Costs of opioid abuse much higher than previously believed

The opioid crisis which has been affecting families across North Dakota and the region for the past few years has also hit homes across the country. According to new data compiled by President Donald Trump's Council of Economic Advisers, the cost...

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Heidi Heitkamp

The opioid crisis which has been affecting families across North Dakota and the region for the past few years has also hit homes across the country.

According to new data compiled by President Donald Trump's Council of Economic Advisers, the costs of opioid abuse are much higher than previously thought. The data states that opioid-involved overdose deaths have doubled in the past 10 years and quadrupled in the past 16 years. The number of opioid-involved overdose deaths has risen by nearly one-third since 2013. Illegally imported fentanyl, a highly potent synthetic opioid, and fentanyl analogs,are thought to be main culprits in the rise of overdose deaths.

Drug overdoses are now the leading cause of injury death in the United States, outnumbering traffic crashes or gun-related deaths. The council said evidence suggests that up to 24 percent of drug overdoses related to opioids are not reported, which could raise the estimated 2015 opioid overdose death toll to over 40,000. Preliminary analysis shows that more than 64,000 lives were lost to drug overdoses in 2016, a rate of 175 deaths a day in 2016, according to the council

The CEA estimates the cost of the opioid crisis in 2015 to be $504 billion, when the number of lives lost in the crisis are accounted for. The CEA's high estimate puts the cost of opioid misuse at $622.1 billion while the most conservative estimate suggests the cost is $293.9 billion.

On Oct. 26, President Trump directed the acting Secretary of Health and Human Services to declare a nationwide public health emergency to bring the full war chest of the U.S. government to fight the opioid crisis.


Sen. Heidi Heitkamp, D-N.D., said although North Dakota does not have the overdose and use rates like West Virginia, opioid use in the state is an "escalating problem." While Heitkamp was pleased that Trump declared the opioid crisis a public health emergency, she said she wished the declaration came with more resources attached.

"Saying it's an emergency is one thing, actually tackling the problem is another," she said. "... We need additional resources and we need strategic thinking and I think the President's declaration will lead to some of the structure pieces, but if we don't fund best practices I think we won't get ahead of this problem."

Earlier this year Heitkamp reintroduced the Budgeting for Opioid Addiction Treatment Act, known as the LifeBOAT Act, which would provide funding for substance abuse treatment. It would be funded by charging a 1 cent fee on every milligram of opioid ingredient in a prescription pain pill, estimated to generate more than $1 billion a year, Heitkamp said.

"We think nothing about taxing cigarettes, we think nothing about taxing alcohol," she said. "This is a product that has led to (many) social ills and we would love to see an ongoing and dedicated source of revenue."

Heitkamp said it's important for members of Congress to remember that addiction cannot be solved in a day. Heitkamp noted that looking at preventive measures is also important.

"We have to look at addiction differently than we have in the past," she said. "That means building workforce. We need more doctors that are trained in medically-assisted treatment, social workers who can assist families and work through the follow-up. We need more boots on the ground and the federal government could do to a lot to incentivise those people to go in that direction."

Sen. John Hoeven, R-N.D., said it has be a coordinated federal, state and local effort to tackle the opioid crisis.

In July 2016, former President Barack Obama signed the Comprehensive Addiction and Recovery Act (CARA) into law, the first major federal addiction legislation in 40 years. Hoeven said the bill encompasses prevention, enforcement and treatment when it comes to opioid addiction.


Last week Hoeven and U.S. Sen. Joe Donnelly, D-Ind., introduced bipartisan legislation aimed at combatting substance use disorders in rural communities. The bill would direct the U.S. Department of Agriculture's Rural Health and Safety Education Competitive Grants Program to prioritize applicants in rural communities using the grants for substance abuse education, treatment, and prevention efforts. Hoeven said bills like CARA and others passed by Congress in the past few years are a good step forward.

"Opioid abuse is the cause of great loss and heartache for too many families and a terrible strain on our communities," Hoeven said in a recent press release. "Action has been taken by Congress and across the administration to address this crisis, and (the President's) declaration is another important step to help reduce the incidence of opioid abuse and drug overdose. At the same time, we continue working in Congress to pass additional legislation and provide the necessary funding to adequately address this crisis, make services available to those who are struggling with opioid abuse and prevent drug trafficking."

Heitkamp agreed that the passage of CARA is also a good step forward, but noted that she did not believe there was enough money or personnel to fully address the current crisis Heitkamp believes that Medicaid, a healthcare program for low-income Americans, is an important tool for fighting opioid addiction as 60 percent of people seeking treatment for opioid-related addiction are on Medicaid. She said that proposed cuts to Medicaid were one of the reasons she opposed efforts to repeal the ACA.

Additionally Heitkamp said it is important for law enforcement and other levels of government to work together.

"If you do not fund law enforcement the price goes down and the access to it increases," she said. "This needs to be done in conjunction with a robust law enforcement response."

U.S. Sen. John Hoeven, R-N.D.

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