The Real Cost of Heroin Addiction
The rise in heroin abuse and addiction represents a real national threat.1 The relatively low street costs of heroin and its widespread availability across the U.S. may make heroin both more appealing and more accessible to users, which can lead to a higher risk of overdose and other dangerous complications.2
The true cost of continuing heroin addiction may remain somewhat hidden, but it comes with a hefty price in numerous aspects. This is why individuals with a heroin addiction may want to seek professional help to start recovery.
Heroin poses a serious threat, especially when the number of heroin-related overdose deaths is taken into consideration. While lower heroin street prices and its availability may seem initially appealing to users, heroin’s heftiest, most deadly costs are hidden.1
Many users start using heroin after their prescription painkillers such as OxyContin become too pricey or not as easily obtainable.1 While turning to heroin appears to be a less expensive opioid substitute, often the hidden costs of heroin are discovered only when it’s too late to undo the consequences of a dangerous, newly formed habit.
When discussing how much heroin costs, it is important to look beyond the cost individuals pay for it per se and focus on the bigger picture: the hidden financial, physical and personal chaos that results from this destructive drug.
The following information will also help you better understand how to best help someone who might be battling a heroin addiction and how to approach them about the issue.
The Street Cost of Heroin
How much does heroin cost on the street? The street price of heroin depends on a number of different factors, including source, location, type of heroin, heroin purity levels, and others. However, the street price of heroin has been much lower in recent years than in past decades.2 Although heroin purity levels are constantly fluctuating, heroin today is much higher in purity and lower in price. All of this is the result of a dramatic increase in drug trafficking in recent decades.1
For instance, in 1981, the average retail-level purity of heroin was 10 percent and the price per gram was $3,480 in 2017 USD. However, by 1999, the average retail-level purity of the drug increased to an average of 40 percent and its price per gram at the retail-level has dropped to $664 in 2017 U.S. dollars.1
While purity of heroin was not associated with overdose, each $100 decrease in the price per gram of pure heroin led to a 2.9% increase in the number of heroin overdose hospitalizations. Additionally, each 10% increase in the market share of Colombian-sourced heroin, regardless of heroin quality, was associated with a 4.1% increase in the number of overdoses in hospitals.3
Increased availability of heroin, which has also been associated with increased use and overdose, has has the same effect on the street price and price per gram of the drug.4
The Hidden Costs You Pay
While the street price of heroin may appear cheap, individuals end up paying more than just the street value of heroin out of their own pocket, depending on their healthcare plan coverage.
In addition to higher medical and legal expenses, costs can include lower income levels, relational costs, and physical/emotional costs.
Below are some of the hidden costs of heroin individuals may face as a result of heroin use.
Medical Care Expenses
A variety of physical consequences may result from using heroin that require important medical attention and treatment.
Costs and ranges listed in the table below are U.S. averages and estimates in U.S. dollars for all types of medical needs, unless stated otherwise; costs vary by city, medical organization, type of health insurance and individual medical needs:5-12
Emergency room visit
No insurance = $740–$3.4K
Insurance = $150–$320
Ambulance ride (L.A.)
No insurance = $1K–$1.3K
Insurance = $200–$260
Doctor’s office visit
No insurance = $38–$396
Insurance = $32
No insurance = $10K
Insurance = $2K–$5K
Heroin abuse facilities
No insurance = $1K–$3K+
Insurance = $0-$1K+
Widely variable costs, depending on individual circumstances
Values followed by “K” are in units of 1000.
The legal costs of heroin use may include prison time, along with federal and state fines. A person may also find themselves getting caught up in child custody disputes, in the event that they have children and are charged with abandonment or neglect.
Below are estimates of typical costs which can vary by state and by type of child custody dispute:13-14
|Possession of heroin||Manufacture, sale or distribution of heroin|
1st offense – 1 year in prison and a $5,000 fee.
2nd offense – 2 years in prison with a $10,000 fee.
1st offense – 15 years in prison with a $25,000 fee.
2nd offense – Up to 30 years in prison with a $50,000 fee.
7 years in prison and up to a $50,000 fee.
10 years to life in prison and a $100,000 fee.
Child custody disputes
Child custody disputes can result in fines between $3,000–$40,000.
Heroin use will often lower a person’s total income either by causing them to neglect their job responsibilities or by removing them from an income-earning environment:15
- Lower earnings: Poor job performance and incarceration can decrease a person’s overall income.
- Unemployment: Using heroin may lower a person’s desire and ability to find and keep a job.
- Incarceration: The rates of criminal activity and incarceration among heroin users are high.
- Premature mortality.
Physical / Emotional Costs
In addition to financial consequences, one of the greatest price tags of heroin is its ability to destroy and even take a person’s life.
- Bodily harm: Heroin may cause immediate and long-term bodily harm and brain damage.16
- Medical complications: Using heroin can make a person vulnerable to problems in pregnancy.17 Heroin users may also be at a higher risk of contracting various diseases such as as AIDS, tuberculosis, hepatitis B and hepatitis C.18
- Co-occurring disorders: Substance use and mental health disorders may be co-related and may co-occur.16
- Decrease in emotional maturity: Long-term heroin use can lead to inability to handle stress without the drug, which can trigger repeated relapse.16
- Heroin withdrawal symptoms which range in severity: There is a wide spectrum of symptoms a person may experience during withdrawal.
- Death: Heroin addiction and overdose can lead to a fatal outcome.16
Heroin affects more than just the heroin user. Relational dynamics with others can severely change for the worse when a person uses heroin:19
- Damage to relationships with loved ones: Reliable, trusting and loving relationships with friends and family may break down.
- Loss of child custody: If a parent uses heroin, they also risk losing custody of children for legal reasons such as neglect or abandonment.
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The Hidden Costs Society Pays
Using a cost-of-illness approach, costs can be estimated in four broad areas:15
- Medical care.
- Lost productivity.
- Social welfare.
According to estimates, the cost of heroin addiction in the United States was $51.2 billion in 2015 US dollars in terms of productivity losses, criminal activities, medical care, and social welfare.20 The large economic burden resulting from heroin addiction highlights the importance of investment in prevention and treatment, although these activities have an economic impact in their own right.15
Increased availability of heroin in the U.S. market has led to a considerable increase in demand for and use of heroin. Another reason for this stems from the fact that many controlled prescription drug abusers started using heroin due to price differences, its availability, and the reformulation of OxyContin®, a commonly abused prescription opioid.1
There is another way in which to look at heroin costs, and that is the overall “societal cost” brought about as a result of this drug’s presence in our cities and towns. In the year 2015, the societal cost was $50,799 per user.20
The U.S. Government has estimated that the nation’s overall annual expenditure on heroin was roughly $27 billion dollars in 2010 and rose to $46 billion in 2016.21 Most of this tremendous figure is due to productivity costs of heroin users (mortality, unemployment, incarceration, etc.).20
Medical complications and conditions such as AIDS resulting from heroin use account for society’s next largest set of costs, followed by heroin-related crime costs and medical care costs.20
Unlike 1 full year of imprisonment costs which are approximately $24,000 per person, the average cost for 1 full year of methadone maintenance treatment for recovering individuals is approximately $4,700 per patient.22
According to several conservative estimates, every dollar invested in addiction treatment programs yields a return of between $4 and $7 in reduced theft, drug-related crime and criminal justice costs. When healthcare-related savings are factored in, total savings can exceed costs by a ratio of 12 to 1.22
Frequently Asked Questions
How Much Does Heroin Addiction Cost?
The weighted average of monthly heroin addiction costs in 2016 were estimated at $1,450, when the price of per pure gram of heroin was estimated at $750 in 2016 USD.21
However, heroin has repercussions that extend far beyond its direct effect on the individual with a heroin addiction. The impact is devastating in terms of medical and social consequences, including health risks, fetal effects, crime, violence, and disruptions in family, workplace, and educational environment.23
How Much Does Heroin Cost?
The average, inflation-adjusted price of heroin in the year 2017 was $307 in 2017 USD, while the average price adjusted for purity was $929.24
Many factors affect the street price of heroin, including the type of heroin used and its purity, i.e., how the drug is “cut” and processed and how available it is to the public in an area at a given time. Instead of focusing on heroin price per gram, the focus is on the typical unit price of heroin, which is about 1/10th of a gram, the average single dose:25
- The average cost of a single dose of heroin purchased on the street has been reported as approximately $10.25
- $10 and $20 bags of heroin have been typical retail transaction for years.26
- Consuming a higher daily number of bags of heroin was significantly predicted by three factors: higher total monthly income, lower bag unit cost, and injection heroin use.25
- The distributors package the Mexican black tar heroin, the most common type of heroin in the state of California, that sells for $20 for 1/5 gram in cellophane or tin foil.27
According to research done in Detroit, Michigan, an individual may spend as much as 75% of their total income on heroin.25 The reason for such a high daily spending habit has its roots in the nature of heroin addiction. Withdrawal symptoms may appear within 8–12 hours of the last dose of heroin, which explains the need for frequent consumption of the drug.16 As individuals become more dependent on the drug, they build tolerance to it, meaning that it takes more and more heroin to get high. This leads to an increasingly expensive and increasingly dangerous habit and the constant threat of overdose.
How Much Does Heroin Cost Per Gram?
The price of heroin per gram depends on various factors. Overall, the price seems to be constantly dropping: in 1981, the average price per gram of pure heroin was $3,260 in 2012 U.S. dollars (USD) at the retail-level. By 1999, that price had decreased to $622 (2012 USD).1 In 2017, the average cost of heroin per gram was $307 in 2017 USD.1
How Much Does a Bag of Heroin Cost?
A bag of heroin in a typical transaction can be expected to cost $10 or $20.26 But if the price of heroin is $1,000 per gram, a “dime bag” which costs $10 may contain only 10 milligrams of heroin.28
How Much Is a Kilo of Black Tar Heroin?
The black tar heroin, ranging in purity from 20 to 60 percent, is dominant in California, easily obtainable and plentiful. Prices range from $15,000 to $80,000 per kilogram.27
How Much Does Heroin Cost the User Per Day?
Individuals with a heavy addiction to heroin spend a significant percentage of their income on heroin.25 The cost of heroin use is dependent on heroin consumption pattern, duration of use, availability, number of suppliers in the areas, distance to suppliers, and others. All these factors determine the number of bags consumed per day, unit purchase amount, and the number of bags purchased over a given period of time.25
Why Is Heroin So Cheap?
The street prices of heroin has been much lower in recent years than in past decades, although it is not clear if the increase in demand has led to the increase in supply or the other way around.2
One of the main reasons why heroin is so cheap is because various cheap agents are used to “cut” the illicit drug. The purpose of mixing these agents with heroin is to increase the volume of supply and obtain larger quantities of the finished product and/or mimic the effect of heroin.29
Why Is Heroin More Popular Than Other Drugs?
The reason why heroin is so popular may be due to the low cost and high availability of the drug.2 Key to prevention of heroin use is reducing exposure, but this is exceedingly difficult since the drug is so widely available. Increased availability of heroin, associated with a nationwide increase in heroin use and overdose, may have been partly caused by the efforts to reduce the availability of prescription opioid analgesics.4
Namely, prescription opioids and heroin have similar chemical properties and physiological impacts, which is why individuals may turn to heroin: the cheaper and easier to obtain alternative to prescription opioids which can provide a better and faster high.2 Individuals who use prescription opioid frequently or who are diagnosed with dependence or abuse of prescription opioids may be more likely to switch to heroin and progress to heroin addiction.30
While the “high” produced by heroin is frequently reported to be a significant factor among individual users, the main reason for switching to heroin seems to be that the drug was both more readily accessible and much less expensive than prescription opioids.31
Along with a considerable increase in production of Mexican heroin, there has been an increase in availability of the easily injectable white powder heroin due to domination of the U.S. market by Mexican and Colombian heroin sources.4 It is estimated that heroin consumption increased by 10% per year between 2010 and 2016, which has led to changes in the composition of heroin use and a notable increase in use among individuals without criminal history.21
How Much Does Heroin Rehab/Treatment Cost?
Individuals struggling to overcome heroin addiction and break out the heroin addiction loop have a range of treatment options available. One of the options is counseling with a licensed therapist within a comprehensive heroin addiction treatment plan which includes both a supervised detoxification service and rehabilitation services.
The costs of different addiction treatment programs vary depending on type, the level of care provided in a treatment facility, duration of treatment and other factors. There are various ways to finance heroin addiction treatment programs, including private insurance, private pay and other sources. There is also state-funded rehab, but this option is not as common as it used to be due to changes in insurance coverage.32
If you or someone close to you shows signs of abusing heroin or signs of struggling with addiction to or withdrawal from heroin, it is important that you reach out for professional help with addressing addiction such as a specialized heroin rehab program and seek more information on financing options and insurance coverage.
- Drug Enforcement Administration. (2015). National Heroin Threat Assessment Summary.
- National Institute on Drug Abuse. (2020) Heroin use is driven by its low cost and high availability.
- Unick G, Rosenblum D, Mars S, Ciccarone D. (2014). The relationship between US heroin market dynamics and heroin-related overdose, 1992-2008.
- National Institute on Drug Abuse. (2020). Increased drug availability is associated with increased use and overdose.
- N. Caldwell, T. Srebotnjak, T. Wang, R. Hsia. (2015). “How much will I get charged for this?” Patient charges for top ten diagnoses in the emergency department.
- G. Claxton, C. Cox, M. Rae. (2015). The cost of care with marketplace coverage.
- L. Zamosky. (2014). Ambulances: Basic info about a service you may take for granted.
- CAREOperative. (2015). Healthcare Bluebook: Medical services.
- K. Ray, A. Chari, J. Engberg, M. Bertolet, A. Mehrotra. (2015). Opportunity costs of ambulatory medical care in the United States.
- A. Pfuntner, L. Wier, C. Steiner. (2013). Costs for hospital stays in the United States.
- U.S. Centers for Medicare & Medicaid Services. (2015). Why health coverage is important: Protection from high medical costs.
- Fox News Associated Press. (2014). Heroin addicts face barriers to treatment.
- K. LaMance. (2015). Heroin state and federal penalties.
- M. Izzi. (2015). How much will a child custody lawyer cost?
- T. Mark, G. Woody, T. Juday, H. Kleber. (2001). The economic costs of heroin addiction in the United States.
- American Society of Addiction Medicine. (2020). The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update.
- National Institute on Drug Abuse. (2020). How does heroin use affect pregnant women?
- National Institute on Drug Abuse. (2020). Why does heroin use create special risk for contracting HIV/AIDS and hepatitis B and C?
- Substance Abuse and Mental Health Services Administration. (2020). TIP 39: Substance Use Disorder Treatment and Family Therapy.
- Ruixuan Jiang, Inyoung Lee, Todd A. Lee, A. Simon Pickard. (2017). The societal cost of heroin use disorder in the United States.
- Greggory Midgette, Steven Davenport, Jonathan P. Caulkins, Beau Kilmet. (2019). What America’s Users Spend on Illegal Drugs, 2006-2016.
- National Institute on Drug Abuse. (2020). Is drug addiction treatment worth its cost?
- National Institute on Drug Abuse. (2020). Heroin Research Report Overview.
- United Nations Office on Drugs and Crime. (2017). Heroin and cocaine prices in Europe and USA.
- Roddy, J., Greenwald, M.K. (2009). An economic analysis of income and expenditures in heroin-using research volunteers.
- Office of National Drug Control Policy. (2001). The Price of Illicit Drugs: 1981 through the Second Quarter of 2000.
- National Drug Intelligence Center California Northern and Eastern Districts Drug Threat Assessment. (2001). Heroin.
- Reuter, P., Caulkins, J. P. Bulletin. (2004). Illegal “lemons”: price dispersion in cocaine and heroin markets.
- Jessica Houck, Latha Ganti. (2019). A Local Epidemic of Laced Heroin Causing Skin Necrosis.
- National Institute on Drug Abuse. (2020). A subset of people who abuse prescription opioids may progress to heroin use.
- Theodore J Cicero, Matthew S Ellis, Hilary L Surratt, Steven P Kurtz. (2014). The changing face of heroin use in the United States: a retrospective analysis of the past 50 years.
- Substance Abuse and Mental Health Services Administration. (2014). What Is Substance Abuse Treatment? A Booklet for Families.
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Help for Heroin Addiction
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