The economic costs of the opioid epidemic include direct costs, funds that must be allocated for purchase of any and all goods and services above that which we would normally allocate for these items were there no opioid epidemic, and indirect costs arising from the need to treat health complications related to opioid misuse, the loss of worker productivity and the long-term negative impact on the children and dependents of individuals with opioid use disorder. The opioid epidemic has significantly increased the financial burden on the criminal justice system as governments must now cover the costs for increased law enforcement, the judiciary, corrections, probation services, and parole. Medical costs directly related to the treatment ofopioid use disorder include inpatient and outpatient addiction treatment, the costs for methadone, buprenorphine, and naloxone. In this chapter we look at the specific areas in which the opioid epidemic has had a very real, and very negative effect on the world economy.