Thanks to the implementation of effective policy, the number of drug overdose deaths in the United States fell by nearly 24 percent in 2024. Members of Congress must act to preserve these policies and gains. And one of the most valuable players in combating the opioid crisis response is Medicaid, which is now very much at risk.
More than one million Americans have died from drug overdoses since 1999. I am a person in long-term recovery from a substance use disorder. I know that for many people, vacant statistics are not very meaningful, but behind this statistic are countless suffering families.
My friend Max, who I knew from treatment, died last year of an opioid overdose. He was only twenty-six years old. As a special education teacher, Max loved his students, and he often giggled while he watched “The Office,” his favorite show. He had his whole life ahead of him. His overdose was likely preventable and leaves a tragic aftermath.
Unequivocal evidence supports treating people suffering from opioid use disorder (OUD) with medications such as buprenorphine. Just initiating a person on medications reduces overdose mortality by 50 percent to 80 percent. In addition, the longer a person takes buprenorphine, the lower their relative overdose hazard ratio.
Roughly 18 percent of people with opioid use disorder are treated with medications. Coverage with public insurance drives access to such medications, and particularly coverage through Medicaid expansion. In 2019, nearly 40 percent of people receiving medications due to OUD were covered by public insurance, compared to 21 percent with private insurance and 17 percent with no insurance. This was enabled by Medicaid. Medicaid provided treatment for over 1.8 million people with OUD in 2021, and more than half were eligible due to Medicaid expansion.
I have witnessed the importance of medications for opioid use disorder first-hand. It took over a decade for my brother, who is now in long-term recovery, to be even offered buprenorphine for his OUD by a health care professional, despite his high risk of overdose. He spent time in jail and prison between 2012 and 2014, and when someone is released from incarceration, their risk of death from overdose is especially high. Astonishingly, it was not until late 2020 that he began treatment with buprenorphine, which has changed—and probably saved—his life.
Under the House of Representatives’ budget reconciliation, the House Energy and Commerce Committee must achieve $880 billion in cuts over a ten-year period. This will undoubtedly require drastic cuts in Medicaid and the Children’s Health Insurance Program.
Without a doubt, this act risks afflicting even more U.S. families with losses from fatal overdoses. Weakening Medicaid will overwhelm rural hospitals especially, compel more people needing medical care to go to emergency departments and wreak financial havoc on hospital systems. And if Congress limits access to prescription medications like buprenorphine, the nation will regress in reducing overdose deaths—even if the current administration successfully reduces the flow of fentanyl across the U.S.-Mexico border.
Congress must see the indispensable role of Medicaid in reducing overdose deaths, and not haphazardly freeze lifesaving federal grant programs that also provide medication treatment to the uninsured. Otherwise, the opioid overdose crisis will only get worse.
Those affected by overdose deaths simply have experienced the unfathomable. More than 320,000 children have lost a parent to overdose over a decade and have experienced an aftermath of trauma and pain. Members of Congress should honor those children and others who have lost by remembering that there are lives that have yet to be saved—especially through Medicaid.
This column was produced for Progressive Perspectives, a project of The Progressive magazine, and distributed by Tribune News Service.