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.
Map of the Day: Navigating the IRS
The Taxpayer Advocate Service – an independent organization within the IRS whose roughly 1,800 employees both assist taxpayers in resolving problems with the tax collection agency and recommend changes aimed at improving the system – released a “subway map” that shows the “the stages of a taxpayer’s journey.” The colorful diagram includes the steps a typical taxpayer takes to prepare and file their tax forms, as well as the many “stations” a tax return can pass through, including processing, audits, appeals and litigation. Not surprisingly, the map is quite complicated. Click here to review a larger version on the taxpayer advocate’s site.
A Surprise Government Spending Slowdown
Economists expected federal spending to boost growth in 2019, but some of the fiscal stimulus provided by the 2018 budget deal has failed to show up this year, according to Kate Davidson of The Wall Street Journal.
Defense spending has come in as expected, but nondefense spending has lagged, and it’s unlikely to catch up to projections even if it accelerates in the coming months. Lower spending on disaster relief, the government shutdown earlier this year, and federal agencies spending less than they have been given by Congress all appear to be playing a role in the spending slowdown, Davidson said.
Number of the Day: $203,500
The Wall Street Journal’s Catherine Lucey reports that acting White House Chief of Staff Mick Mulvaney is making a bit more than his predecessors: “The latest annual report to Congress on White House personnel shows that President Trump’s third chief of staff is getting an annual salary of $203,500, compared with Reince Priebus and John Kelly, each of whom earned $179,700.” The difference is the result of Mulvaney still technically occupying the role of director of the White House Office of Management and Budget, where his salary level is set by law.
The White House told the Journal that if Mulvaney is made permanent chief of staff his salary would be adjusted to the current salary for an assistant to the president, $183,000.
The Census Affects Nearly $1 Trillion in Spending
The 2020 census faces possible delay as the Supreme Court sorts out the legality of a controversial citizenship question added by the Trump administration. Tracy Gordon of the Tax Policy Center notes that in addition to the basic issue of political representation, the decennial population count affects roughly $900 billion in federal spending, ranging from Medicaid assistance funds to Section 8 housing vouchers. Here’s a look at the top 10 programs affected by the census:
Chart of the Day: Offshore Profits Continue to Rise
Brad Setser, a former U.S. Treasury economist now with the Council on Foreign Relations, added another detail to his assessment of the foreign provisions of the Tax Cuts and Jobs Act: “A bit more evidence that Trump's tax reform didn't change incentives to offshore profits: the enormous profits that U.S. firms report in low tax jurisdictions continues to rise,” Setser wrote. “In fact, there was a bit of a jump up over the course of 2018.”
