Patients in New York who rely on opioids to manage chronic pain have been affected by the state's decision in July 2019 to enforce an excise tax on opioid prescriptions. “The goal of the tax is to penalize pharmaceutical companies for their role in the opioid epidemic and to generate funding for treatment programs.” Unfortunately, this tactic fails to address the root of the problem and worse, to avoid paying the tax, many manufacturers and wholesalers have stopped selling opioids in New York State all together. And instead of the anticipated $100 million of tax revenue, tax revenue is reportedly less than $30 million.
Taxes on opiate medications is intended as part of an effort to curb the misuse of prescription opioids. But, instead of affecting manufacturers, the bulk of the burden is falling on patients who depend on prescription opioids to manage pain. And as can be the case, good intentions don’t always lead to good decisions, and often have unintended consequences and collateral damage in the form of patients losing access to essential medication.
According to UCSF School of Medicine: “when there is decreased supply, users often substitute drugs with which they may be less familiar. They also can change habits, making dosing less reliable. Overdoses go up, paradoxically, as supply goes down.”
A study by the Academy of Orthopedic Surgeons shows, “states, where cannabis is legal are associated with significant reductions in opioid prescribing in the Medicare Part D population. This finding was particularly strong in states that permit dispensaries, and for reductions in hydrocodone and morphine prescriptions.”
While it is essential to reduce the misuse of opioid medications it is also important to ensure that patients have access to medicines that will manage their pain and support a good quality of life.
On Monday, during his State of the State address, New York Governor Andrew Cuomo re-emphasized marijuana legalization as a priority for this year’s legislative session. The National Academy of Sciences found cannabinoids an effective treatment for chronic pain in adults (NAS Report 2017). With attention paid to the impact cannabis-based medicines can have on pain management and opioid use, marijuana legalization is a much better plan than an opioid tax.