The Opioid Epidemic
The United States continued participation in the over prescribing of prescription drugs is causing consequences that have trickled down to state and local levels. Texas is currently facing an opioid crisis and the negative backlash of the spiked drug abuse and dependence on pain pills is growing. The number of deaths caused by opioids has increased along with the number of robberies committed in order to obtain these pills. The financial burden of this crisis weighs heaviest on health insurance companies. Solutions to this crippling phenomenon include passing legislation that invokes a mandate to ensure patients aren’t over prescribed and increasing the penalties for pharmacy robberies. This type of legislation exists in the Texas House and Senate during this 85th legislative session and these changes seek to alleviate the burden that opioids have caused in our State.
First, addressing the evidence that supports the growing epidemic is crucial. In the Clinical Toxicology Journal, an article published in 2014 stated that “Codeine exposures increased significantly from 189 to 522 (176%, p = 0.00014), including a 263% increase for age >20 years. Codeine misuse increased 443% and adverse drug events 327%. Oxycodone exposures increased from 134 to 189 (39%, p = 0.0143), increasing only among patients age >20 years. Reported heroin exposures increased from 156 to 179 (15%, p = 0.2286) and tramadol from 666 to 708 (6%, p = 0.0193). Other opioid exposures changed little or had limited reports” (Haynes 2014). The increased use of alternative drugs such as codeine, oxycodone, and heroin was due to the strict regulation that was placed on hydrocodone; this pattern illuminates that more regulation is effective when attempting to impact the opioid crisis. Represented in Figure 1 is the recorded number of deaths caused by opioids in some Texas counties. Not all of the counties are listed, however this analysis omits the deaths that are not recorded as opioid overdoses, potentially underestimating the total deaths.
The next issue fueled by this crisis includes the numerous pharmacies that are being robbed in order to acquire these highly sought after opioids. According to the Modern Medicine Network, Texas fell in at number seven on the list of “Top 20 States for Pharmacy Robberies,” in reference to statistics posted by the Drug Enforcement Agency. Texas has a total of 23 recorded pharmacy robberies is 2014, and between January and June of 2015, 12 pharmacies were recorded being burglarized. In order to help reduce the amount of opioids readily available, legislators in Texas are seeking to regulate prescribers and dispensers of the opiates. House Bill 3208, authored by Larry Gonzales, seeks to increase monitoring of prescribing patterns and increase the requirements needed to obtain these drugs at pharmacies. This could potentially decrease the amount of opioids available for theft, illegal purchase, and abuse.
Lastly, the crippling effects of the opioid epidemic on the health insurance industry are immense. The cost of rehab treatment for drug addicts, medical expenses of recovering addicts, and the cost of prescribing these drugs to manage pain add up and the burden is placed on the insurance companies. In an article published in the International Journal of Pharmaceutical and Healthcare Marketing, a study was conducted in Texas in order to determine the cost of medical detoxification and the results concluded, “The total economic costs of alcohol and drug abuse in Texas were estimated at $25.9 billion for 2000. Alcohol abuse cost has been roughly calculated to be $16.4 billion (63 percent), while drug abuse or dependency was accounted for $9.5 billion” (37 percent), (Liu, 2000). In the same year, about $679 million was spent on specialty treatment services for alcohol and other drugs (Liu, 2000). An estimated $286 million was spent to treat clients primarily for alcohol abuse and $393 million primarily for drug dependence” (Coustasse 2008). This study reveals the exorbitant cost of drug and alcohol abuse that needs to be addressed in order for insurance money to be allocated to areas of other need.
The overall evidence that the opioid epidemic is having financial and lethal effects on Texans is vivid. The presented solutions in the House and Senate provide regulations that would essentially reduce the amount of opioids present in the market and potentially reduce the death, addiction, and robbery of this substance. The increasing effect of over prescribing this substance has slowly been gaining traction and if negligence continues the opioid epidemic will continue to grow and harm the people and economy of Texas.
Coustasse, Alberto (2008) “Cost of medical detoxification among drug and alcohol users in a private Texas hospital”, International Journal of Pharmaceutical and Healthcare Marketing, Vol. 2 Issue: 2, pp.134–142, doi: 10.1108/17506120810887925
Haynes, A. (2016 ). Trends in analgesic exposures reported to Texas Poison Centers following increased regulation of hydrocodone. Clinical Toxicology ,54(5), 434–440 . Retrieved April 7, 2017.
Liu, L.Y. (2000), Economic Costs of Alcohol and Drug Abuse in Texas, Texas Commission on Alcohol and Drug Abuse, Austin, TX.