Opioid overdoses accounted for around one-fifth of these hospitalisations and one-quarter of these emergency room visits. Medicare and Medicaid are the primary' payers in around two-thirds of opioid poisoning cases. Public outlays are also incurred through costs for policing, law enforcement and other public services in dealing with drug overdoses. In addition, the treatment of addiction represents another cost often borne by public authorities. On the other side of the ledger, lost productivity also has effects on tax revenue. Estimates of this suggest that in 2016 the combined impact would reduce Federal, State and local tax revenue by almost $16 billion, or around 3/ percentage point of current receipts.