the total population of the county. This helps us compare the number of people in poverty to the total population. It's important to note that counties with more people may not always have the highest poverty rates. A county needs a large number of people below the poverty threshold compared to its total population to have a high poverty rate.
Median Household Income by Locality, Compared to State Median Income, 2021
Source: 2021 American Community Survey (ACS) 5-Year Estimates.
How We Measure Median Household Income
To find the median household income of a county, we arrange all the household incomes from lowest to highest. Then, we look for the income value that falls exactly in the middle of the list. This value shows the median household income for that county. The median value helps us get an idea of how much people earn in that area, considering everyone, and also helps avoid the impact of extremely high or low incomes.
The Human Cost
The largest part of these labor losses comes from people dying due to opioid overdoses, estimated at $1.9 billion. When we calculate the economic costs of losing lives, it's crucial to remember that these estimates don't include the true value of the lives we've lost, which is immeasurable.
The Losses We Cannot Measure
There are harmful effects of the opioid epidemic that can't be reduced to a dollar amount. These include the emotional impact, reduced quality of life, and other negative effects on communities. So, the numbers mentioned in this study, while important, don't capture the complete impact of the opioid crisis in Virginia.
The Virginia Department of Health (VDH) is dedicated to ending the opioid epidemic, which takes thousands of lives every year.
VDH's Opioid-Reduction Efforts
VDH has several programs to cut down on opioid use and overdoses, such as:
Teaming up with emergency departments to connect those who've had an overdose with peer support and treatment programs.
Sharing the Centers for Disease Control and Prevention's “It Only Takes a Little to Lose A Lot” media campaign all across Virginia.
Gaining a better understanding of the groups affected by opioid use through data and surveillance.
Providing educational opportunities for healthcare providers through an online education platform.