Opioid use has climbed significantly over the past two decades, but made an especially large jump in 2020, increasing 13%, according to analyst firm GlobalData.

Cases of opioid use disorder (OUD) could reach 1.9 million by the end of this year while 21 million Americans suffer from alcoholism, according to GlobalData projections. Both conditions require billions of dollars in treatment costs and could have a negative impact on U.S. life expectancy.

Because substance abuse tends to affect young and middle-aged adults disproportionately, it “could lead to stagnation or even a decrease in the U.S. life expectancy as more younger adults die prematurely,” said Walter Gabriel, an epidemiologist at GlobalData.

OUD is also fueling demand for FDA-approved medications intended to treat OUD including buprenorphine and methadone.

The opioid crisis could also fuel growth in drugs such as Belbuca from BioDelivery Sciences International, which is a novel formulation of buprenorphine that is a Schedule III drug with a reduced risk of dependency and respiratory depression compared to Schedule II opioids such as OxyContin. The company COLL has also introduced Xtampza ER, which is an extended-release formulation of oxycodone designed to limit addiction risk.

The U.S. market for opioid addiction could almost double from $1.5 billion in 2021 to $2.9 billion in 2028, according to GlobalData projections.

The rise of alcoholism during the pandemic could also increase the need for pharmaceuticals that treat cirrhosis, cardiomyopathy and other complications.

Prevention, however, is also critical when it comes to alcoholism and OUD, Gabriel said. “More awareness of substance use should be put forward,” he explained. “In addition, a preventative approach should be taken to reduce the proportion of Americans transitioning from substance use to substance misuse.”