American opioid crisis

American opioid crisis is at its worst, a factor that has prompted President Donald Trump to declare it as “a public health emergency.” Over the last few years, Americans communities across the nation have witnessed unprecedented death from opium related complication. However, it is not just the death of people addicted to these strong pain medication and devastation of communities that is worrying, but also the extent to which it is taking financial toll on the American populace. According to one report prepared by The Council of Economic Advisers, an agency that works closely with the Executive Office of the President, the economic cost of the opioid crisis in 2015 alone was $504 billion.

A study conducted in 2013 by CDC’s National Center for Injury Prevention and Control, established that health care cost related to opioid abuse stood at about 30%. The total costs for substance abuse and healthcare topped $28 billion. According to the same report most of these cost was covered by insurance as only 25% fell on the shoulders of the public. Government contribution through insurance came in the form of Medicare, Medicaid, government-funded treatment programs and related public insurance. The report further indicated that almost 2 million Americans abused or showed dependency on prescription opioids. While reacting to this report CDC Director Dr. Tom Frieden expressed his fear for the rising cost of the same epidemic stating that “The rising cost of the epidemic is also a tremendous burden for the health care system” (Kolhatkar, et al. 2017).

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It is on the premise of this findings that this work find it necessary to study and establish the magnitude of the economic burden of opioid abuse, prescription opioid overdose and dependence to inform research, clinical practice, and other policy makers. Such is the case that policy makers seeking to address this crisis need cost information to establish the most appropriate approaches to implement. This work serves to detail the effects of opioid crisis in the economics of healthcare in the U.S, draw opinions on the solutions to the problem and/or future implications and give recommendations on some of the ways this issue can be solved.

To better understand the seriousness of the whole issue one only needs to consider some of the opinions raised by stake holders in this sector. According to one Anupam Jena, a health economist and physician at Harvard Medical School, president Trump should consider “running the U.S. government like a business” and make tackling of opioid crisis a priority. Jena comments on the widespread abuse of opioid saying “The number of people who lose their lives from prescription opioids is larger than the number who’ve lost lives to motor-vehicle accidents.” Business is about making profit and thus Jena must be suggesting that America as a country needs to reassess the costs incurred due to the wide spared opium abuse. Jena parallels the efforts to end motor vehicle accidents and the fight against opium abuse and says “Think of all the things that we do to make sure people don’t die from motor-vehicle accidents. We have air bags, speed limits, cops giving out tickets for speed violations. There are a lot of things we do to reduce deaths from motor vehicles. The deaths coming from prescription opioids is exceeding that now” (President Trump declares opioid crisis a national emergency, 2017).

Chris Christie, the New Jersey governor compares opioid –overdose victims to terrorist attacks equating the scale of each three weeks loss to that witnessed during the 9/11 attack. The findings of Chris Christie led commission, which carried out a study on the same issue established that Opioids that include drugs and painkillers like fentanyl and heroin, are undeniably accountable for large-scale human suffering. Even as one people try to come to terms with the above findings, Chris Christie points to the fact that healthcare economics is almost always forgotten in the whole conversation. The study openly agrees that the crisis significantly affects the American economy.

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What really caused this sudden rise in opium crisis? Stakeholders have in the past tried to establish some of the causes to the sudden rise. One such opinions linked the rise to the changes that Food and Drug Administration made on its rules regarding opioid drugs advertisement made on TV.  People supporting this notion suggest that the frequent advertisement of these drugs while naming only the most substantial possible side effects increased people awareness of the drugs. Over time consumers with such knowledge have made inquiries on such drugs. There even cases of patients threatening doctors for not prescribing opioid (Kolhatkar, et al. 2017).

In 2016, the National Center for Injury Prevention and Control published one of its findings in the in the journal Medical Care addressing the effects of opioid crisis in the economics of healthcare in the U.S. According to this study, the United states governments incurs an estimated cost of $78.5 billion annually to treat abuse, overdose and dependence on prescription opioids. This figure relates to data collected in 2013 when about 2 million Americans fulfilled the criteria for prescription opioid dependency and abuse, and some 16,000 succumbed to death due to prescription opioid overdose. Contextualizing the same figure, puts the figure at about $79.9, ideally the same cost of the Supplemental Nutrition Assistance Program (SNAP) that same year. A more recent finding by CEA depicts a higher value having gone beyond the “conventional methods to put value on the lives lost. It is important to note here that even before the CEA study the projected costs of the crisis remained high. Such is the case that people with untreated opioid use complications incurred healthcare-costs identified as being $18000 more compared to those without such complications (The opioid crisis, 2017).

`Another national survey dealing with Drug use and Health showed that 97.5 million Americans abused prescription pain pills in 2015. The report agreed that deaths due to drug-overdose has tripled in the last 2 decades and opioid abuse today kills not less than hundred people daily. This report however highlights the missing conversation on the harm caused to the American economy which it describes as being on a scale never witnessed in the entire history of drug crisis. Some other studies have attempted to come up with exact figures on the cost of the crisis.  In 2011, a study published in the journal Pain Medicine placed the estimated health-care cost linked to prescription opioid abuse at about twenty-five billion dollars.

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In the same study published in the journal Pain Medicine, Howard Birnbaum, a health-care economist establishes that “If people don’t have jobs, they don’t have money to spend in the grocery store, on gasoline. It’s the old multiplier effect: the socioeconomic burden is much broader than on any individual or any firm.”  On his part he puts the estimated total cost of opium crisis to the economy above the previously stated $55.7 billion. Another study carried out two years later after 2011 showed placed the cost at $78.5 billion (Wolters Kluwer Health: Lippincott Williams and Wilkins, 2016, September 14).

There is no doubt that American opioid crisis exists and that actions should be taken to reduce the exposure of the American population to these drugs. The process of fixing current crisis will definitely require a combination of solutions. This approaches should be approached carefully to ensure only the most efficient and most effective solutions get the first priority. First, it is very important to equip the doctors and other healthcare givers to handle the existing cases of addiction and help stop the spread of the same crisis through peer influence. Second, the law enforcement agencies at the federal, state and local level should step up their efforts to discourage the use of opium. Here three-pronged plan of border seizure, arrest and prosecution of people found trafficking and selling opium will help check the supply of these drugs into the country. Those found guilty of these outlawed activities should face long term incarceration Koh, H. (2015).

Government should boost efforts aimed at reducing supply of prescription opioids which often end up being abused. This should be done with care through drug monitoring programs and still ensure enough supply of the same drugs for patients presently suffering from chronic pain. Another approach to checking the supply of pain drugs should include improvement of ways used by the medical systems to manage pain. Here, it is important that the government embraces a more holistic approach which will cut the need for   opioid especially for the many people identified as taking opioids outside of medical use. On the subject of treatment, the government should ensure readily available treatment for those already addicted as a way minimizing the chances of such people seeking alternative treatment by themselves. This approach will require healthcare givers to move to places where people addicted or using opium are instead of waiting for them to do the same.

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May be the most effective way to deal with this issue is to prevent further opioid abuse, opioid overdose and dependence. Here mandatory physician education on the risks associated with opioids will substantially help in prevention. The public awareness on the same dangers should also be encouraged. A wide range of social programs not openly related to drug abuse carry the potential to minimize the economic consequences of opium abuse.  For example, vocational training programs rolled out to target young people depicting high risk of becoming opium peddlers. Additionally, interventions can be targeted on people showing vulnerability to homelessness, unemployment, social deprivation and exclusion from educational opportunities.