The Hidden Cost
Mark R. Hayes, Executive Director, Arkansas Municipal League
The Hayes-Bratton Story
My personal story regarding the opioid epidemic has been told in several public forums. It’s not a secret. My wife Alison and I have been an open book regarding the death of our son Wells in hopes of saving the lives of others.1 For those who may not be familiar I’ll recap our story. At age 23 Wells died from an overdose of fentanyl in the early morning hours of April 18, 2020. We were a mere 40 or so feet from him in our home. He was downstairs, in his bathroom. His preferred method of delivery into his body was to smoke the drug off a piece of tin foil.23 The fentanyl he smoked in those dark morning hours was deadly.4 There was no knowing if it was so potent as to kill upon minimal use, or just get the high he sought. I’ve said many times, the illicit drug manufacturing operations of the world do not have the quality control measures that other lawful industrial companies do. They don’t care about the user. They care only about the money. Fentanyl, by the way, is a synthetic opioid as opposed to morphine which comes directly from the opium poppy plant. Heroin is made from morphine which comes from the opium poppy plant’s seed pod.5 Wells had been through a long history of destructive behavior and in the two years prior to his death had been in two different recovery programs. During that time his best friend died from an overdose and two days after Wells died a dear friend of his from rehab also died. Three young men in the prime of life, gone.
There are several things that all of us need to know about the opioid epidemic in our country and in particular in Arkansas. Here are some national statistics from the Centers for Disease Control and Prevention regarding what it calls the “opioid epidemic:”6
- In 2019 over 70% of the drug overdose deaths in our country were from opioids.7
- Nearly 73% of all opioid overdose deaths involve synthetic opioids.8
- Synthetic opioid overdose deaths were nearly 12 times higher in 2019 than in 2013.9
- Nearly 40 people die every day from a heroin overdose.10
- In modern history there have been three waves of opioid overdose deaths in the United States beginning in the 1990s and continuing to this day.11
Let’s drill down a little deeper and look at Arkansas. According to the Arkansas Take Back website12 and the Arkansas Opioid Dashboard:13
- Opioid related deaths rose from 180 in 2019 to 215 in 2020.14
- In 2020, 34 of our 75 counties had opioid prescription rates of over 100 for every 100 people in the respective county. The highest was Poinsett County with 151.5 opioid prescriptions for every 100 Poinsett County residents. In no particular order, here are a few of the highest county rates in our state: Stone, 127.6; Ouachita, 129.2; Calhoun, 115.3; and Greene, 130.6.15
- The 75-county average of opioid prescriptions per 100 people in Arkansas is a whopping 86.3.16
- Naloxone17 is a lifesaving drug that offsets opioid overdoses. According to the office of Arkansas Drug Director Kirk Lane, in 2019 185 lives were saved in Arkansas from the use of Naloxone. In 2020 the number more than doubled to 391.
The Economic Impact18
Anecdotally it’s not difficult to contemplate the monetary impact of drugs and overdoses. The simple act of calling 911 to get help with an opioid overdose victim causes a multitude of manpower hours and energy to occur within seconds. The dispatcher will be totally consumed with the call until a first responder arrives. In most municipalities the police will be the first to arrive because they are in their patrol vehicle and already moving. Sometimes it’s one officer and other times it’s two or three depending on the location of the emergency and the officers. Next will be an ambulance or a fire fighting vehicle of some sort. Whichever gets there first the other is soon to follow. The personnel varies but for example purposes let’s say its two folks in the ambulance and four to six in the fire vehicle. From my own experiences, and there have been several, that’s about right. Add to the mix a narcotics detective, perhaps a patrol sergeant and maybe a battalion commander. You get the idea I’m sure. In all likelihood—again I’ve lived this—it’ll be 30 minutes to an hour before transport to the hospital if the victim is saved by the first responders. If not, and I know this all too well, it’ll be three to four hours and many many more public officials will be on the scene. If there is a save, then there’s a ride to the hospital and ensuing treatment. My experience here is varied. We’ve been in and out in a couple of hours on a couple of occasions. We also spent almost three days watching Wells on a ventilator until he was well enough to leave the hospital. The point I’m trying to make is taxpayer time and money is immediately adversely affected. Of course, the health care system is impacted as well. Remember however, this is just the short-term economic impact. The very short-term.
General Economic Information
- The University of Toledo produced an economic study regarding one of the most hard hit opioid epidemic areas in the country, northwest Ohio.19 In 2019 alone, the study concludes that northwest Ohio suffered a $1.6B impact which included 2,082 jobs lost, 4.5% gross domestic product loss and an $8.67M cost for every overdose loss. The study goes to great length to explain that the overdose death is merely the tip of the economic iceberg. The shortened life span has a downhill effect of a lost employee, taxpayer and consumer all of which directly and negatively tie to the economy.
- According to a 2021 CDC weekly report, the 2017 cost to the national economy regarding opioid disorders (not deaths) was $471B. Opioid fatalities totaled $550B for a grand total of $1,021B.20
- In March of 2019 the Federal Reserve Bank of Cleveland produced a working paper titled Opioids and the Labor Market.21 While the paper makes myriad points one in particular stood out to me: prescription opioids (not heroin or other illegally obtained opioids) can account for as much as 44% of the realized national decrease in men’s labor force participation between 2001 and 2015.
- The American Action Forum has produced various papers and materials on this subject. Labor market analyst Ben Gitis wrote a lengthy paper in 2018 regarding opioids and the labor force.22 He concludes in 2015 the following: nationwide over 2M prime age individuals were not in the workforce due to opioids, costing nearly $1.6T in real economic output and the two states that suffered the largest economic effects were Arkansas and West Virgnia.
Arkansas’ Hidden Cost
Hopefully by now it’s become clear that opioids, legal and non, are wreaking havoc on our country, our state, our cities and towns, our economy and our loved ones. Our family story is but one of tens of thousands of tragedies playing out everywhere in America and Arkansas. Against that background, here’s a deeper dive into our states suffering.
- Between 1999 and 2015 prescription opioids per capita in Arkansas rose 1,946%. That equates to about 21% annually.23
- From 1999 to 2015 Arkansas lost 574M work hours because of this epidemic.24
- In 2015 18,500 men and 24,900 women were absent from the Arkansas workforce due to opioids.25
- Arkansas’s real GDP from 1999-2015 grew 1.5% annually. Had opioids not drawn so many prime-age workers from the workforce our state’s economy would have grown more than twice as fast.
Arkansas is at a crossroads. We must join together, government and business alike, if we are to beat this scourge. As many of you know the cities and counties of Arkansas have joined together to bring litigation against the industry that caused the majority of this harm. That effort is critical to a pragmatic and long-term plan that brings our state back to health. Cities and counties have asked the state to join our efforts but to date we do not have a signed memorandum of agreement that would allow settlement negotiations to begin. The business community is the silent partner in those efforts, although that may be more of an unconscious matter for many of you readers. What I mean by that is simply this. Please educate yourselves about the litigation. It’s clear our economy, your business, has suffered dramatically from this epidemic. What’s needed now is for the silent partner to be heard. Join us in making Arkansas healthy and successful.
- In May of 2020 I wrote about Wells death in-depth and I did so again this past April. Here are the links if you’re interested: https://www.arml.org/static/arml/2020_05_City_and_Town_WEB.pdf
- Setting aside death, this is a succinct article on the various health issues that come from smoking heroin and fentanyl. For context, fentanyl is 50-100 times more powerful than morphine. https://vertavahealth.com/heroin/smoking/
- If you’re interested in learning more about the hows and whys of heroin/fentanyl, use here’s an article. Warning: some of the linked pages and articles are graphic and disturbing. https://www.thefix.com/content/heroin
- The problem with illegally manufactured fentanyl is its potency. The buyer has absolutely no idea if it’s been cut with sugar or combined with heroin, meth or anything else for that matter. https://www.thefix.com/content/what-are-effects-heroin
- I considered titling this section of the paper Lawyers, Guns and Money given my personal experiences with this horrible epidemic but thought better of it after discussing the matter with my wife. Apologies to the late Warren Zevon who wrote and sang the song on his 1978 album: Excitable Boy.
- THE ECONOMIC IMPACT OF THE OPIOID EPIDEMIC, IN NORTHWEST OHIO, 2019, The University of Toledo, Oleg A. Smirnov, Ph.D.
If you or someone that you care about is dealing with opioid-use or substance-use disorder, please reach out and seek treatment. Find help by contacting the national drug addiction helpline (24/7/365) at 1-800-644-HELP (4357) or the Arkansas Mental Health & Addiction Support Line at 1-844-763-0198.