STAT – a national publication focusing on health launched by the Boston Globe in 2015 – last week published a startling report based on interviews with public health experts at 10 universities that predicted nearly a half-million Americans will die from opioid use over the next decade.
By 2027, “the annual U.S. death toll from opioids alone will likely surpass the worst year of gun deaths on record, and may top the worst year of AIDS deaths at the peak of that epidemic in the 1990s, when nearly 50,000 people were dying each year,” the STAT report noted. “Beyond the immeasurable pain to families, the overdoses will cost the U.S. economy hundreds of billions of dollars.”
These findings demand a concerted, aggressive government response. While most reporting on the opioid epidemic has focused on how the overprescription of OxyContin and the rapid spread of cheap, powerful painkillers like fentanyl are taking a brutal toll on users in impoverished areas of the eastern U.S., the epidemic is very much present in the West as well.
Yet the federal response to this epidemic has been disappointing. Congress passed the Comprehensive Addiction and Recovery Act of 2016 to give law enforcement agencies more access to the overdose-treatment drug naloxone, to establish standards that would discourage physicians from being quick to prescribe painkillers and to improve addiction treatment practices, but President Obama was right to fault Republicans for not agreeing to include funding that would provide direct help to hard-hit states. Still, Obama is not without fault himself. Instead of naming an opioid “czar” with a public health background to lead the charge against the epidemic, in late 2015, he assigned responsibility to Agriculture Secretary Tom Vilsack – then went at least 10 months without having a one-on-one meeting with Vilsack to discuss what needed to be done.
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Of more immediate concern, of course, is the current president. Yes, Donald Trump created a presidential commission on the opioid crisis led by New Jersey Gov. Chris Christie, and the commission is working with highly regarded drug treatment experts on a report outlining a national strategy.
But it is one thing to come up with a strategy and another to execute it. Enactment of the Senate’s proposed replacement for the Affordable Care Act would doom the prospects of a vigorous federal response to the opioid epidemic. While the Senate bill is expected to include $45 billion over 10 years to address the crisis, it also calls for a phase-out of the Medicaid expansion provided by the ACA. This expansion has been crucial to getting open-ended, ongoing care to opioid addicts in states like West Virginia and Ohio, which is why GOP senators from those states (Shelley Moore Capito and Rob Portman, respectively) are cool to the Senate bill.
Every lawmaker – not just those at the opioid epidemic’s epicenter – should share these concerns. Opioids pose the most daunting U.S. public-health challenge of the 21st century by far. It wouldn’t just be “mean” to pass a health overhaul that crippled the nation’s ability to respond to this challenge. It would be catastrophic.