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Unbudgeted: How the Opioid Crisis Is Blowing a Hole in Small-Town America’s Finances

Paula Seligson & Tim Reid  |  September 20, 2017

INDIANA, Pa./CHILLICOTHE, Ohio (Reuters)—As deaths mount in America’s opioid crisis, communities on the front lines face a hidden toll: the financial cost.

Ross County, a largely rural region of 77,000 people an hour south of Columbus, Ohio, is wrestling with an explosion in opioid-related deaths—44 last year compared with 19 in 2009. The drug addiction epidemic is shattering not just lives but also stressing the county budget.

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About 75% of the 200 children placed into state care in the county have parents with opioid addictions, up from about 40% five years ago, local officials say. Their care is more expensive because they need specialist counseling, longer stays and therapy.

That has caused a near doubling in the county’s child services budget to almost $2.4 million from $1.3 million, says Doug Corcoran, a county commissioner.

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For a county with a general fund of just $23 million, that is a big financial burden, Corcoran says. He and his colleagues are now exploring what they might cut to pay for the growing costs of the epidemic, such as youth programs and economic development schemes.

“There’s very little discretionary spending in our budget to cut. It’s really tough,” Corcoran says.

Cities, towns and counties across the United States are struggling to deal with the financial costs of a drug addiction epidemic that killed 33,000 people in 2015 alone, data and interviews with more than two dozen local officials and county budget professionals shows. (See graphics on the opioid crisis.1)

The interviews and data provide one of the first glimpses into the financial impact on local governments, but it is far from complete because there is no central database collating information from counties and states. So, the true scale is still mostly hidden from view.

Opioids, primarily prescription painkillers, heroin and fentanyl—a drug 50–100 times more powerful than morphine—are fueling the drug overdoses.

President Donald Trump last month called the epidemic a “national emergency” but has not yet made an official national emergency declaration. Such a move would give states access to federal funds to fight it.

Building a Picture
Counties grappling with rising overdoses face higher costs in emergency call volumes, medical examiner and coroner bills, and overcrowded jails and courtrooms, says Matt Chase, executive director of the National Association of Counties, which represents 3,069 county and local governments.

At his group’s July annual meeting, a presentation where county officials shared tips on tackling the opioid crisis, and the budget problems the crisis is triggering, played to a packed room, Chase says.

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