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.
Chart of the Day: A Buying Binge Driven by Tax Cuts
The Wall Street Journal reports that the tax cuts and economic environment are prompting U.S. companies to go on a buying binge: “Mergers and acquisitions announced by U.S. acquirers so far in 2018 are running at the highest dollar volume since the first two months of 2000, according to Dealogic. Thomson Reuters, which publishes slightly different numbers, puts it at the highest since the start of 2007.”
Number of the Day: 5.5 Percent
Health care spending in the U.S. will grow at an average annual rate of 5.5 percent from 2017 through 2026, according to new estimates published in Health Affairs by the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS).
The projections mean that health care spending would rise as a share of the economy from 17.9 percent in 2016 to 19.7 percent in 2026.
Trump Clearly Has No Problem with Debt and Deficits
A self-proclaimed “king of debt,” President Trump has produced a budget that promises red ink as far as the eye can see. With last year's $1.5 trillion tax cut reducing revenues, the White House gave up even trying to pretend that its budget would balance anytime soon, and even the rosy economic projections contained in the budget couldn’t produce enough revenues, however fanciful, to cover the shortfall.
The Trump budget spends as much over 10 years as any budget produced by President Barack Obama, according to Jim Tankersley of The New York Times. And it projects total deficits of more than $7 trillion over the next decade — "a number that could double if the administration turns out to be overestimating economic growth and if the $3 trillion in spending cuts the White House has floated do not materialize in Congress,” Tankersley says.
Trump — who once promised to both balance the budget and pay down the national debt — isn’t the only one throwing off the shackles of fiscal restraint. Republicans as a whole appear to be embracing a new set of economic preferences defined by lower taxes and higher spending, in what Bloomberg describes as a “striking turnabout” in attitudes toward deficits and the national debt.
But some conservatives tell Tankersley that the GOP's core beliefs on spending and debt remain intact — and that spending on Social Security and Medicare, the primary drivers of the national debt, are all that matters when it comes to implementing fiscal restraint.
“They know that right now, a fundamental reform of entitlements won’t happen," John H. Cochrane, an economist at Stanford University’s Hoover Institution, tells Tankersley. "So, they have avoided weekly chaos and gotten needed military spending through by opening the spending bill, and they got an important reduction in growth-distorting marginal corporate rates through by accepting a bit more deficits. They know that can’t be the end of the story.”
Democrats, of course, have warned that the next chapter in the tale will involve big cuts to Social Security and Medicare. Even before we get there, though, Tankersley questions whether the GOP approach stands up to scrutiny: "This is a bit like saying, only regular exercise will keep America from having a fatal heart attack, so, you know, it's ok to eat a few more hamburgers now."
Part of the Shutdown-Ending Deal: $31 Billion More in Tax Cuts
Margot Sanger-Katz and Jim Tankersley in The New York Times: “The deal struck by Democrats and Republicans on Monday to end a brief government shutdown contains $31 billion in tax cuts, including a temporary delay in implementing three health care-related taxes.”
“Those delays, which enjoy varying degrees of bipartisan support, are not offset by any spending cuts or tax increases, and thus will add to a federal budget deficit that is already projected to increase rapidly as last year’s mammoth new tax law takes effect.”
IRS Paid $20 Million to Collect $6.7 Million in Tax Debts
Congress passed a law in 2015 requiring the IRS to use private debt collection agencies to pursue “inactive tax receivables,” but the financial results are not encouraging so far, according to a new taxpayer advocate report out Wednesday.
In fiscal year 2017, the IRS received $6.7 million from taxpayers whose debts were assigned to private collection agencies, but the agencies were paid $20 million – “three times the amount collected,” the report helpfully points out.
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