Small-Town American Budgets Devastated By Opioid Crisis As 41 States Subpoena Big Pharma

A surge in Opioid consumption, primarily prescription painkillers, heroin and fentanyl - a drug 50 to 100 times more powerful than morphine - and the resulting spike in overdose related deaths is devastating families in rural America.  But the opioid epidemic is laying waste to more than just the broken families it counts among its victims, as Reuters points out today, rural municipalities are finding it nearly impossible to fund the surging costs associated with overdoses which come in the form of emergency call volumes, medical examiner and coroner bills, and overcrowded jails and courtrooms.  

As an example, Ross County, Ohio, a town of only 77,000, says its budget for child services has doubled in just 5 years and 75% of the children place into protection come from homes where parents have opioid addictions.

Ross County, a largely rural region of 77,000 people an hour south of Columbus, Ohio, is wrestling with an explosion in opioid-related deaths - 44 last year compared to 19 in 2009. The drug addiction epidemic is shattering not just lives but also stressing the county budget.


About 75 percent of the 200 children placed into state care in the county have parents with opioid addictions, up from about 40 percent five years ago, local officials say. Their care is more expensive because they need specialist counseling, longer stays and therapy.


That has caused a near doubling in the county’s child services budget to almost $2.4 million from $1.3 million, said Doug Corcoran, a county commissioner.


For a county with a general fund of just $23 million, that is a big financial burden, Corcoran said. He and his colleagues are now exploring what they might cut to pay for the growing costs of the epidemic, such as youth programs and economic development schemes.



But it's not just the cost of child services that is wreaking havoc on municipal budgets as everything from autopsy and toxicology costs to court fees and jail expenses are surging throughout rural America.

Autopsy and toxicology costs there have nearly doubled in six years, from about $89,000 in 2010 to $165,000 in 2016, county data shows.


Court costs are soaring, mainly because of the expense of prosecuting opioid-related crimes and providing accused with a public defender, local officials say.


The county is using contingency funds to pay for the added coroner costs, said Mike Baker, the county’s top government official. Last year, the county drew $63,000 from those funds, up from $19,000 in 2014, he said. In 2014, the county saw 10 drug-related deaths. In 2016, the number had grown to 53.


In Mercer County, West Virginia, 300 miles (483 km) to the south of Indiana County, opioid-related jail costs are carving into the small annual budget of $12 million for the community of 62,000 people.


The county’s jail expenses are on course to increase by $100,000 this year, compared to 2015. The county pays $48.50 per inmate per day to the jail, and this year the jail is on course to have over 2,000 more “inmate days” compared to 2015, according to county data.


“At least 90 percent of those extra jail costs are opioid-related,” said Greg Puckett, a county commissioner who sits on a national county opioid task force. “We spend more in one month on our jail bill than we spend per month on economic development, our health department and our emergency services combined.”

Meanwhile, as Bloomberg has just noted, attorneys general from 41 states are broadening their investigation into the opioid industry and have served subpoenas to five pharma companies that make the most powerful prescription painkillers.

They announced Tuesday that they had served subpoenas requesting information from five companies that make powerful prescription painkillers and three distributors. Forty-one attorneys general are involved.


The investigation into marketing and sales practices seeks to find out whether the industry's own actions worsened the epidemic.


If the industry cooperates, the investigation could lead to a national settlement.


The Healthcare Distribution Alliance said in a statement that it's not responsible for the volume of opioid prescribing but that it does want to work on solving the public health crisis.


Dozens of local and state governments have already filed, announced or publicly considered lawsuits against drugmakers or distributors.

To add some context to the scale of the opioid epidemic, the California Department of Public Health recently dropped some staggering statistics showing that there are a remarkable number of counties in California where annual prescriptions for pain killers actually exceed the population.  

Trinity County is the state’s fourth-smallest, and ended last year with an estimated population of 13,628 people.


Its residents also filled prescriptions for oxycodone, hydrocodone and other opioids 18,439 times, the highest per capita rate in California.


Besides Trinity, other counties with more prescriptions than people include Lake, Shasta, Tuolumne and Del Norte counties. In the Sacramento region, El Dorado, Placer and Sacramento counties had prescription rates above the statewide average, with Yolo County slightly below the state average.


A county’s prescription total represents all opioids dispensed via prescriptions filled at a pharmacy and tracked by the state. Statewide, 15 percent of Californians were prescribed opioids in 2016, ranging from 7.3 percent of residents in tiny Alpine County to almost 27 percent in Lake County.

As might be expected, the scripts per capita are highest in California's more rural northern counties.


So who is participating most in this deadly epidemic?  Well, according the Centers for Disease Control and Prevention, the biggest abusers of opioids are high-school educated, unemployed, white people living in small towns...

“The following characteristics were associated with higher amounts of opioids prescribed: a larger percentage of non-Hispanic whites; higher rates of uninsured and Medicaid enrollment; lower educational attainment; higher rates of unemployment; (small-town) status; more dentists and physicians per capita; a higher prevalence of diagnosed diabetes, arthritis, and disability; and higher suicide rates,” concluded the authors of a Centers for Disease Control and Prevention study released in July.


“What you’re seeing in California is what you’re seeing in many parts of the country, including Oregon,” Korthuis said. “There are still a lot of rural counties around the U.S. that are awash in prescription opioids.”

Of course, growth in opioid addiction is hardly just a California phenomenon.  According to the CDC's Annual Surveillance Report of Drug-Related Risks and Outcomes, addiction-related deaths are far more prevalent in the rural 'rust-belt' states of the Midwest.


Meanwhile, the epidemic is growing far more severe every year with overdose deaths up 167% across the country since 1999.

The rate of drug overdose deaths increased from 6.1 per 100,000 population in 1999 to 16.3 in 2015; for unintenttional drug overdose deaths, the rate increased from 4.0 per 100,000 in 1999 to 13.8 in 2015; for drug overdose deaths involving any opioid, the rate increased from 2.9 per 100,000 in 1999 to 10.4 in 2015 (p<0.05); for unintenttional drug overdose deaths involving any opioid, the rate increased from 2.1 per 100,000 in 1999 to 9.3 per 100,000 in 2015 (p<0.05). For all four categories of drug overdose deaths, increases in rates were largest from 2013 to 2015, with the rate increasing on average by 9% per year for overall drug overdose deaths (p<0.05), 11% per year for unintenttional drug overdose deaths (p<0.05), 15% per year for drug overdose deaths involving any opioid (p<0.05), and 16% for unintenttional drug overdose deaths involving any opioid (p<0.05).


But don't worry too much because, as Princeton Economist Alan Krueger told us recently, there is a simple solution to the opioid epidemic in the U.S...apparently it can all be solved with just a little more Obamacare.


JimmyJones Snaffew Tue, 09/19/2017 - 12:48 Permalink

About freaking time they start going after big Pharma.  They knew damn well that their synthetic Heroin was highly addictive.  Its almost the same exact chemical structure as heroin, it doesn't treat pain, it gets you so high that you just don't care about the pain.  Why do you think they are fighting legalization of weed so hard?  Because they can't patent it completely .

In reply to by Snaffew

4shzl tmosley Tue, 09/19/2017 - 12:54 Permalink

Absolutely.  If you want get high, get high.  If you're a miserable, self-destructive individual who can't or won't be educated about the risk, go for it.  I favor universally available, cheap opioids -- much better to have dysfunctional, defective creatures overdose than to spend billions on ineffective treatment or exhorbitant incarceration.

In reply to by tmosley

sickavme JimmyJones Tue, 09/19/2017 - 13:04 Permalink

I went in for surgery when my appendix went on the fritz and all they wanted to give me while I waited for the doctor to go digging around in my stomach is these highpowered opiod/morphine drugs. They said it was the "best they had" and crap like that but for some reason the crap only worked for 10 minutes on me and would wear off... Then I had them give me regular tylenol and that did the trick... And of course, when I got out of the hospital the prescription for pain was the morphine crap... I went down to walmart and grabbed a big bottle of tylenol and slept like a baby for three days....

In reply to by JimmyJones

sickavme Snaffew Tue, 09/19/2017 - 13:50 Permalink

When I was in highschool, weed was on the menu almost all the time. But then school was over, I joined up with the navy, got married, kids, the whole works... 20 years after the last time I touched the stuff, some kids were smokin up at my neighbors and I was like I'll take a hit for nastolgia sakes... I woke up in the hospital, they said I had a seizure or something... Never again...

In reply to by Snaffew

NoDebt sickavme Tue, 09/19/2017 - 14:06 Permalink

"I woke up in the hospital, they said I had a seizure or something..."You made the same mistake I did X years ago.  Assuming weed today is the same as weed from decades ago.  It's not.  The shit is STRONG.  To the point of almost being hallucinogenic.  It was the last reminder I needed.  I suspect the last one you'll need, too.

In reply to by sickavme

sickavme NoDebt Tue, 09/19/2017 - 14:22 Permalink

When I was a little highschool brat, I remember it being something like you would smoke around half a joint and the effect was slow, taking about half the night. But the transition was smooth, predictable, and just mellow.... But the stuff that I smoked that day(about a year ago), skipped all that and went straight to "this is the part where you get fucked up" stage.It smelled like weed, tasted like weed, but the effect was anything but... And those kids are on it too... Very worrisome...

In reply to by NoDebt

M4DM4N sickavme Tue, 09/19/2017 - 15:47 Permalink

Not sure what you smoked, but I smoked  a lot in the early 90's and then after a couple of decades off, I smoked again recently.  Yes it was much stronger but not seizure inducing...nowhere near it.  I think you got some weed laced with something else. 

In reply to by sickavme

Malleus Maleficarum Joe Davola Tue, 09/19/2017 - 15:34 Permalink

"Legal" doesn't mean "no consequences." Drinking's legal, but overdo it? There are definitely consequences - up to and including death. Some people seem prone to self-destruct, period. Whether society and the law approves is irrelevant to such people. I strongly suspect that, in a legal environment, purity would be standardized and ODs would plummet. Laudanum use was quite fashionable in Victorian England, for example. Abusing opioids is inadvisable under any circumstances, no doubt. I wouldn't worry though: the Drug War is far too profitable for the government to ever end it! 

In reply to by Joe Davola

Manthong ljag Tue, 09/19/2017 - 14:10 Permalink

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This country needs to go all Duterte on the distributers and pushers. But we might lose some CIA and cops in the process, 

In reply to by ljag

lincolnsteffens 4shzl Tue, 09/19/2017 - 16:38 Permalink

The illegal drug trade has caused increasing death, violence and corruption. With legalization there might be  an increase in overdose or long term health problems but narco terrorism, inner city gang violence, smuggling, public corruption, public expenditures for interdiction and incarceration would all be dramatically reduced.I've been preaching that for thirty years.  Evidently not many agree with my sermons.

In reply to by 4shzl

JimmyJones tmosley Tue, 09/19/2017 - 12:56 Permalink

I think it wasn't till the early 1900's that any drug was "illegal", I am not sure what changed in the federal Gov't but from what I understand they didn't have the authority to make anything illegal to posses.  It took a constitutional amendment to have alcohol prohibited but yet no amendment was necessary for the other "bad" drugs?  So the question is what changed that all of a sudden gave  the Federal Gov't all of these expanded powers they now have but before it was clear they didn't have the authority to do?

In reply to by tmosley

sickavme JimmyJones Tue, 09/19/2017 - 13:09 Permalink

The very first attack on drugs in the US was because of the chinese railroad workers...It was racially/religously motivated... It was all downhill from there once they figured out that they could make a drug into something that was taxed(but would never be authorized to be taxed) in order to skirt the constitution. Here's a good read on the history of the war on drugs.

In reply to by JimmyJones

Snot Boogie JimmyJones Tue, 09/19/2017 - 13:49 Permalink

I'm pretty sure it was the courts and their interpretation of the commerce clause of the Constituion, so that anything that, even indirectly, affects interstate commerce can be regulated by the federal government.  So, if someone selling weed in Idaho has an effect on the price/supply/other factor in Texas, then it can be regulated federally.  Really, though, this allows the regulation of almost everything by the feds, not just drugs, and I highly doubt the commerce clause was intended to be the loophole for federal intervention that it has become.    For an example, see the Supreme Court ruling in Gonzales v. Raich, which allows for the 'indirect' effect on interstate commerce being enough Constitutionally for the feds to regulate under the Controlled Substances Act.  

In reply to by JimmyJones

HillaryOdor Snot Boogie Tue, 09/19/2017 - 13:51 Permalink

Who knows what the intent was?  The whole constitution reads like one giant power grab by the new government, rife with vague language that can be interpreted a million ways.  The only semi-decent parts are the amendments at the end.  I don't know why people worship the damn document so much, part of the programming I guess.  I'm more of a declaration of independence kind of guy.

In reply to by Snot Boogie

lincolnsteffens JimmyJones Tue, 09/19/2017 - 17:17 Permalink

 "So the question is what changed that all of a sudden gave  the Federal Gov't all of these expanded powers they now have but before it was clear they didn't have the authority to do?"Nothing gave the gov. any new authority. Government with the aid of Lawyers came up with a plan to slowly strip human beings in the USA of their rights. One of the ways the Fed. Gov. accomplishes this is a tricky use of the Federal Gov. to regulate inter-state commerce. Another method involves the gradual takeover of most public education to instill a sense of an individuals powerlessness and the avoidance of teaching children their Constitutional Rights and how to defend them. To top off this slow to fizz cocktail, the television enters nearly every home to mold the tone and limit the information to only what the molders of the country want.To top all this off the education system never teaches the definitions of legal terminology. If people knew what many of the common words we use mean in law they would realize how they have been tricked into allowing their rights to slowly shrink through statutes, regulations and codes that aren't supposed to apply to human beings, only government officials and people that contract with government.

In reply to by JimmyJones

7thGenMO lincolnsteffens Tue, 09/19/2017 - 17:49 Permalink

Yes, but let's not forget that .gov is simply the administrative wing of the anonymous oligarchy that funds .gov through The Fed.  As long as we had a free market, hard money system (as enshrined in the Constitution) they had substantial, but limited power.However, when their Deep State prick named Tricky Dick took us off the gold standard, Lady Liberty was sold as a harem girl to the Saudi's for one petrodollar (system).  Now, she's a toothless whore, that, after giving oral to those camel jockeys, cries out in her old hag voice, "DON'T TOUCH MY SOCIAL SECURITY!" 

In reply to by lincolnsteffens

shocktherapy tmosley Tue, 09/19/2017 - 14:43 Permalink

shocktherapy  tmosley Sep 15, 2017 8:32 PMComing to a neighborhood near you.  that social breakdown among low-income whites was starting to mimic trends that had begun decades earlier among African Americans: Rates of out-of-wedlock births and male joblessness were rising sharply. Then came the stories about a surge in opiate addiction among white Americans, alongside shocking reports of rising mortality rates (including by suicide) among middle-aged whites.

In reply to by tmosley

GUS100CORRINA JimmyJones Tue, 09/19/2017 - 12:52 Permalink

Small-Town American Budgets Devastated By Opioid Crisis As 41 States Subpoena Big PharmaMy response: GOOD!!! Let the LAW SUITES COMMENCE!!!The Greek word “pharmakia” literally means “drugs”, and appears five times in the New Testament: in Gal 5:20, Rev 9:21, 18:23, 21:8, and 22:15.  “Pharmakia” is translated into our English Bible as either “witchcraft” or “sorceries”. We also get our English word “pharmacy” from the Greek word “pharmakia”.  In each of the above five passages, “pharmakia”, or “drugs” is listed as a work of the flesh of man as opposed to the Spirit of God working in us.  

In reply to by JimmyJones

TuPhat JimmyJones Tue, 09/19/2017 - 13:02 Permalink

Apparently, Jimmy, you don't know that much about it.  I was given an opioid painkiller when I had a kidney stone.  It does treat the pain.  The pain went away and I relaxed and passed the stone.  Before getting to the hospital I thought the pain was going to kill me.  They do have a use that is good and helpfull.  Abuse however is different.  Legalizing all drugs and making them non prescription would be a step in the right direction.  Some people still kill themselves with alcohol but it isn't destroying the world.  Let people make their own choices.

In reply to by JimmyJones

7thGenMO TuPhat Tue, 09/19/2017 - 13:50 Permalink

Out here in District 12 (well, not actually "The Hunger Games", but close - The Ozarks), I can safely say that it is "OUT OF CONTROL!"  Local LE is simply overwhelmed.  There are three state prisons within an hour's drive filled to the brim with drug offenders and my town has become populated with their kin that need to frequently visit them.  The locals know where the drug dens are - 15 to 40 people living in one house is a tell tale sign, but LE simply doesn't have the resources to shut them down.  They dragged an overdosed 17-year-old girl out of one just last week.IMHO - legalizing pot might help, but I'm hesitant to say that we should legalize opiods, such as some countries in Europe, because Americans are not as educated.  Also, people addicted to opiods simply do not have the power of choice.  I've come across a few in town, and they can be down right scary.  The look in their eyes is indescribable, but if you look at photos of the downtrodden from the Great Dispossession, you'll get the drift.  If we are going to legalize opiods, then I'll need to put on extra security as I'm afraid it will likely become a "Mad Max" scenario, at least temporarily.A better solution might be to educate people.  For all of the money spent on the MIC the past 15 years, an entire generation could have been provided with a free college education.  Obviously, the oligarchy running the show doesn't want an educated populace.  Perhaps the destruction of our society is a consequence of pure greed.

In reply to by TuPhat

Malleus Maleficarum 7thGenMO Tue, 09/19/2017 - 15:53 Permalink

It doesn't have to be "either-or." Education would definitely be good, depending on who's doing the "educating." Medical personnel teaching harm reduction? Probably. The government propagandizing and running fear and subservience-based campaigns? Probably not. Our nation seems headed to 'Mad Max' status regardless of rates of drug usage. TRUE freedom and free markets could solve most of our problems.You're forgetting the economic aspects, I think. First, opioids are hugely expensive under Prohibition and Big Pharma. There is money to be made from addiction - prisons, police, state-sponsored 'treatment' rackets, etc. - it's a growth industry in many, many ways. Still, pure pharmaceutical-grade heroin can be made for literally pennies. Second, most of those people are probably being simultaneously bled by the police/government, via probation fees (which can be astronomical) and can't find work because of their criminal records. Not many people would choose to be trailer-trash. Still, it should be their right until their choice infringes on others' freedom. There is ample historical evidence that drugs can be used safely, and even indefinitely, when they are legal and controlled by free-market forces. Plenty of grandmas go to the doctor every month and get their "fix," living productively, otherwise.

In reply to by 7thGenMO

7thGenMO Malleus Maleficarum Tue, 09/19/2017 - 17:21 Permalink

I agree in part with what you are saying because being a prison guard is one of the better paying jobs around here, and there is still the mentality of treating drug users as having bad morality.  However, deep down I think people in this "growth industry" know they are cogs in a system that preys on the downtrodden.  I hope at some point that people will catch on that many of the downtrodden, if given the chance, would work a decent job like their parents had before the oligarchy that controls the money supply forced many into poverty through de-industrialization.  Until people have education and hope of a better future, I'm highly skeptical that opiod legalization would work here just because it worked in Portugal.

In reply to by Malleus Maleficarum

ljag Captain Chlamydia Tue, 09/19/2017 - 14:25 Permalink

Let's see....hmmmmm. What did all those growers do in the 80s and 90s you know BEFORE...THE CORPS got their greedy hands on it? Underground sound familiar ? Fuck their patents.
I think all real pot smokers should line up at these dispensaries and tell the corps that their weed didn't get them high and demand their money back. How would the suits know? They wouldn't know good weed if it stuck to their fingers.

In reply to by Captain Chlamydia

City_Of_Champyinz Snaffew Tue, 09/19/2017 - 12:55 Permalink

And the simple fact that the war on drugs has had absolutely no effect on the supply of drugs in this country shows that it is an epic failure.  And Narcan needs to be banned, I just read a story this morning about some junky overdosing twice in 45 minutes.  What the fuck is that?? It is time for natural selection to be allowed to thin the herd...

In reply to by Snaffew