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WASHINGTON — As lawmakers pondered the economic costs of an opioid epidemic that is devastating Ohio, state Attorney General Mike DeWine offered a set of grim circumstances that seemed to stun them into silence.
Babies born drug dependent, confined to neonatal intensive care units for an average of 14 days at tremendous cost to the state’s health care system. A foster care system “bursting at the seams,” with 50 percent of the kids in the system there because at least one parent was addicted. Jails overflowing, often serving as de facto detox centers. Employers unable to find qualified applicants who can pass a drug test.
And finally, the grimmest fact of all: Every time someone dies of an opiate overdose, demand for opiates goes up in that community, as addicts seek the highest possible high at the risk of their own lives.
“What is difficult about the drug problem we have is how pervasive it is,” DeWine told the congressional Joint Economic Committee, a panel chaired by Rep. Pat Tiberi, R–Genoa Township that also includes Sen. Rob Portman, R–Ohio. “It is absolutely everywhere ... nothing makes sense about this.”
Witness after witness testified that while the epidemic is widespread, working class whites seem to be struggling in particular.
Sir Angus Deaton, a professor of economics and international affairs emeritus at Princeton University, said the epidemic has contributed to an increase in death among middle–aged whites. He said while mortality rates among that group had declined for decades, the trend ended abruptly in recent years. More died in in 2015 than 1998.
Many of those deaths, he said, are “deaths of despair,” including suicides, deaths from liver disease and accidental overdoses of legal and illegal drugs. In 2015, among white non–Hispanic men and women aged 50 to 54 without a college degree, deaths of despair are around 110 per 100,000. Fifty of those deaths are from overdoses.
“Opioids are a big part of this story,” he said.
Richard Frank, a professor of health economics at Harvard Medical School, offered a thinly veiled criticism of the health-care bill that passed the House earlier this year, saying that it would reduce access to Medicaid for those who are addicted. Medicaid covers 34 percent of those who have opioid use disorder, he said, and in the state of Ohio, Medicaid pays for nearly 30 percent of the Buprenorphine prescriptions in 2016. Private insurance, meanwhile, covers 42 percent of those with an opioid use disorder.
He said while the 21st Century Cures Act — a bill that appropriated $1 billion for comprehensive drug treatment over two years — was intended to focus on the treatment gap, he worries that that money may be used to “backfill” for those who lose coverage if Medicaid is cut.
The professor said under the GOP House bill, Medicaid’s cap is essentially set so it locks in 2016 per capita spending patterns. But deaths from opioids are growing by about 15 percent, hospital admissions by six percent, and drug treatment by 10 to 12 percent a year.
“What happens when you have a per capita cap based on 2016 patterns and new things happen or old things grow faster, you start to fall behind very quickly.”
But Tiberi focused on the economic aspects of the epidemic, lamenting the fact that many of the employers in the district report struggling to find qualified job applicants who can pass a drug test. The epidemic, he said, is “undermining parts of the economy” as well as devastating families.
Across Capitol Hill, Sen. Sherrod Brown, a ranking member of the Senate Banking Committee, also lamented epidemic’s impact on the economy during a hearing of that committee. He recently met with the chair of a small bank of Gallipolis who wanted to talk about the opioid epidemic rather than banking issues.
“The lack of opportunities in communities has contributed to an increase in prescription opioid overdose, abuse and dependence,” he said. “Between now and lunchtime, odds are someone in my state will die of an overdose.”