Opioid crisis ‘everywhere,’ DeWine says

CONGRESS

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 Thursday.

He spoke of 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 half of the kids there because at least one parent is addicted. Jails overflowing, often serving as de facto detox centers. Employers unable to find qualified applicants who can pass drug tests.

And finally, the grimmest assessment: Every time someone dies of an opioid overdose, demand for opioids goes up in that community, as addicts seek the highest possible high — even at the risk of their lives.

“What is difficult about the drug problem we have is how pervasive it is,” DeWine told the Joint Economic Committee, a panel of House and Senate members chaired by U.S. Rep. Pat Tiberi, R– Genoa Township, that includes U.S. Sen. Rob Portman, R–Ohio. “It is absolutely everywhere … nothing makes sense about this.”

Witness after witness testified that although 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 deaths among middleaged whites. He said that mortality rates among that group had declined for decades until the trend ended abruptly in recent years. More died in 2015 than in 1998.

Many of those deaths, Deaton 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, the rate of deaths of despair was around 110 per 100,000 people. Fifty of those deaths were from overdoses.

“Opioids are a big part of this story,” Deaton said.

Richard Frank, a professor of health economics at Harvard Medical School, offered a thinly veiled criticism of the health-care bill that the House passed last month, 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 Ohio last year, Medicaid paid for nearly 30 percent of all prescriptions for buprenorphine, which is used to treat such disorders. Private insurance, meanwhile, covers 42 percent of those with an opioid-use disorder.

Frank said that although the 21st Century Cures Act — a federal law enacted in December that appropriated $1 billion for comprehensive drug treatment over two years — was intended to focus on the treatment gap, he worries that the money might be used to “backfill” for those who lose coverage if Medicaid is cut.

The professor said that under the GOP House health-care bill, Medicaid’s cap is essentially set so that it would lock in 2016 per-capita spending patterns. But deaths from opioids are growing by about 15 percent a year, hospital admissions by 6 percent, and drug treatment by 10 percent to 12 percent a year, he said.

“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,” Frank said.

Tiberi focused on the economic aspects of the epidemic, lamenting that many of the employers in his 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, U.S. Sen. Sherrod Brown of Ohio, the top Democrat on the Senate Banking Committee, also lamented the epidemic’s impact on the economy during a hearing of that committee. He said he met recently with an official of a small bank in 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,” Brown said. “Between now and lunchtime, odds are someone in my state will die of an overdose.”