Gutting the Government Could Reignite the Drug Overdose Epidemic

Medicaid is also a primary payer for lifesaving treatment. A recent study in JAMA Network Open, which analyzed claims data, found that Medicaid made up 93 percent of claims for substance use disorder treatment and 75 percent of claims for telehealth treatment. Private insurance by contrast made up 6 percent and 24 percent, respectively. Still, people on Medicaid face barriers in accessing treatment: Another study found that only 55 percent of Medicaid enrollees diagnosed with opioid use disorder received treatment. These disparities are worse in the South—with Oklahoma, Arkansas, Mississippi, and Alabama having rates ranging from 19 percent to 25 percent. Cuts to Medicaid would only increase these barriers to evidence-based treatment and health care and potentially lead to higher rates of overdose and overdose deaths.

All of these factors—job loss, losing health care, losing access to treatment and services—can cause a disruptive impact to people who use drugs or have a substance use disorder. If you take methadone daily and all of a sudden, you’re no longer covered by Medicaid, you’re at risk of using street drugs and courting an overdose. If the overdose prevention team that gives you naloxone, supplies, and other resources has to cut back its hours or close completely, an overdose could turn into an unnecessary and preventable death.

We saw all of this during the first few years of the pandemic, when overdose deaths skyrocketed to over 100,000. A study conducted in Rhode Island during 2020 found that job loss in the previous year was associated with increased overdose risk, while another study from New Jersey found that losing medical insurance tripled the risk of overdose. Back in Rhode Island, researchers interviewed people who use drugs during the Covid-19 pandemic and found that many of them could not access housing, social services, and health care. If such indiscriminate cuts to federal health care funding and the workforce committed to addressing the nation’s overdose crisis are to go through, we risk returning to this dire situation.