Cannabis-related healthcare visits were far less costly than cocaine, opioid, or multiple drug visits in Florida | Research

The takeaway

In an analysis of 709,658 illicit drug-related healthcare encounters in Florida, cannabis SUD was the lowest-cost reference group, with cocaine increasing ED costs by 9.25% and opioids increasing inpatient costs by 23.4%.

Health economists, drug policy makers, and hospital administrators managing substance-use-related care.

$6.4B in drug-related costs; cannabis lowest-cost; opioids +23.4%

What the researchers found

Across 709,658 drug-related healthcare observations in Florida (2016-2018), total costs were estimated at $6.4 billion. Using cannabis SUD as the reference group, cocaine increased ED visit costs by 9.25% and multiple drug use by 6.12%. For inpatient stays, opioids increased costs by 23.4% and inhalants by 16.3% compared to cannabis. Medicare paid the largest share ($2.16B), followed by Medicaid and commercial insurance ($1.36B each).

Why it matters

Healthcare cost data helps quantify the relative burden of different substances. Cannabis SUD being the least costly drug-related condition supports harm reduction arguments and resource allocation decisions.

The numbers in context

$6.4B total over 3 years; 709,658 observations; cannabis as lowest-cost reference; cocaine +9.25% ED; multiple drugs +6.12% ED; opioids +23.4% inpatient; inhalants +16.3% inpatient; Medicare $2.16B, Medicaid $1.36B.

How the study worked

Retrospective analysis of Florida Agency for Health Care Administration ED and inpatient datasets (2016-2018) with 709,658 observations, using cost-to-charge ratios and linear regression comparing healthcare costs by substance type.

What this study cannot tell us

Florida only (may not represent other states); administrative coding may misclassify substances; cannot account for polysubstance use complexity; cost-to-charge ratios are estimates; does not capture outpatient, mental health, or long-term costs.

How to read the evidence

Strong: large state-level administrative database with 709,658 observations and appropriate cost estimation methods.

When this study was published

Published 2020.

The bigger picture

Over half of the $6.4 billion in drug-related healthcare costs were paid with taxpayer dollars. The relative cost hierarchy (opioids highest, cannabis lowest) has direct implications for how healthcare systems should prioritize prevention and treatment spending.

Questions still open

Would cannabis legalization reduce total drug-related healthcare costs by shifting users away from more harmful substances? What are the hidden costs (lost productivity, family impact) not captured in hospital data?

Common questions

How expensive is cannabis-related healthcare compared to other drugs?

Cannabis SUD was the least costly drug-related condition in Florida hospitals. Compared to cannabis, cocaine-related ED visits cost 9.25% more, opioid inpatient stays cost 23.4% more, and inhalant hospitalizations cost 16.3% more.

Who pays for drug-related healthcare?

Medicare paid the most ($2.16 billion), followed by Medicaid and commercial insurance ($1.36 billion each). Over half of the $6.4 billion total came from taxpayer-funded sources.

Read the original research

Healthcare cost associations of patients who use illicit drugs in Florida: a retrospective analysis.

Substance abuse treatment, prevention, and policy, 15(1), 73

View on PubMed ↗Publisher’s paper ↗

Citation

Ryan, Jessica L; Rosa, Veronica R. (2020). Healthcare cost associations of patients who use illicit drugs in Florida: a retrospective analysis.. Substance abuse treatment, prevention, and policy, 15(1), 73. https://doi.org/10.1186/s13011-020-00313-2