Financial impact of opioids, alcohol, & street drugs

Transcription

1 2018 Los Angeles State of Reform Health Policy Conference Financial impact of opioids, alcohol, & street drugs A COMMUNITY-BASED ORGANIZATION S PERSPECTIVE VITKA EISEN, MSW, ED.D. PRESIDENT & CEO, HEALTHRIGHT 360

2 Death Rates Nationally & California Drugs (not alcohol) 2017 data Nationally 72,287 overdose deaths California 5,304 overdose deaths Alcohol excessive use 2010 data Nationally ~88,000 deaths Economic cost $249 billion California Economic cost $35 billion Source: Centers for Disease Control and Prevention

3 CDC reported overdose deaths

4 Cost of SUD in the U.S. Health Care Overall Year Estimate Based On Tobacco 1,2 $168 billion $300 billion 2010 Alcohol 3 $27 billion $249 billion 2010 Illicit Drugs 4,5 $11 billion $193 billion 2007 Prescription $26 billion $78.5 billion 2013 Opioids 6 Exceeds $800 billion! 1. U.S. Department of Health and Human Services. The Health Consequences of Smoking 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; (PDF, 38MB) 2. Xu X, Bishop EE, Kennedy SM, Simpson SA, Pechacek TF. Annual Healthcare Spending Attributable to Cigarette Smoking: An Update. American Journal of Preventive Medicine 2014;48(3): [accessed 2017 Feb 28]. 3. Centers for Disease Control and Prevention. Excessive Drinking is Draining the U.S. Economy. Updated January Accessed April 21, National Drug Intelligence Center. National Drug Threat Assessment. Washington, DC: United States Department of Justice; MB) 5. Birnbaum, HG. et al. Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United States. Pain Medicine 2011; 12: Florence, CS et al. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013; Medical Care. Volume 54, Number 10, October 2016.

5 Social Costs of Methamphetamine in the United States in 2005 (in $ millions) Cost Lower Bound Best Estimate Upper Bound Drug Treatment ,070.9 Health Care Intangibles/Premature Death 12, , ,548.6 Productivity ,054.9 Crime and Criminal Justice 2, , ,740.9 Child Endangerment ,165.7 Production/Environment Total: 16, , ,280.9 Note: Due to rounding, numbers may not sum precisely. Rand Drug Policy Research Center, 2005

6 Cost of excess alcohol use* $249 billion in 2010 $807 per person $2.05 per drink Cost breakdown 72% lost productivity 11% healthcare!0% criminal justice 5% motor vehicle crashes Binge drinking is responsible for most of those costs 77% 40% of costs are paid by federal, state, and local governments California has the highest cost per state at $35 billion *CDC website

7 Cost benefit of SUD treatment Every $1 invested in treatment yields a reduction in $4- $7 in criminal justice costs When health costs are added, cost reduction increases to $12. National Institute on Drug Abuse (NIDA), (2018), Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)

8 HHS Community Preventative Task Force Recommendations to reduce excessive alcohol use: Regulate alcohol outlet density Increase alcohol taxes Dram shop liability (liability for etoh beverage distributers) Limits on day of sale Limits on hours of sale Enhance enforcement of sales to minors Screening, brief intervention, referral, and treatment (SBIRT)

9 Solutions to addressing health care needs and costs of SUD Close the gap between those needing care and those receiving it Better integrate medical and behavioral healthcare Expand the use of evidence-based practices to coordinate care, treat SUD, as well as other chronic care conditions. National Council for Behavioral Health

10 2017 Data HealthRIGHT 360 ~4,000 people served in residential and outpatient substance use disorder treatment in: San Francisco San Mateo Santa Clara Ventura Los Angeles San Diego 42% reported at least 1 emergency department visit in the past 12 months Treatment participants reported previous use of: Stimulants 64% Nicotine 58.1% Alcohol 53.1% Opioids 41.6% Note: most treatment participants reported using more than one substance

11 No wrong door SUD tx Transgender specialty care HIV and Hep C care Dental care Patient Care coordination Primary care Psychiatry and mental health Housing, income, and social supports

12 About HealthRIGHT 360 Nonprofit healthcare for very low income people since 1967 Specialty in treating substance use and co-occurring mental illness Services in 11 California counties with 89 sites from Solano to San Diego + 7 prisons and jails 27,000 clients served in 2017 Beds for over 1,500 individuals in either treatment or transitional housing every night 1,300 + employees $140M in annual revenue from federal, state, and local dollars + fundraising Continuum of care: Outreach Primary Care (4 FQHCs) Medication Assisted Treatment for addiction Dental Social determinants of health (services for housing, employment, social supports, recovery management, and health navigators) Residential substance use disorder treatment with integrated mental health Outpatient and intensive outpatient behavioral health treatment Recovery residences and transitional housing

13 Questions? Vitka Eisen, MSW, Ed.D T: