Opioid addiction has truly become a crisis. It is a public health epidemic in the United States which is having enormous economic and social implications. The question of how to stem and reverse the causes and consequences of this crisis is currently on the minds of policy makers — but perhaps too few of them.

The Joint Economic Committee of the US Congress has recently been hearing testimony from economists and state representatives. Their aim has been to lay out the economic repercussions of what has become, in many ways, a global scourge.

Powerful statistics were read to the House, statistics that shocked many of those unfamiliar with the subject matter. Conceivably the greatest social impact is the death-toll: 91 Americans die from opioids every day. Reiterated in many of the testimonies was the preventable characteristic to these deaths.

The economic burden is also something which needs scrutinizing. It is estimated that the opioid crisis costs the US economy nearly $80 billion every year — a figure that is only likely to increase. Relaying testimony to Congress does little but outline the problem. Greater action is needed.

The opioid crisis has a regional character, with less affluent states bearing the brunt of the impact. Places with higher levels of unemployment tend to have higher rates of substance abuse. To crunch numbers, over 50 percent of people in the US with an opioid use disorder (OUD) have incomes below 200 percent of the federal poverty line.

Giving more people essential access to the treatment services they need was one factor debated at the congressional hearing in June. Only 20 percent of people with OUDs are currently receiving treatment for their disorder. In 2016, that equated to 1.97 million people who needed, yet had no access to, treatment services.

In the fight against opioid addiction, three essential services exist. Medicaid, private insurance, and federal grants. Medicaid takes care of about 34 percent of people with an OUD, becoming an indispensable solution to the crisis. Quite how indispensable Medicaid is in combatting the opioid crisis has become a hotly debated political question.

This opens up wider questions as to the general state of healthcare in the United States, and of the vital need for reform. What we have been privy to recently, a partisan and behind-closed-doors debate on the future of healthcare, will not provide the reform necessary to combat this escalating crisis, or indeed, any other crises that might become apparent. If a radical shift in policy-making is not debated further, opioid abuse statistics will only worsen in the years to come.

Harvard health economics professor, Richard Frank, affirmed through recourse to national survey data, that over half the people who do not receive treatment do not receive treatment as a result of either not being able to afford it, or because there are no providers available where they live. Other reasons include not being ready to give opioids up, stigma, and denial of the problem itself.

There is no simpler solution than expanding treatment services. Access to relevant healthcare is essential. Many of the congressional testimonies advised that recent proposals to cut Medicaid would have a devastating impact on the services people will have access to.

Martin Heinrich, junior Democratic Senator for New Mexico, declared that Medicaid accounts for around 30 percent of treatments for opioid problems in his state. “At exactly the time that congress should be giving states more tools to fight this epidemic, House Republicans passed a bill that would repeal Medicaid expansion, artificially cap the program, and shift the burden about who and what to cut onto individual states.”

The playing field, politically, economically, and socially, is becoming murkier by the day. Most opioid addictions stem from legal prescriptions. On top of this, there is growing concern over illegal distribution, with an increasing level of drugs ordered through avenues such as the “Dark Web.” If representatives do not start proposing bi-partisan policy measures for reversing the epidemic, the implications could be catastrophic in scope.

About the author

ANTHONY TIPPING is a political economy specialist at Emory University's Laney Graduate School. He holds an MSc in economic history from the London School of Economics.