The U.S. opioid crisis has cost more than $1 trillion since 2001, according to a report Tuesday from nonprofit health research and consulting firm Altarum. The costs have accelerated over the past few years and if they maintain their current rate could cost an additional $500 billion by 2020.

The analysis found that in 2001, the opioid epidemic cost $29.1 billion per year and has ballooned to $115 billion per year by 2017. The majority of the costs went to healthcare, lost wages and productivity.

Altarum’s analysis found that the average age of an opioid overdose death is 41, costing the individual $800,000 in lost earnings and productivity.

The healthcare industry absorbed roughly a quarter of the costs ($215.7 billion), with overdose care and emergency-room visits representing the majority of the costs.

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