The Rapidly Rising Death Toll of the Heroin Epidemic

The death toll from the heroin epidemic has been climbing dramatically in recent years — and the annual rate of overdose deaths nearly doubled between 2011 and 2013, according to a new CDC study.
From 2002 through 2013, heroin use in the United States rose by 63 percent, and the rate of abuse or dependence climbed a staggering 90 percent. Deaths from heroin-related overdoses nearly quadrupled, with more than 8,200 people dying in 2013 alone.
The CDC report says that heroin use has increased across most demographic groups — men and women, most age groups, and across all income levels. Rates of heroin use are still highest among men, those ages 18 to 25, people with income less than $20,000 a year, people in urban areas, and those who do not have health insurance or are on Medicaid. But other groups are turning to the drug, too. “Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured and people with higher incomes,” the CDC says.
The heroin trend isn’t happening in isolation, the CDC study says. Almost all heroin users — 96 percent — also took at least one other drug, and 61 percent used at least three other drugs. Abuse or dependence on opioid painkillers is the strongest risk-factor for heroin use or addiction, the report says, with cocaine addiction also high on the list. People who are addicted to prescription opioid painkillers are 40 times more likely to use or be addicted to heroin, and 45 percent of people who used heroin were also addicted to painkillers.
Another key reason is that heroin is becoming cheaper and more widely available. According to the DEA, the increase in heroin seizures in the U.S. from 2010 and 2014 rose 81 percent, from 2,763 kilograms to 5,014 kilograms. More and more law enforcement agencies are identifying heroin as their primary drug threat, but the CDC report suggests that health care workers focus on reducing the abuse of painkillers by improving prescribing practices.
The study also recommends that states increase access to “medication-assisted treatment” programs that use methadone, buprenorphine and naltrexone along with behavioral counseling. And it says the rapid rise in heroin-related deaths highlights an “urgent need” to broaden access to naloxone, a drug that can reverse the effects of heroin and opioid overdose.
Quote of the Day: A Big Hurdle for the Tax Cuts

“He goes in and campaigns on an issue, and the challenge is he then talks about executing drug dealers. Why do you think the press is going to cover the tax cuts if you’ve given them the much more exciting issue?”
-- Grover Norquist, president of tax-cutting advocacy group Americans for Tax Reform, on President Trump’s failure to sell the tax law.
The Obamacare Mandate That Could Produce $12 Billion in Fines in 2018
Republicans effectively eliminated the individual Obamacare mandate in the tax package signed late last year. Although the new regulation reducing the mandate penalty to zero doesn’t take effect until 2019, President Trump has cited the rule change as a victory over the health law so many conservatives oppose. “Essentially, we are getting rid of Obamacare. Some people would say, essentially, we have gotten rid of it," Trump told a crowd in Michigan two weeks ago.
However, many parts of the Affordable Care Act are still in effect and will continue to operate even after the individual mandate is eliminated in 2019.
In particular, the employer mandate, which requires companies with more than 50 employees to offer health benefits or face fine of roughly $2,000 per worker, will continue to play a significant role in the Obamacare system. The Congressional Budget Office estimates that the mandate will produce more than $12 billion in fines in 2018 alone.
Some conservative groups are pushing lawmakers to stop enforcing the employer mandate, but the IRS is still working to enforce the law. According to The New York Times Monday, the IRS is sending out notices to more than 30,000 businesses that have failed to comply.
Chart of the Day: It’s Still the Economy, Stupid

Security may be the top policy issue for Republican voters, but the economy is the top concern for Democrats, independents and voters overall, according to Morning Consult’s latest polling on the midterm elections. Health care is third on the list, followed by “seniors’ issues.” The results are based on surveys with more than 275,000 registered U.S. voters from February 1 to April 30.
Number of the Day: $13 Billion
An analysis by Bloomberg finds that the roughly 180 companies in the S&P 500 that have reported earnings for the first three months of the year saved almost $13 billion thanks to the corporate tax cut enacted late last year. Those companies’ effective tax rate dropped by more than 6 percentage points on average. About a third of the tax savings went to 44 financial firms.
How a Florida Doctor with Social Ties to Trump Delayed a $16B Billion VA Project

A West Palm Beach doctor who is friends with Ike Perlmutter, the chairman of Marvel Entertainment and an informal adviser to President Trump on veterans’ issues, has held up “the biggest health information technology project in history — the transformation of the VA’s digital records system,” Politico’s Arthur Allen reports. Dr. Bruce Moskowitz “objected to the $16 billion Department of Veterans Affairs project because he doesn’t like the Cerner Corp. software he uses at two Florida hospitals, according to four former and current senior VA officials. Cerner technology is a cornerstone of the VA project. … Moskowitz’s concerns effectively delayed the agreement for months, the sources said.” Read the full story.