Auditor General DePasquale: Fentanyl Crisis Costs Society Billions, Action Needed to Prevent Overdoses and Save Lives

Pennsylvania taxpayers paid at least $178 million for opioid-related hospital stays in 2017

October 16 2019

Auditor General DePasquale: Fentanyl Crisis Costs Society Billions, Action Needed to Prevent Overdoses and Save Lives

Pennsylvania taxpayers paid at least $178 million for opioid-related hospital stays in 2017

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Special Report

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HARRISBURG (Oct. 16, 2019) – Auditor General Eugene DePasquale today said while Pennsylvania is making progress in the fight to curb fentanyl overdoses, his new special report shows significant work remains to be done to save lives and stop the flow of the dangerous drug.

“Fentanyl, which can be 50 times more powerful than heroin, is often present in street drugs such as heroin and cocaine, but users don’t realize it,” DePasquale said. “Beyond the tragic cost in lives lost to overdoses, the fentanyl epidemic is driving billions of dollars in costs to Pennsylvania taxpayers and our economy.”

The new report, titled “A Deadly Dose: Fentanyl’s Impact on Pennsylvania,” notes that:

• Pennsylvania taxpayers paid at least $178 million for opioid-related hospital stays in 2017.
• Fentanyl contributed to a 65 percent increase in overdose deaths between 2015 and 2017.
• Fentanyl was among the top three deadliest drugs in nearly every Pennsylvania county that tracked the data in 2017.

“While Pennsylvania was able to achieve an 18 percent drop in overdose deaths from 2017 to 2018, mainly due to the increased access to overdose reversal medications like naloxone, the state still saw more than 4,000 overdose deaths last year,” DePasquale said. “Fentanyl’s deadly strength also poses a risk to first responders and law enforcement officers who may come into contact with the drug.”

Naloxone, also known under the brand name Narcan, can quickly reverse the toxic effects of an overdose and save lives, but it does not treat the root disease: opioid use disorder.

DePasquale’s special report makes three primary observations:

• The impact of the opioid and fentanyl crisis in Pennsylvania is broad, deep and costly, causing devastation in communities across the state and the nation. Opioid treatment and deaths cost the United States approximately $500 billion per year in health care and treatment costs, criminal justice costs, lost productivity and mortality costs, according to the While House Council of Economic Advisors. Pennsylvania’s share of that cost is roughly $25 billion per year – or nearly $2,000 per person.
• The federal government needs to enact a comprehensive plan to curb the illegal importation of fentanyl and its precursor ingredients, most of which comes from China. While much of it comes through the U.S. mail, it also comes through legal ports of entry and evades detection.
• Emergency treatments and long-term recovery options need to be adjusted to fully benefit the maximum number of people. For example, the state should expand partnerships with local authorities, physicians and advocacy groups to reinforce the effectiveness of Medication-Assisted Treatment (MAT), to diminish lingering stigma of its use and to adequately fund a range of MAT options in prisons, jails and recovery facilities. The state should also expand access to preventive measures, such as fentanyl test strips, which are currently illegal in Pennsylvania.

“Test strips that allow users to determine if fentanyl is present are one of the best overdose-prevention measures developed so far,” DePasquale said. “The General Assembly should act to make test strips legal and widely available because they can help to save lives.”

DePasquale’s report also makes 10 recommendations for state and federal policymakers and legislators to consider.

Review the full report and learn more about the Department of the Auditor General online at www.PaAuditor.gov.  

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EDITOR’S NOTE: The 10 recommendations contained in Auditor General Eugene DePasquale’s special report on fentanyl are as follows:

1. The human and financial costs of the opioid crisis are immeasurable and will continue as the supply shifts to fentanyl. These costs must continue to be addressed at all levels of government.
2. In U.S.-China negotiations, the Trump administration should clearly prioritize and provide incentives for the Chinese government to block exports of fentanyl and its precursors.
3. Congress must use its oversight authority to ensure that the Trump administration is appropriately funding and tasking its agencies to implement and enforce new laws — and laws Congress has already passed — to confront the fentanyl crisis. Congress must not allow the Trump administration to focus on actions not supported by data about how fentanyl gets into the U.S.
4. The General Assembly should legalize fentanyl test strips for use across Pennsylvania.
5. State officials should continue to fund naloxone distribution and lift any barriers to access for healthcare workers, opioid users or family members.
6. State officials should expand partnerships with local authorities, physicians and advocacy groups to reinforce the effectiveness of Medication-Assisted Treatment (MAT), to diminish lingering stigma of its use and to adequately fund a range of MAT options in prisons, jails and recovery facilities.
7. The Pennsylvania State Board of Medicine should do as much as it can to simplify the requirements for X-waivers to prescribe buprenorphine/Suboxone and other MAT prescriptions to increase convenient access to physicians and healthcare workers to treat more opioid users who want to recover, and eliminate waiver limitations for nurse practitioners.
8. The governor and General Assembly should ensure they are not inadvertently creating barriers to treatment for opioid users.
9. State officials should consider student loan repayment, home and auto loans, and other benefits to steer students — and mid-career workers — to the fields of addiction medicine, behavioral health sciences and nursing. The governor’s Workforce Development Command Center could be part of this process.
10. The state should help counties fund certifications and deployment of Certified Recovery Specialists.