Ever since OxyContin hit the market in 1996, the opioid epidemic has caused extreme turmoil. In 2015, 33,000 people died as a result of opioid-related overdoses. And of the 20.5 million people suffering from substance abuse in that year, 2 million were addicted to opioid pain relievers. The crisis didn’t emerge out of a vacuum. In the late 1990s, pharmaceutical companies aggressively marketed opioid pain relievers while downplaying their addictive qualities. Many lawsuits have been filed since then.
Now, major cuts to Medicaid are on the docket for Republicans in the House and Senate, which could mean major trouble for addiction treatment programs throughout the country.
Victims of this horrible crisis rely on the addiction treatment services provided by Medicaid. Take Charlene Yurgaitis for instance. She was working as a supervisor in Lancaster, PA, at an insurance company, but after some younger folks moved in next door, she started doing OxyContin recreationally, which led to experimentation with harder drugs, namely heroin. After ten years of that, she decided she wanted to get help and put an end to the cycle of addiction. That was earlier this year.
Road to Recovery
She has had a difficult time on the road to recovery. As she told NPR, “I’ve been doing everything that I can possibly do to stop using.” She continued, “My normal thought is to just do it. Nobody will ever know.” Part of the program is a dose of Vivitrol (or naltrexone) once per month – it helps stave off cravings.
Vivitrol prevents the high that usually accompanies OxyContin by stopping the drug from binding to the brain’s receptors. It’s quite effective. The only problem is that it costs $1,000 a dose. Thankfully, in states like Pennsylvania, Medicaid covers the cost of treatment, which in addition to the Vivitrol shots, includes therapy and a recovery coach. And actually certain prisons are starting to offer the drug to inmates suffering from addiction.
According to Yurgaitis, recovery would have been impossible if not for the coverage provided by Medicaid. “I would never be able to afford counseling. I would never be able to afford psych meds. I would never be able to afford the Vivitrol shot.”
Of course, she’s not alone. In Pennsylvania, over 124,000 people rely on Medicaid for their addiction treatment. If the Republicans succeed at passing the American Health Care Act (AHCA) next week, then Medicaid would lose around $880 billion over a ten year period and reduce its enrollment by 14 million people in 2026.
Members of Congress representing Pennsylvania don’t seem interested in protecting Medicaid. Representative Lloyd Smucker, a Republican who represents Yurgaitis’ district, voted for AHCA; and Pat Toomey, the GOP Senator, has said Medicaid should be cut.
“Medicaid is growing at an unsustainable pace,” reasoned Toomey. “If we’re going to overhaul this program, which we need to by virtue of Obamacare, we can at least put it on a sustainable path.”
To make up for the federal cuts states would have to limit eligibility, reduce benefits or raise taxes. But Toomey hasn’t seemed phased by this: “What they’re saying is: Their state governments would decide that it’s not worth it to us to have these people on Medicaid when we can buy it at 43 cents on the dollar.” He added, “That’s a decision that they’re free to make, but to suggest that the federal government is being unreasonable when we’re offering to pay more than half of the cost of an expansion that we didn’t support in the first place, I’m sorry, I just disagree.”
Making a Bad Situation Worse
But what of the sufferers? According to Dr. Sarah Kawasaki, there’s really no road to recovery without the help of naltrexone. Without naltrexone, Dr. Kawasaki thinks “that by necessity, they would probably have to go back to using heroin or any other medications they could find on the street to avoid getting sick. And I would worry about that.”
As Yurgaitis put it, “Why are you trying to change something that’s working? You know, that’s what I don’t understand.”