When it comes to opioid abuse, the numbers are sobering to behold. In 2016 alone, opioid drug abuse took the lives of 64,000 Americans. As a result, state governments are thinking outside the box to combat the epidemic.
Everything’s on the table from prevention programs to new taxes — and Vermont is no exception. In 2014, a CBS-TV report, “Vermont Faces Opiate Drug Abuse Crisis,” got the attention of residents and legislators alike. The news outlet reported that Vermont had experienced a nearly 800 percent increase in the abuse of opiates since 2000. Some 4,000 Vermonters were in opioid drug treatment programs at the time of the report, and deaths from heroin overdoses had doubled between 2000 and 2014.
It’s 2018, and Vermont’s opioid crisis hasn’t gone away.
The Vermont Senate Health and Welfare Committee this year proposed a prescription opioid tax — euphemistically termed as either an “assessment” or a “surcharge” by politicians hiding from tax increases. The effort was seen as a way to punish the pharmaceutical industry for marketing opioids to doctors as means for treating pain.
Among the Vermont opioid tax’s champions is Sen. Claire Ayer, D-Addison, chair of the Senate Health and Welfare Committee. The tax had been introduced as an amendment to H.922, but the bill never made it to the floor during this session. Meanwhile, Ayer, and others such as Senate President Pro Tem Tim Ashe, P/D-Chittenden, said that the tax would not hurt state taxpayers.
“It’s not a tax on Vermonters, but it’s what’s called a morphine milligram equivalent (MME) measure. It’s a really logical way to fund opioid treatment programs, and it doesn’t take money from other programs,” Ayer told True North Reports.
“The surcharge, as proposed, is based on the strength of the particular drug being prescribed. As an example, I had surgery on my shoulder recently; the painkiller prescribed to me was $8.80 a bottle, so it’s not even very expensive to begin with.”
Al Gobeille, secretary of the Vermont Agency of Human Services, said while he understands the emotional concerns prompting the proposed tax, he believes that it’s actually a tax on health-care benefits and legal drug purchases.
“Right now, the bill didn’t survive, but it could be brought up in the next legislative session,” Gobeille told True North. “I share Senators Ayer’s and Ashe’s passion for holding drug companies accountable for the crisis, but I am not sure how such a tax would work and where it would live. It ends up looking like a consumer tax where the expense would be passed on to Vermonters.”
“Obviously, we don’t want to raise a tax for no reason,” Scott said during an April 4 news conference in the Statehouse. “We want to make sure there’s a viable plan to put forward. $14 million (of the $28 million tobacco settlement) is going to opioids. So, maybe some of that money could go to the initiative that (the Senate Health and Welfare Committee) is trying to fulfill.”
Meg Hansen, executive director of VCHF, said that legislators are going to continue to pursue an opioid tax.
“Levying such a tax will not … achieve its declared objective of punishing drug makers,” she told True North. “Instead, it will result in far-reaching, negative consequences including hurting the sick and driving non-medical users to the black market – teeming with dirt cheap heroin, fentanyl (a prescription opioid pain killer), and other lethal chemical weapons.”
Hansen added that the state has no means right now of ensuring that an opioid tax would not be passed on to the consumer.
“Senator Ashe claims that the tax would be ‘as far removed from the consumer as possible’ to decrease the likelihood of companies passing on the tax burden to Vermont consumers,” Hansen said. “However, the state can’t determine whether any future increases in drug prices would be related to the opioid tax or as a result of other factors like closed-door price negotiations between pharmaceutical manufacturers, insurance companies and middlemen called PBMs — pharmacy benefit managers.”
She also said an opioid tax in Vermont would not decrease drug abuse and actually end up fueling black market activity such as happens with the illegal cigarette trade.
“And an opioid tax would not address the present drug crisis that is driven by heroin and fentanyl abuse,” Hansen noted. “Big Pharma created the opioid crisis in the 1990s.”
According to Ross Marchand, director of policy for the Washington, D.C.-based Taxpayers Protection Alliance Foundation, while the opioid tax proved dead on arrival in the Vermont Legislature, it’s only a matter of time before the idea once again rears its ugly head.
“Punishing the vast majority of patients that moderately use opioids is a wrongheaded solution to a tragic public health crisis,” Marchand told True North.
Marchand says there’s no silver bullet for cutting down on opioid addiction and death rates in Vermont. “Such a state tax would only harm patients who need the drugs without reducing addiction,” he said.
He also echoes Hansen’s concerns when it comes to illegal black market activity that would likely follow in the wake of any state opioid tax.
“Criminal distribution networks can fuel other illegal activities,” he said. “Cross-state cigarette smuggling, for instance, provided a financing stream for the terrorist organization Hezbollah. Additionally, al Qaeda trainees used illegal cigarette distribution networks to fund trips to Afghanistan.”
VHCF’s Hansen doesn’t minimize Vermont’s opioid crisis, but she doesn’t see how a tax will ever solve the real problem facing Vermont.
“Fentanyl and its deadlier analogs should indeed be regarded as chemical weapons,” she said. “The Associated Press reports that the number of accidental overdose deaths related to fentanyl in Vermont increased by one-third over the past year. … But an opioid tax will not address this urgent public health crisis.”
Lou Varricchio is a freelance reporter for True North Reports. Send him news tips at firstname.lastname@example.org.