State plans opioid treatment expansion with proceeds from drug tax

DOVER — It can be very easy to forget these days that COVID-19 isn’t the only public health crisis raging across the country.

Americans continue to die from drug overdoses, particularly using opioids, and the dangers and stress posed by the coronavirus make many reluctant or unable to get help and more likely to use.

Delawareans are no exception. As of early December, the state had seen 316 suspected overdose deaths in 2020, more than the number from the same time period last year. 2019 finished with 431 drug overdoses here, according to the Division of Forensic Science, meaning 2020 could surpass 500 fatal overdoses.

Health officials are hopeful an opioid tax could help reverse that trend.

Instituted in 2019 by the General Assembly, the Opioid Impact Fee requires large manufacturers to remit funding to the state based on drug sales. Brand-name opioids cost 1 cent per morphine milligram equivalent — a standard unit used to calculate the strength of such drugs — or 0.25 cents for generics.

Under the statute, a 10-milligram pill of oxycodone costs an extra 15 cents (brand-name) or 4 cents (generic).

State officials said Tuesday that the Department of Health and Social Services has collected about $1.5 million so far ($500,000 per quarter), with an approved plan to spend $700,000. More money will be dispensed in the near future.

The funding, use of which is determined by the DHSS secretary based on recommendations from the Behavioral Health Consortium, Addiction Action Committee and the Overdose System of Care Committee, will go to several areas. Officials plan to use $300,000 to close gaps in services, particularly on weekends and outside regular business hours, when Bridge Clinics are not open; $250,000 to address social determinants of health, such as disparities in access to transportation and transitional housing; $100,000 for administrative expenses; and $50,000 to purchase 925 kits of naloxone, an overdose-reversing medication.

“When we started down this road, we heard from countless naysayers who falsely claimed either that this legislation would hurt pharmacies, negatively impact consumers or fail to make a difference,” said Sen. Stephanie Hansen, a Middletown Democrat who introduced the enabling legislation. “Fears such as these prevent progress and have allowed this crisis to go on so long.

Stephanie Hansen

“This announcement (Tuesday) proves we can hold drugmakers accountable. We can bring innovative, new tools to bear to confront addiction in our communities. And we can do more to break the cycle of abuse, addiction and death that has touched so many families in our state,” Sen. Hansen said.

The legislation was projected to bring in around $2.7 million annually in the first three years, although a state fiscal analyst noted that prescribing rates would see at least a small decrease as a result of the fee.

So far, Mallinckrodt Pharmaceuticals and Purdue Pharma have paid the most because of the opioid tax, at $383,000 and $365,000, respectively. No company has resisted paying, according to the Department of State, which helps administer the fund.

In 2018, Delaware was second among states in the fatal overdose rate, according to the Centers for Disease Control and Prevention. The CDC also said the state leads the nation in the prescription rate for high-strength opioids.

Nationally, more than 70,000 people fatally overdosed on opioids in 2017, a sixfold increase compared to 1999. Slightly more than two-thirds of those deaths were from prescription opioids, according to the enabling legislation.

“There are no easy solutions when it comes to treating people struggling with substance use disorder,” said Lt. Gov. Bethany Hall-Long, the chairwoman of the Delaware Behavioral Health Consortium. “To be successful, we must take a truly holistic approach. This means supporting both the individual and their family as we attempt to remove the social determinant barriers that hinder an individual on a path to recovery.

“The Opioid Impact Fee is helping Delaware to build that behavioral health system infrastructure. This legislation is doing more than just generating revenue. It will help us to save lives, rebuild families and restore communities torn apart by addiction.”

DHSS Secretary Molly Magarik emphasized the importance of establishing 24/7 clinics for addicts discharged from hospitals to prevent them from falling through the cracks and right back into the spiral of drug use.

“It was really important to look at how can we enhance services,” she said.
Individuals battling addiction can visit helpisherede.com or call (833) 946-7333 for assistance.