By Printus LeBlanc

The US is in the midst of a drug overdose epidemic, the principle killer drugs being opioid-based prescription drugs and heroin. The problem is so bad even, the liberal New York Times admits that drugs are killing more people than guns:, “Drug overdoses are now the leading cause of death among Americans under 50.” Not guns, not car accidents, but drug overdoses. How did we get here? What happened?

Has anyone in Congress heard of third order analysis/effects? During the consideration of Obamacare, both Congress, and the previous administration, clearly failed to conduct an analysis of possible effects. The intelligence community calls this third order analysis, or third order effects. No one did an analysis of what happens if millions of people suddenly get instant access to opioids, with the passage of Obamacare. What happens after some of those people get addicted? I don’t remember hearing those questions during the runup to Obamacare.

Like it or not, Obamacare, looks to have had an impact on the current crisis – and a dire impact indeed. The following analysis using publicly available data comparing the average opioid overdose death rates of states that took Medicaid with states that did not take Medicaid, reveals some disturbing patterns emerging.

Figure 1 illustrates that opioid overdose death rates were both higher and rose more steeply in states that took Medicaid funding. This pattern is particularly evident in the years following the signing of the law in 2010.

Figure 1

Figure 2., which measures the difference between death rates in states that took Medicaid and those that did not- demonstrates an even more stunning development. For a decade, the difference between these two pairings was never higher than 1.6 opioid overdose deaths per 100,000 people. The difference reaches its lowest level of .73 in 2009, prior to the signing of the law. Following Obamacare’s enactment, the line begins a rapid ascent, rising to a difference of 3.96 in 2015. In that five-year period, which included the decision of several states to accept Medicaid expansion, the difference in opioid overdose death rates between the states accepting Medicaid and those that had not, increased by over 200 percent.

Figure 2

183,000 people in the last 16 years died due to opioid overdoses, as appalling as these numbers are, they do not tell the whole story.

Nearly 60 percent of those deaths occurred in the last four years as the epidemic accelerated post Medicaid expansion. To put that in perspective, if the rate continues to climb, it is expected over 400,000 people could lose their lives to the opioid epidemic, in the 16 years following the implementation of Obamacare. I don’t remember that being a selling point for the law.

The opioid epidemic has brought a lot of additional problems with it, aside from death. What happens to the children of those addicted to opioids?

Recent data has shown a substantial increase in children being taken from their parents for substance abuse problems. As Figure 3 illustrates, the number of children in the foster care system had been decreasing steadily the decade prior to Obamacare being signed into law.

Statistics available from Child Trends, a nonprofit research child development organization, show following the signing of the law, we see a decrease in the rate of decline. By 2012, there’s that magic year again, the trend reversed itself and for the first time in over a decade, the US had more children enter foster care than the year before.

Figure 3

There is no doubt as to why this is happening. The opioid epidemic. U.S. News and World Report blames the rise on the opioid crisis stating for the corresponding increase in the number of children in foster care, “data from the Adoption and Foster Care Analysis and Reporting System report shows that from 2009 to 2014, parental drug abuse as a reason for removal rose from 22.1 percent in 2009, to 29.7 percent in 2014 — the largest increase of any factor causing removal.”

While correlation does not necessarily imply causation, it is difficult to ignore a pattern. Yes, everything must be considered, such as state economies, but remember, according to the last administration and the media, the economy was doing great. So, it must be something else. As Congress overhauls Obamacare and addresses the opioid epidemic in this country, it should look at the data and come to its own conclusions. When it does, it is likely to discover the hidden trail of devastation left by this law, resulting in the tragic deaths of tens of thousands and the dissolution of families across the nation. Because ultimately it isn’t about charts and graphs, the opioid epidemic is about real lives being lost and the ravages those losses leave behind.


Obamacare increased the Medicaid roles/recipients dramatically.  “Free opiates for all” seemed to be the net result.  Some patients had a legitimate need.  Many other patients found ways to supplement their income (illegally).  Addicts were flooded with inexpensive, easily obtained opiates.  Many non-addicts became dependent to higher doses due to tolerance.  Now physician’s are being threatened by medical boards that want to remove licenses from “over-prescribers”.  Meanwhile, folks who are dependent on opiates need to get their fix or go through withdrawal–they WILL get their opiates–somewhere!!

Dr. Raymond Oenbrink
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