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Medicare and private health insurance companies pass on the cost of prescription drug abuse to consumers in the form of higher premiums, according to the Coalition Against Insurance Fraud.

According to a 2007 report by the group, the cost of prescription painkiller abuse for insurers is $72.5 billion. Most of the cost comes from treatment, in the form of visits to the emergency room, rehabilitation, and associated health problems, CNN Money reports. Medicare and health insurance companies also pay for the costs of the drugs themselves. The coalition says the average “doctor shopper”—a person who goes from doctor to doctor collecting prescriptions for the same drugs—costs insurers between $10,000 and $15,000 per year.

A study published in 2011 in the Clinical Journal of Pain found prescription drug abuse led to $42 billion in costs related to lost productivity, as well as $8.2 billion in criminal justice costs.

“There’s no doubt that this is a growing cost to society,” Kevin Sabet, a former senior advisor at the White House Office of National Drug Control Policy, told CNN Money. “We’re in the midst of an epidemic, and it’s really time for America to wake up.”

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