Don’t Forget Our Frontline Caregivers in the Opioid Epidemic

Don’t Forget Our Frontline Caregivers in the Opioid Epidemic

America’s opioid epidemic will go down in history alongside the Spanish flu, typhoid, polio and AIDS as one of our worst public health disasters. Between 1999 and 2017, almost 218,000 people in the United States died from overdoses connected to prescription opioids, and almost as many more died from overdoses connected to illicit opioids. Of the 70,000 drug overdose deaths in 2017, two-thirds of them were opioid-connected. Deaths continue at the rate of 130 a day.

The impact on our health care system and our hospitals has been staggering. Since 2001, it is estimated that the opioid epidemic has imposed more than $216 billion in health costs, with more to come, as people continue to live with addiction and the lingering health effects of opioid abuse. This has directly affected our nation’s hospitals, which provide billions of dollars of unreimbursed care.

A generation ago, states responded to the public health costs of smoking with lawsuits, leading to a $246 billion settlement in 1998 with tobacco companies. Today, state and local governments across America are seeking compensation in court from those at the heart of the opioid epidemic: the drug companies that made and marketed opioids and their distributors.

The manufacturers of prescription opioids are alleged to have grossly misrepresented the risks of long-term use of those drugs for people with chronic pain, and distributors allegedly failed to properly monitor suspicious orders of those prescription drugs. Many of these lawsuits have been bundled together into the National Prescription Opioid Litigation in federal court in Cleveland.

In addition, hundreds of hospitals have filed lawsuits in state and federal courts seeking compensation for the many billions of dollars lost for uncompensated care and costs incurred as front-line providers.

With the federal trial set to begin next month, at least one major drug maker is proposing a settlement — wrapped in the protections of bankruptcy court — but those negotiations are likely to drag on.

While the 1998 tobacco settlement is considered a landmark case in that corporations had to account for the impact their product had on society as a whole and public health care programs in particular, there was one missing component: Hospitals and front line providers were not part of the settlement. Those essential caregivers did not receive funds for the uncompensated care they had to provide as a result of tobacco use.

And in a more recent example of hospitals being overlooked: The federal government recently allocated $2 billion in emergency funds to states and municipalities to help fight the opioid crisis — yet hospitals will receive none of these federal funds.

Hospital emergency rooms are often the first stop for patients with opioid use disorder (although it’s rarely the last). The demands of caring for opioid-addicted patients — from newborns exposed to opioids in the womb to long-term addicts experiencing cardiac infections from IV drug use — have stretched the resources of hospitals. These patients often require intensive, expensive and long-term treatment.

And very often, hospitals bear tremendous costs for this care because patients lack insurance or are unable to pay out-of-pocket expenses.

We have a chance to do better if the opioids lawsuits are eventually settled and funds become available to the governments and hospitals. While the harm caused to state and local governments cannot be overlooked, no one will win unless the claims of our hospitals are given significant attention.

Let’s learn the lessons of the tobacco settlement and use opioid settlement funds to help those who have been at the tip of the spear in fighting the epidemic and are most needed to deal with its aftermath in the years ahead.

John Kasich, a former governor of Ohio, and E. Gordon Gee, president of West Virginia University and chairman of the West Virginia University Health System, are founders of Citizens for Effective Opioid Treatment, a nonprofit organization working to find solutions to the opioid crisis and to provide information about the negative impact of the crisis on America’s hospitals.

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