Mike DeWine on Ohio’s opioid crisis: “Nothing makes sense about this”

Ohio Attorney General testified before Congress today

Ohio Attorney General Mike DeWine ticked off the costs of the state’s opiate epidemic: Babies born addicted. A foster care system “bursting at the seams.” Jails overflowing. Employers unable to find qualified applicants who can pass a drug test.

Then there was this: Every time someone dies of an opiate overdose, demand for opiates goes up in that community, as addicts are lured by the possibility of a higher high.

“Nothing makes sense about this,” DeWine told the congressional Joint Economic Committee, chaired by Rep. Pat Tiberi.

Tiberi, R-Genoa Township, convened the hearing to explore the opioid crises’ effect on the economy.

And the findings were striking: While mortality rates among middle-aged white non-Hispanics had declined for decades, that ended abruptly in recent years, and mortality rates for the group were higher in 2015 than 1998.

Many of those deaths, he said, are “deaths of despair,” including suicides, deaths from alcoholic 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, deaths of despair are around 110 per 100,000. Fifty of those deaths are from overdoses.

Rep. John Delaney, D-Md., said the opioid epidemic has served as a “match to the fire” for people who are already struggling in society.

Richard Frank, a professor of health economics at Harvard Medical School, offered a thinly veiled criticism of the health care bill that passed the House earlier this year, 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 the state of Ohio, Medicaid pays for nearly 30 percent of the Buprenorphine prescriptions in 2016. Private insurance, meanwhile, covers 42 percent of those with an opioid use disorder.

He said while the 21st Century Cures Act – which appropriated $1 billion over two years – was intended to focus on the treatment gap, he worries that that money may be used to "backfill" for those who lose coverage if Medicaid is cut.

He said under the GOP House bill, Medicaid’s cap is essentially set so it locks in 2016 per capita spending patterns. But deaths from opioids are growing by about 15 percent, hospital admissions by six percent, and drug treatment by 10 to 12 percent a year. “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.”

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