Medicaid expansion could help address Oklahoma’s surging meth crisis

Jensen Armstrong was an Open Justice Oklahoma intern in Summer 2019. She’s currently working as a graduate assistant and completing her master’s in Strategic Communication at the University of Oklahoma.

As the state works to lessen the impact of the opioid crisis through the work of the Commission on Opioid Abuse, people struggling with opioid addiction are making the switch to the cheaper, more potent effects of methamphetamine. In 2017, methamphetamine (also known as speed or ice) was one of the main contributors to Oklahoma’s overdose deaths. It’s difficult to recover from methamphetamine addiction — most individuals relapse within their first year of treatment.

Public efforts to treat addiction at both the state and federal levels aren’t well-funded enough to support comprehensive treatment programs, and private substance abuse treatment plans are often too expensive for those affected by addiction. Medicaid expansion would allow the state to serve lower-income populations that are affected by meth use by making addiction treatment available to a greater portion of the state.

The meth crisis is costing Oklahoma communities

Meth has been labelled Oklahoma’s “No. 1 killer” by police, its body count surpassing opioids’. Methamphetamine-related overdose deaths in Oklahoma increased by 136 percent between 2012 and 2017. The number of meth-related admissions to alcohol- and drug-certified treatment providers in Oklahoma doubled between 2012 and 2018, making meth a factor in half of all substance abuse admissions. Because meth is funneled into the U.S. across the southern border, the nation’s meth crisis is hitting Oklahoma hard. The stimulant’s low cost makes it more accessible to rural, low-income communities, and its addictive nature makes it very difficult to quit. Extreme economic stress often contributes to experimentation with the stimulant, especially in rural or urban blue-collar communities where working multiple physically taxing jobs to make ends meet is the norm.

Addiction can also have harsh consequences in Oklahoma’s justice system: One-third of all incarcerated Oklahomans were in prison for drug-related offenses in 2018, but a scarce 10 percent of people experiencing incarceration (about 2,300 out of 28,000) were treated for substance use disorders in 2015. Treating addiction as an issue of public health rather than a one of criminality could limit the number of people in prisons and jails for drug-related offenses. Medicaid expansion would have a two-pronged impact on the criminal justice system: first, by helping people exiting prisons and jails seek treatment so they don’t reenter the criminal justice system; and second, by providing treatment options that help people avoid a scrape with the law in the first place. Investment in holistic, wraparound care can go a long way toward cutting costs on the backend. Rehabilitation through community programs is estimated to cost $5,000 per beneficiary each year compared to the $19,000 required to keep a person imprisoned, which saves taxpayers money.

Medicaid expansion would allow more people to seek treatment for addiction 

Using federal funds to expand Medicaid coverage is the best option we have to fight Oklahoma’s meth problem. The loss of life to drug overdoses incurred by failing to expand health coverage has been staggering: A study conducted between 2009 and 2015 found that the lives of roughly 2,300 to 5,500 people struggling with substance use disorders in the U.S. may have been saved by the treatment afforded to them by the expansion of Medicaid eligibility. 

Many Oklahomans with a high risk of drug-related hospitalization or overdose would be eligible for Medicaid if the state expanded coverage. States that rejected Medicaid expansion have been more likely to see hospital closures in rural areas due to financial bankruptcy. Six rural Oklahoma hospitals have shut down over the last nine years, devastating their local economies, and many more are at risk. Patients in areas far from hospitals have fewer opportunities for substance abuse treatment and face significantly longer wait times for the emergency services they would need in the case of an overdose. Accepting federal health care funding could make necessary treatment more accessible to these underfunded and uninsured communities.

Holistic, wraparound care is key

There are currently no effective chemical treatments for meth addiction or “rescue drugs” for meth overdoses like there are for opioid abuse. Patients in recovery from meth use must rely on cognitive behavioral therapies and multi-step programs, which are more likely to be successful when combined with wraparound care that provides support for the effects of trauma, unemployment, criminal justice involvement, and other issues that may contribute to substance abuse and addiction. 

The state ballot initiative for Medicaid expansion could help Oklahoma address the meth crisis

Expanding Medicaid would enable existing preventive services and educational initiatives that are overwhelmed, underfunded, and understaffed to better serve Oklahoma communities. Supporting individuals’ recovery when they’ve been abusing less addictive substances (i.e. gateway drugs) could protect them from developing an addiction to methamphetamine in the first place.

The 2020 Oklahoma Medicaid Expansion Initiative is an ongoing petition for a state constitutional amendment that would allow the state to accept federal health care funding. Our communities are suffering from the rippling effects of addiction; Oklahoma has the opportunity and the responsibility to enact life-saving change by expanding Medicaid.

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