Kentucky Considers Opioid Tax That Raises Legal, Moral Questions

By Kelly Burch 03/07/18

One opponent of the tax proposal believes it could increase the stigma that people who need opioids to cope with pain already deal with. 

 woman looking up at many question marks

The state of Kentucky is considering implementing a 25-cent tax on each dose of prescription opioids filled in the state, a first-in-the-nation move that some say would decrease the amount of opioids in the state, and others call downright immoral. 

“We hope that pain pills will quit being dumped into this state at the level that they are,” state Rep. Steven Rudy, a Republican who leads the House’s budget committee, said, according to STAT News.

The tax proposal is part of Kentucky’s budget plan, which also includes an increased tax on cigarettes. It was approved by the House last week, but has not yet been considered in the Senate. The tax revenue would be used to cover shortages in other ideas of the budget including education, rather than being directed toward addiction treatment and prevention efforts like some people might expect. 

Rep. James Kay told The Washington Post that it’s only fair that the state gets a portion of the money made off opioids. “These pills are profiting the big pharmaceutical drug companies billions and billions and billions of dollars a year. You know how much our state budget gets? Zero,” he said. 

The tax would generate an estimated $70 million annually, and some healthcare professionals believe it might cut down on prescribing. Lawmakers intend for the tax to be borne by the pharmaceutical companies, and the legislation gives the state attorney general the right to prosecute companies that pass on the cost to consumers. 

However, Nick McGee, spokesman for the Pharmaceutical Research and Manufacturers of America, said that the tax raises legal concerns. “Taxing prescribed medicines that people legitimately rely on to raise revenue for a budget shortfall is a pretty problematic precedent,” he said.

It’s not clear how taxing manufacturers might impact opioid prescribing and use, but Dr. Andrew Kolodny, director of opioid policy research at Brandeis University, said that it might work. “I think it could help reduce aggressive prescribing,” he said. “Right now it is too cheap and easy to give a patient a narcotic when they have a pain problem.”

However, Dr. James Patrick Murphy, former president of the Greater Louisville Medical Society, told the Louisville Courier Journal that the tax would be immoral. "If it was cancer patients, or heart medicine, they would never do it," Murphy said. "It's so offensive.”

He added that the tax could increase stigma that people who need opioids to cope with pain already deal with. "They already feel they're being made the scapegoats of this problem," he said. 

At least thirteen other states are considering taxing prescription opioids. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.