The Economic Cost of Virginia’s Opioid Epidemic

Source: “2017 State of the Commonwealth” report

The rate of drug overdose-related deaths is lower than Virginia than it is in the United States as a whole — 16.5 deaths per 100,000 compared to 19.8 nationally — but that is about the only morsel of consolation that can be derived from a special focus on the opioid crisis in the 2017 State of the Commonwealth Report.

The number of opioid deaths in Virginia was relatively stable between 2007 and 2010, after which it began climbing sharply as the epidemic spread, reaching 1,138 in 2016. Aside from the personal tragedies of overdose victims and their families, the economic cost has snowballed as state and local governments has spent more on emergency response and substance abuse treatment, and as drug addicts have dropped out of the workforce.

“The consensus is that opioid addiction causes individuals to drop out of the labor force by making them less ambitious, more lackadaisical and even unresponsive to ordinary labor market incentives,” states the report, written by Robert M. McNabb and James V. Koch with the Center for Economic Analysis and Policy at Old Dominion University.

Labor force participation in the U.S. has been on decline for many years, reaching a 40-year low in May 2015. As of Sept. 2016, 11.4 million men between the ages of 25 and 54 were not working or seeking work. Forty-four percent of men not in the labor force were taking painkillers daily; by contrast only 20% of working men and 19% of unemployment men took painkillers. A Federal Reserve Bank of Boston-sponsored study estimated that 20% of the decline in labor force participation could be attributed to opioid use and abuse.

What is the cost of such behavior to the Virginia economy? This is not easy to measure. If, however, labor force participation rate data in Virginia have declined 3 percent due to opioid addiction, then the Commonwealth has experienced between $4.5 billion and $7.6 billion in lost productivity. To put it another way, the lost productivity is at least equal to 1 percent of the Commonwealth’s gross domestic product for 2017 and may be as high as 1.6 percent.

In addition, in 2008, untreated substance abuse resulted in $613 million in public safety expenditures (police, jail, prison) and health car services by local and regional governmental units, according to a Joint Legislative Audit and Review Commission (JLARC) study. In 2010, the average hospital stay for drug abuse patients was 3.8 days, and the treatment cost was almost $30,000. “No doubt these numbers are higher today,” the authors write.

What is to be done? While the opioid epidemic has become a top-of-mind, national issue, some physicians are insufficiently trained in how to prescribe opioids while managing chronic patient pain. “Both physician and pharmacy education are in order.” McNabb and Koch also recommend researching nonaddictive painkillers, creating a national prescription registry to catch abusers who obtain multiple prescriptions from multiple physicians, and funding the use of methadone to wean users from their addiction and naxalone to reverse the effects of overdoses.

But there are no magic solutions. “Opiate misuse and abuse ultimately reflect our society — the values attitudes, laws, geography and range of economic opportunities that together make us who we are. Hence, one cannot press a single button and eliminate the scourge of opiate addiction because this wave of abuse represents the conjunction of a set of complex phenomena deep within us.”

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6 responses to “The Economic Cost of Virginia’s Opioid Epidemic”

  1. LarrytheG Avatar

    I think it’s important to understand WHY people find and use drugs, including but not by any means restricted to opioids in particular. Until this point in time, “we” have treated drug use as problem with the “person” and not necessarily their circumstances that can influence the choices they make and if there are few jobs available – as they say .. idle hands are….. the devil.

    Here’s that geography :

    percent of total commercial and medicaid opioid claims across Virginia

  2. jalbertbowden Avatar

    This is very difficult to say because I find many holes to be poked in these debates, but what I find most interesting is the foundation that this was built on, big pharma + corporate americana breaking a myriad of laws in their pursuit of oxycotin riches, is never even mentioned.
    Almost as upsetting, are these ideas that doctors are overwhelmed/aren’t aware of what they are doing.
    Or that pharmacists aren’t in the know that they are handing out massive quantities of pills to people that literally look like walking zombies.
    From all the solutions mentioned, notice that most affect citizens.
    Yes, we should have a pill database, but the focus should be on doctor’s mass prescribing, with catching pill heads in the secondary.
    Yes, the industry should be educated, just not by pharmaceutical representatives that legally bribe doctors into pushing their wares which should never have been green-lighted by the fda in the first place.
    Yes, we should research non-addictive pain killers, primarily weed.
    We should bring back the laws prior to 1992 when the fda ceded sovereignty to private business.
    We should hold purdue pharmaceuticals accountable for all of this, including shutting down their entire operation and locking up as many of them as possible.
    We shouldn’t be allowing for-profit business in medical field. If you want to get all death of the market/no innovation hysterical, then if still allowed, it should be extremely narrow and highly regulated x 10.
    Notice how dealers are now being charged with murder? Odd how they get charged, but the doctor who initially got the overdosed user hooked is never even mentioned.
    Furthermore, and this is as wild as it gets, restrictions on accessing pills is not even solid ground here. The insane thing about opiates is that users can die if they go into withdrawal, so cutting them off legally is literally a springboard for crime. I am not saying just give them to them, but I am saying that cutting them off directly leads to crimes in pursuit of their fix.

    As to LarrytheG’s comment, swva has always been oddly into pills, at least since I was in college in the late 1990’s. Extreme contrast from where I grew up (hrva) but also with rva/nova crowds in general. I know this stuff is everywhere, but it sure felt like in swva it was just wide open.
    I made a very similar map once of the number of meth lab busts across the states, and it was almost exactly like the one you posted. I found it so odd that Montgomery County had at least 2 or 3 times the number of busts than Virginia Beach. More importantly, opiates and amphetamines are two different animals entirely, and the fact that swva has embraced both tells me that there is something else going on. I won’t go so far as to say idle hands, but will say that misery loves company. If you have no hope, no outlook, if you can’t look past today because you are struggling that hard to survive, these drugs actually seem almost appealing.

    Regarding the why: people use drugs for the effects. and when I say drugs I mean drugs, not this weak watered down version America likes to peddle. Alcohol, caffeine, nicotine, these are all drugs too.
    Why do you consume alcohol? Coffee? Dr. Pepper?
    The same reason why you take advil or the pills your doctor prescribed to you.
    The effects.
    Unfortunately, each substance can have a different experience for each person. Without being exposed to the realities of them via education, individuals find out for themselves, quite often the hard way.

  3. djrippert Avatar

    A long but readable explanation of the history of oxy and why it became so addicting to those who tried to use it as prescribed. It doesn’t cover the crazies who chop it up and snort it but does bring Perdue’s actions into serious question. Moreover, the disgraceful interplay between the FDA and Purdue and the courts and even asshat Eric Holder make for good reading. The article could be titled, “Another installment of Tales From the Swamp.”

  4. LarrytheG Avatar

    re: ” If you have no hope, no outlook, if you can’t look past today because you are struggling that hard to survive, these drugs actually seem almost appealing.”

    works the same way whether in rural RoVa or Va urban areas… if you don’t have a job or prospects of one – things go sideways… and it don’t take a doctor prescribing something for someone to get an equivalent.

    Most folks who have a decent job.. a career .. good pay and benefits – do not throw it away over drugs. Some might, most don’t but take a look at 100 chronic unemployed and see what is going on.

    I want to add one more – smoking – it kills 7 times as many people as opioids and before they die they end up costing everyone else – employer-provided insurance and Medicaid.

    Finally – I’m not understanding how folks on opioids are any different than folks on crack cocaine , heroin, or meth or a variety of other drugs , many prescribed.

    Why do we not have ONE policy with respect to drugs and addiction – in general and why are some treated as criminal and others not? If you use crack cocaine – you go to prison – if you use opioids.. you need “help”?

  5. The striking thing to me is the regional distribution of the problem, and what that suggests about solutions. This is a chart of “overdoses” — I don’t know if that means deaths from overdosing but assume so. LG, thanks for the additional chart showing claims for opiod cost reimbursement (can’t tell if this is number of claims or dollar amount of claims but shouldn’t be too much difference in distribution. JABowden, you touch on other aspects of this epidemic: abusive over-prescribing, big pharma’s complicity, the long-standing abuse problem in far SW Va. But there’s something else going on here. Why is there such a horrrendous pocket of death in Richmond County, and nearly as bad in Fauquier and Culpeper, or in Caroline and King William? These don’t line up with LG’s map of where the pill sales are. Are we looking at a failure of intervention or EMS response in those counties, or excessive distance to a treatment facility?

  6. TooManyTaxes Avatar

    I find it interesting to see the relatively high rates of addiction in Fauquier County, which has the 28th highest household income in the 2010 census.

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