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ACA Increased Opioid Treatment, Not Opioid Abuse

There was an odd theory floated last year by conservatives and others opposed to the Patient Protection and Affordable Care Act (ACA or ObamaCare if you prefer): the expansion of Medicaid made the Opioid Epidemic worse, maybe even caused it.

Citing cherry-picked statistics, the theorists say that the states with the biggest Medicaid expansion and the most opioid abuse are one and the same, and therefore one led to the other. That’s the beginning of a theorem, a starting point for analysis, but not a proof. Proponents of the theory felt we should act on it immediately, just in case.

Well, ACA has been wounded but is not yet dead, which is good because to the extent that the theory was based on evidence, that theory was wrong. An analysis by the nonpartisan Center on the Budget and Policy Priorities finds that “Opioid-related hospitalizations were higher in expansion than non-expansion states as early as 2011, three years before Medicaid expansion took effect, and have been growing at roughly the same rate in expansion and non-expansion states since expansion took effect. Medicaid is part of the solution to the opioid crisis, not a cause.”

There are plenty of people and things to blame for the opioid abuse epidemic, but Medicaid is  not one of them.

I’m sure opponents of ACA can quarrel with the facts — “cavill, if it doe not finde a hole, will make one” — but the truth is that they didn’t like, don’t like, and will never like ACA or anything remotely like it. They are not overly concerned about the opioid crisis or providing substance abuse treatment even when it reduces costs to society. And it does.

The National Institutes of Health’s National Institute on Drug Abuse website states: “Substance abuse costs our Nation over $600 billion annually and treatment can help reduce these costs. Drug addiction treatment has been shown to reduce associated health and social costs by far more than the cost of the treatment itself.” NIDA isn’t interested in coddling addicts, merely getting them help.

What many ACA opponents prefer is some sort of punishment for addicts, which NIDA anticipates by stating: “Treatment is also much less expensive than its alternatives, such as incarcerating addicted persons. For example, the average cost for 1 full year of methadone maintenance treatment is approximately $4,700 per patient, whereas 1 full year of imprisonment costs approximately $24,000 per person.” That’s five times as much to satisfy a Calvinist impulse to punish the wicked as it is to treat the problem.

And that’s not the whole story. There are more savings to consider. “According to several conservative estimates, every dollar invested in addiction treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to healthcare are included, total savings can exceed costs by a ratio of 12 to 1. Major savings to the individual and to society also stem from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths.”

We can save money and do the compassionate thing at the same time.

Mental health and treatment for alcoholism, drug abuse, and other substance use disorders are still guaranteed as essential health benefits, for most private insurance as well as ACA. Get help now if you need it. We can assist you.