Opioid Legislation and the Cost of Treating Addiction

By Nick Cavarocchi, Jr., Vice President

The ongoing opioid crisis is unquestionably a major public health challenge. Since the mid-2000s, the annual cost of treating opioid addiction and treating patients who overdose on opioids has drastically increased. Opioid-related deaths have risen over the last three years – up by 28 percent in 2016 alone. The Food and Drug Administration (FDA) is looking closely at certain opioids that may have a higher abuse potential, with a view to making sure patients are prescribed opioids only when medically indicated. 

According to a recent analysis done by The Kaiser Family Foundation, in 2016, people that got their health coverage through their employer received $2.6 billion in opioid treatment services, compared to $273 million in 2004. 

On April 24, Senate Health, Education, Labor, and Pension (HELP) Committee Chairman Lamar Alexander (R-TN) plans to mark up the Opioid Crisis Response Act, a bill intended to combat the opioid epidemic by making it easier to prescribe smaller packs of opioids for shorter periods; develop non-addictive painkillers; and detect illegal drugs coming across the border. This legislation updates how certain opioid treatment and prevention grants are allocated to states, with states more severely affected by the epidemic receiving more funding. 

Some specific populations face particularly acute risk.  Nearly one infant is born every fifteen minutes with signs of drug withdrawal, and babies born to mothers using opioids are at risk for neonatal abstinence syndrome (NAS) along with other health problems.  States and local communities are making every effort to help children and families affected by opioid abuse and ensuring that newborns and children affected by drug abuse get the care they need. Congress also must do its part by supporting these local efforts.   That is why Sen. Alexander’s bill provides further funding and support to states to strengthen their health care workforce to increase access to substance use disorder treatment, including medication-assisted treatment, and access to mental health services in schools.  This legislation will also provide grants to states to improve data collection.

The cost of treatment for opioid dependency presents a serious hurdle to recovery.  Private insurance and Medicaid coverage of outpatient methadone treatment, including medication and integrated support services, varies across states and can still entail daily out-of-pocket costs for a population that may be unable to afford it.  For the uninsured, costs of daily treatment can reach several hundred dollars per month. 

As with every public health crisis, the costs of inaction are severe, in the form of costs associated with criminal justice justice, treating babies born with dependence on opioids, greater transmission of infectious diseases, and treating overdoses.