INDIANAPOLIS — Opioid misuse is costing Indiana about $4 billion annually, according to an Indiana University study released this week.

In 2016, potential lost wages due to opioid misuse totaled $752 million, according to the study, conducted by Ryan Brewer, associate professor of finance at Indiana University-Purdue University at Columbus, and Kayla Freeman, a doctoral candidate in finance at the IU Kelley School ofBusiness.

In the past 15 years, the number of opioid overdose deaths has cost Indiana $43.5 billion. This year, the loss is expected to amount to a staggering $4 billion. That total includes $1.75 billion due to unemployment and $1.25 billion in lost gross state product.

The two researchers examined costs from cradle to grave, finding:

• Total marginal costs for neonatal abstinence syndrome births totaled more than $36 million in 2016.

• Total funeral costs for victims of opioid overdose deaths rose from $1.2 million when the crisis began in 2003 to $7.1 million in 2016.

• An estimated 5,243 Indiana children were in foster care due to parental opioid misuse – 600 percent higher than 2003.

• Annually, drug arrests and court costs exceed $13 million; incarceration costs more than $70 million.

The report is based on the economic impact of the opioid overdose deaths of 12,300 Hoosiers from 2003 through 2017. Researchers noted that the number is nearly the same as the population of Pike County in southern Indiana.

The report includes recommendations for action:

• Community leaders, law enforcement, business professionals and others should avoid stigmatizing Hoosiers afflicted by the epidemic.

• A concerted effort – through funding, engineering and scientific investments – to develop non-addictive pain relievers by the bio-sciences industry could help solve the crisis and bring positive economic attention to Indiana.

• Educational leaders from pre-K through college could expand curricula to promote better understanding of the risks associated with the misuse of pharmaceuticals, as well as learning ways to identify at-risk students for intervention. Currently, the Indiana Department of Education leaves opioid discussions to individual districts, an official said.

“I think it’s important for mayors, leaders at various levels, the state level, as well as the local level, to understand the scope of the problem, understand the value of the problem,” Brewer said. “Therefore, when we look for investments as solutions, we can understand what the appropriate level would be.”

Areas of the state hit hardest include eastern and southern counties and the far northwest corner, he said.

Topping the list of negative impacts are employee absenteeism and prescription pain-reliever use at work, according to the state chamber. For example, a northern Indiana healthcare system reported that 12 percent of its workforce, about 1,000 people, was hit by opioid abuse.

The ability of businesses to hire a skilled workforce has been significantly diminished by the opioid crisis, according to Jennifer Pferrer, executive director of the Wellness Council of Indiana, a subsidiary of the Indiana Chamber of Commerce. Since February, the council has assisted hundreds of employers by explaining the crisis and how to review internal pol ic ies regarding substance use by employees.

Perhaps as a result, the longheld stigma is changing.

“We have some employers that are really beginning to think differently and say, if you come in under the influence, then it is our responsibility to help you access treatment, if you’re willing to do that,” Pferrer said. “Are they supportive of a recovery-friendly environment, or is it more punitive in nature when it comes to managing employees who have substance abuse issues?”

While there are employer costs for initiating such support systems, the costs can be counterbalanced by decreasing the rate of employee turnover, Pferrer noted.

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