California lawmakers are considering a $50 million annual tax on the opioid industry designed to address some of the opioid-related problems plaguing the state and the entire country. But the proposed tax, similar to plans being pursued in states like Minnesota, New Jersey, and New York, would harm pain patients.
In California’s proposal, opioid makers would be taxed based on how many grams of opioids they distribute. Drugmakers would pass these costs on to patients. Thus, cancer patients, wounded veterans, and many others suffering from incurable pain would consistently be paying the state’s opioid tax. Since prescriptions for chronic pain are used for extended periods of time, people with chronic illnesses would disproportionately pay the tax. And since many of these patients have disabilities that prevent them from working, the tax could be an incredible financial burden for many people.
Given that less than one percent of both acute and chronic pain patients who are given opioids go on to become addicted, this tax would do little to prevent future opioid addiction. Indeed, the vast majority of those who become opioid addicts are people who already recreationally use other drugs. In fact, 78 percent of those abusing common prescription opioids never obtained their drugs via prescriptions from their doctors. And as opioid prescribing has continued to decrease, heroin use has increased. That’s why the majority of drug overdoses are now caused by injectable opioids like fentanyl and heroin, not prescription pills. It is also why the American Medical Association blames illegal drugs, not prescription medications, for most of the increase in drug overdoses in recent years.
For those suffering chronic pain, decreasing their access to medications and raising their taxes would be cruel and unnecessary. Instead of a tax, the state should look to policies that would reduce obstacles that are preventing patients from getting the medications and treatments they need.
For addicts in need of treatment, the state could increase the number of licenses available that allow doctors to provide medication-assisted addiction treatment. With medication-assisted treatment, people who are addicted to heroin or prescription opioids can be given medications like buprenorphine and methadone to reduce their cravings and risk of overdosing while receiving counseling.
Approximately 90 percent of substance abusers in California have never received treatment, so helping them can produce significantly positive results. In 2016, for example, Massachusetts expanded the number of licenses to provide medication-assisted treatment. And it issued a standing order to allow naloxone, which can reverse opioid overdoses, to be purchased without a prescription at pharmacies. A year later, Massachusetts was one of a small number of states that saw a reduction in total opioid overdoses.
California has already moved to provide access to naloxone and removed its step therapy laws, which require patients to try — and fail — with one treatment before moving on to the next. But there are currently not enough medication-assisted treatment licenses in California to treat everyone who has an opioid addiction so increasing the number of doctors who can help is the logical next step in reducing addiction and overdoses in the state.
An opioids tax that will ultimately be passed on to pain patients isn’t the answer. Californians should resist an opioid tax that would reduce access to chronic pain treatment, fail to prevent addiction, increase health insurance premiums, and possibly push more patients to seek out dangerous drugs on the black market.
This article first appeared in the Orange County Register.