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The Journal Gazette

  • Fiddian-Green

Friday, November 09, 2018 1:00 am

Twin scourges of tobacco, opioids demand concentrated action

Claire Fiddian-Green

Claire Fiddian-Green is president and CEO of the Richard M. Fairbanks Foundation, which seeks to advance the vitality of Indianapolis and the well-being of its people.

Last year, Indiana's tobacco and opioid epidemics killed 14,200 people – more than the number of deaths caused by Hurricane Katrina, 9/11 and all motor vehicle accidents in Indiana over the past decade combined.

The horrifying magnitude of these epidemics shows that we are not doing nearly enough to end these crises.

A pair of reports released recently by the Richard M. Fairbanks Foundation underscores the impact of both health challenges – on lives, businesses, taxpayers and communities. From the tripling of children in foster care after  opioid misuse by their parents, to the $1,125 annual tax burden every Hoosier household pays to cover tobacco-related health care costs, these epidemics affect everyone. All of us must act with urgency and be part of the effort to stop them.

There has been meaningful action by policymakers, health care leaders, civic leaders and others to confront both epidemics, particularly the opioid crisis. But the ever-changing nature of opioid misuse and the entrenched tobacco problem mean there is still tremendous unfinished business.

More than 1,700 Hoosiers died from drug overdoses in 2017 – an all-time high and a 75 percent increase since 2011. The vast majority were linked to opioid misuse. This was driven in part by a trend seen across states: a rapid rise in the synthetic opioid fentanyl. Allen County ranks third highest of Indiana's 92 counties in drug-overdose deaths, with 88 in 2017.

While the opioid epidemic has grown worse, tobacco use is an even more deadly and persistent health challenge, causing seven times as many deaths in Indiana as opioids last year.

Between smoking and secondhand smoke, 12,500 Hoosiers die from tobacco use each year – the equivalent of more than two dozen Boeing 747s crashing with no survivors. One in five Hoosiers smokes, and each year 3,700 Indiana children become new daily smokers. There has also been an alarming rise in the number of youth using e-cigarettes.

These epidemics carry a severe financial toll. Tobacco use costs Indiana $8.3 billion every year in direct health care costs and productivity losses. The opioid epidemic was responsible for an estimated $4.3 billion in economic damages to Indiana in 2017, including $1 billion for social service costs in areas such as criminal justice and foster care. Imagine the ways we could improve Indiana's infrastructure, and strengthen our education and workforce development systems, if we could stop pouring money into paying for the consequences of tobacco and opioid addiction.

The good news is that there are clear, actionable solutions.

A proven policy approach – and the No. 1 way to deter tobacco use – is raising the price of tobacco. Data show that a $2 increase in Indiana's cigarette tax would prevent an estimated 58,100 Hoosier youths from becoming adult smokers, encourage 70,100 adults to quit smoking and prevent 36,300 future smoking-caused deaths based on the state's current population.

Health systems are at the center of addiction treatment and prevention. One of the ways they can drive change is by increasing access to medication-assisted treatment, the gold standard for treating opioid abuse.

Employers can take meaningful steps, such as offering comprehensive health plans that provide coverage for opioid use disorder and smoking cessation.

K-12 schools have a prime opportunity to help combat these crises before they start by implementing evidence-based substance use prevention programs.

Colleges and universities can adopt programs that address opioid misuse among students and implement strictly enforced nicotine-free policies.

Given the scope of the opioid and tobacco epidemics, none of these steps in isolation is sufficient. But working together, we can make critical strides to reverse the patterns of addiction that take a toll on lives, communities and our economic well-being.

Progress requires leadership and action from all of us, and we must act with urgency. Some 14,200 lives, and counting, depend on it.