A new study of the state's opioid epidemic by Ohio State University researchers shows a staggering economic toll of $6.6 billion to $8.8 billion a year -- about the same amount the state spends annually on K-12 education.
And though treatment needs have skyrocketed, the state has not responded: It has the capacity to treat only 20 percent to 40 percent of the 92,000 to 170,000 Ohioans abusing or addicted to opioids. The shortage is especially acute in rural areas hit hardest by the drug crisis.
The 22-page report released on Wednesday by researchers with the C. William Swank Program in Rural-Urban Policy at Ohio State found the state has done a good job of cracking down on opioid prescriptions. But it pointed out that many addicts have switched to street drugs such as heroin, making expanded access to treatment the more pressing need.
The report comes virtually on the eve of President Donald Trump's expected declaration of a national opioid emergency.
Ohio is among the nation's leaders in opioid-related overdose deaths, with a record 4,050 fatalities in 2016, a 33 percent increase from 2015.
"Enacting new laws to take down pill mills and lessen access to prescription opioid drugs alone isn't going to fix the problem," said Mark Partridge, chairman and professor in Ohio State's department of agricultural, environmental and development economics, and one of the report's authors.
"We need a broader-based approach that includes working with physicians and hospitals in under-served areas to encourage providers to obtain the waiver required to prescribe opioid treatments to their patients," he said. "As it now stands, many people in rural areas of Ohio have extremely limited access to medication-assisted treatment, which is a particularly critical issue."
For example, the report noted, of the 26 certified methadone treatment centers in Ohio -- where addicts must visit daily for treatment -- only two are in non-metropolitan areas, Jackson and Athens, leaving most rural Ohioans without ready access to care.
The report paints an equally grim picture regarding the availability of other medication-assisted treatment, such as buprenorphine and naltrexone, considered the most cost-effective treatment for opioid addiction.
Vermont, the report notes, offers one of the best examples of state efforts to expand access to treatment. In 2000, Vermont was one of eight U.S. states without any opioid-treatment providers, meaning residents had to go to neighboring states for help. Today, Vermont has excess capacity to treat addicts.
Vermont created a system connecting regional drug-treatment centers to local providers certified to prescribe buprenorphine, allowing patients to be easily referred to the program that best fits their needs.
"Ohio has done well to expand Medicaid to provide access to treatment, but has not been strategic in building a network of treatment which may not be expensive, just a matter of coordinating," said Mark Rembert, report co-author and co-founder of Energize Clinton County, a community economic-development nonprofit.
The financial toll of the opioid crisis comes from the expense of medical care and treatment, criminal justice and lost productivity of addicts.
"The opioid crisis is draining resources that could otherwise be used to support the economic development of the state," Rembert said.
Expanding access to treatment is the immediate concern, but the report recommends that long-term, the state should focus on improving opportunities for Ohioans to further their education and find jobs that pay well.
The report found that areas of the state with lagging economic growth and low economic mobility had higher drug overdose death rates. It also found that overdose deaths were strongly linked to educational attainment. In 2015, the drug overdose rate for those in Ohio with a high-school diploma was 14 times higher than those with a college degree.
Ohio State's Partridge stressed that the state can't afford to go it alone. Both attention and funding from the federal government are crucial in making a dent in the opioid-abuse problem because states such as Ohio already are too stretched.
"A federal/state solution is key," Partridge said. "The federal government has the resources and best practices necessary to tackle a public health and economic challenge of this magnitude."
(c)2017 The Columbus Dispatch (Columbus, Ohio)
