home Commentary, North America, Politics Taxing opiates will not fix America’s addiction problems

Taxing opiates will not fix America’s addiction problems

The so-called “prescription pill epidemic” has been making headlines in the U.S. for years—and much to the consternation of chronic pain patients and their advocates, few media outlets or government bodies have focused on the effects that the “pain pill panic” has had on people who need access to opiate pain medications for legitimate reasons, such as chronic or acute post-surgical pain.

A group of U.S. Senators, led by West Virginia Senator Joe Manchin (D), recently introduced a piece of legislation that would establish permanent funding for opiate addiction treatment by collecting a federal tax on all opiate pain medications. The legislation, dubbed the Budgeting for Opioid Addiction Treatment Act, or LifeBOAT Act, would be the first of its kind to tax consumers directly with the aim of fighting the opiate epidemic by establishing more funds for addiction treatment. Depending on the medication dose, patients would have to pay anywhere from a 75-cent to a 3-dollar fee for a 30-day supply of opiate medications, along with their co-pay or out-of-pocket payment.

Certainly, proposing more funds for drug addiction treatment is an admirable goal, but taxing consumers—including chronic pain patients, who, like many people with disabilities in the United States, tend to be economically poorer than people without chronic pain or other disabilities—is not the way to go about fulfilling such a goal. The 75-cent or $3.00 fee every month might not be a problem for someone with chronic pain who has a steady job or other income, but for someone with chronic pain for whom every penny counts, such a “small fee” could add up.

According to CNN, the LifeBOAT Act would offer rebates on the proposed tax for opiate medications prescribed for people with cancer-related pain, those who need pain management for end-of-life care, and patients for whom opioids are prescribed as “part of medically assisted treatment;” however, a clearer definition of “medically assisted treatment” is needed. Do people with chronic pain on short or long-term opiate therapy count as patients who are going through “medically assisted treatment?” Without stricter guidelines as to who gets the rebates and under what circumstance(s), this part of the legislation might end up hurting chronic pain patients, many of whom already deal with enough frustration and bureaucratic roadblocks to get their medications refilled every month.

Furthermore, the collapsing of two separate issues—opiate abuse and addiction versus the correct use of opiates in treating chronic pain—into one seems problematic. Ignoring the differences between these issues is not a new thing; politicians, heads of government agencies such as the CDC and FDA, and the media have been turning the focus to the pain pill addiction that, we are told, has been affecting “ordinary Americans” for years, while leaving out Americans with chronic pain who use opiate medications to responsibly manage physical pain.

Most “ordinary” people with opiate addictions do not start with correctly prescribed pain pills; a 2014 study indicated that 75% of opioid abuse starts with “nonmedical use” of pain pills on the part of the addict, usually with medications that are not prescribed to them, but to a family member or friend. For people with chronic pain who utilize their medications responsibly, the chance of getting addicted to opiates is slim. The problem with collapsing the opiate addiction and opiates for chronic pain issues into one—and making consumers who are prescribed opiates pay more for their medication, as the LifeBOAT Act proposes—is that it puts the burden onto people with chronic pain who receive opiate medications legally. These patients will end up paying a high cost for something that will not benefit them unless they are addicted to their medication. People with chronic pain who need opiate medications did not create the “pain pill epidemic,” but are being made to clean up a mess that has little to do with them.

Photo: Global Panorama/Creative Commons

5 thoughts on “Taxing opiates will not fix America’s addiction problems

  1. FOLLOW THE MONEY! Govt HealthCare Programs & Insurance Companies Don’t Want To Continue To PAY For Our Meds! But Rather Than Bite The Hands That Feed Many Of Them (Big Pharma) They Go After the Most Vulnerable Which Is Why We Are Targeted! There Are 116 MILLION Citizens In The USA ALONE Who Suffer Chronic Pain DAILY! We AREN’T ADDICTS and certainly AREN’T Responsible For The Addictions & Overdoses Of Others!

  2. When I first heard about the bill, I was appalled. I have been a chronic pain patient for years, I went through all conservative treatments, finally resorting to surgery. The surgery failed, in multiple ways. Follow up with specialists indicated no surgical correction or treatment would hel me. My results are lifelong. They offered me their condolences though so there’s that :). My primary physician, having been involved with my care for 10 + years, and I outlined a medicinal treatment plan for my pain; we focused on my quality of life. My medication provides me a period of reduced pain; the pain is still present, it’s always present. But that period of reduced pain is such a welcomed break.
    To put all opoid users into a category of abusers is discriminatory; I take my medication as prescribed, I don’t get euphoric from my meds nor do I want that sensation. I do not give or sell my medication (God forbid, why would I diminish what provides me with an opportunity to feel relief ), I have a medication contract with my doctor, I keep my meds locked away, I comply with all my doctors directions, I use one doctor and one pharmacy. Someone explain why I am targeted, burdened financially for the actions of others? This isn’t the life I envisioned; I had achieved my career goals; we had plans of traveling the country when we retired, camping, four wheeling the back country, being financially sound. All of that is gone. All of that is gone. And now, because medicinal treatment is the final option for some relief, you’re categorizing me as an addict and penalizing me for actions of others. Mr. Manchin, you need to HEAR us; law abiding chronic pain patients who have run out of treatment options and medication is what provides us, even briefly, an opportunity to feel semi normal. Mr. Manchin, please conduct due diligence and HEAR us. Don’t disregard the massive amount of people that will suffer!

  3. A few clarifications: The cost of the tax, although it has been stated as averaging 75 cents to 3 dollars per month in the press releases, is wildly inaccurate. The milligrams of particular opioids vary significantly however, in my research, I’ve found none that would cost that little that would be prescribed to treat chronic intractable pain. Many patients are prescribed either hydrocodone (lortabs, vicoden, etc) or oxycodone (percocets) for immediate release. They typically treat moderate pain and are usually prescribed to chronic pain patients at 10 mg. 4 times per day by conservative doctors (who are terrified of the DEA). If we do the math, we come up with 40 mg / day = 40 cents / day times 30 days = $12.00 per month….for TAX – on top of the cost of the co-pay which depends on the insurance company. Tramadol (Ultram), on the other hand, provides most people much less pain relief however it is categorized as an opioid and, the recommended daily dose for chronic pain is 50 to 100 mg every 4 to 6 hours with a maximum dose of up to 400 mg per day. If we use the most conservative dose of 50 mg every 6 hours that would equal 200 mg / day = $2.00 / day times 30 days would equal $60.00 per month…for TAX ALONE! Those are just two examples. Many people take an extended release drug and a separate immediate release drug for “breakthrough pain”. This is what Joe Manchin has proposed to charge chronic pain patients who have been responsible and compliant usually for years, who go to their doctors and pay a co-pay or doctor fee every month as legally required, and then fill their prescriptions legally – purportedly to pay for treatment for people who use and abuse illegal drugs. (However, Manchin’s local paper quoted him as describing it as essentially an economic stimulus package for WV). Please note that quite a few of those legitimate chronic pain patients are Senior Citizens receiving Social Security and disabled former workers living on SS Disability, and, if their income is low enough, receiving Medicaid in addition to Medicare – So they are proposing to take government money from these people’s living expenses to pay for TAXES on their drugs to “treat” addicts.
    A second clarification would be the meaning of “Medication-Assisted Therapy”. By that term, they are referring to drugs to treat addicts by replacing opioids with drugs like Methadone and Buprenorphine and Suboxone. THOSE would be exempt from the tax! (Ironically, those drugs have been found to be even more addictive than prescription drugs AND the Naloxone / Narcan they are pushing that can save people in an opioid overdose, won’t work with those drugs.)
    The totality of the programs promoted by that bill – as well as several of the other 18 bills that were rammed through the House right before they took off on break – are actually designed to benefit pharmaceutical companies who are making new “abuse-resistant” opioids as well as the Buprenorphine and Suboxone style drugs (medication-assisted therapy) who want to charge more – and make the insurance companies and government programs pay more by legislatively requiring them. These bills also benefit the new HOT Billion Dollar Investment Industry(according to Wall Street publications) in “Addiction Treatment”. Those businesses apparently don’t feel like they are getting enough insurance and government money either so there are bills for that now too. The only problem has been how to finance it – how to come up with those big government bucks for those companies/donors without raising “income” taxes (because, of course, no Republicans can vote for an income tax increase because of their pledge to Grover Norquist and his Americans For Tax Reform who will find someone and fund them to run against any Republican who raises taxes.) However, Joe Manchin guaranteed senators that not one of them would lose even one vote for supporting this bill to tax legitimate pain patients to benefit these companies and the WV economy.

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