Dr. Stephen Skoly: Opioid Tax Bill Would Harm Families and Businesses and Do Nothing to Address the Problem


The opioid epidemic is a widespread, complicated problem, and only a collective effort will begin to solve it. The healthcare community and lawmakers need to work in tandem to find policies that effectively lessen opioid abuse while still keeping our state’s economic health as well the health and safety of the patient in mind. It’s unfortunate, however, that Senate Bill S0798, the Opioid Stewardship Act, fails on both accounts.

This bill seeks to levy $7.5 million in annual taxes on the healthcare system for the distribution of prescription opioid medications to healthcare facilities throughout our state, including pharmacies, hospitals, and urgent care clinics. The motivation behind the legislation is clear; legislators seeking to disincentivize use by taxing the products that they believe have contributed to growing rates of addiction and overdose. However well-intentioned, this is a costly approach that misses the mark.

Prescription opioids serve a clinical and legitimate medical purpose. Postoperative analgesia, cancer, trauma, and chronic disease are just a few examples of the many medical conditions and procedures that require opioid- containing medications.

Just like all taxes imposed by lawmakers, there will be reactions as these added costs will somehow be passed onto patients in the healthcare system. Employers that provide health coverage could see insurance premiums rise, while families could experience higher prescription costs; all for an epidemic being fueled by illegal behavior that S0798 would not address.

Those suffering and without adequate insurance would be most impacted, and would be incentivized to seek more dangerous drugs on the underground market.

As a medical professional, I find it morally reprehensible that our lawmakers might inflict economic pain on patients who are suffering acute physical pain; especially at a time when Rhode Island has one of the worst economies in the entire country.

Examples of the real and unintended consequences of taxes on prescription opioids are showcased in New York. In fact, Rhode Island’s Opioid Stewardship Act is nearly identical to a bill recently passed in the Empire State. This New York bill was loudly opposed by patients, healthcare providers, the business community, and other lawmakers, who expressed ire that the bill’s hefty and punitive tax would lead to increased costs or restricted access to care.

I find it confounding that Rhode Island lawmakers would draw inspiration from another state’s misguided legislation. Reacting to a crisis in haste, just to claim you did something, is itself misguided. This legislation represents another example of “not letting a crisis go to waste.”

There is no debate that a robust response to the opioid epidemic is necessary. But when developing policy, Rhode Island legislators need to acknowledge the importance of protecting the affordability and accessibility of necessary medications for our state’s patients and their families. The Opioid Stewardship Act fails to make these considerations. Rhode Island legislators need to understand that opioid prescribing protocol are evolving based on evidence based medicine and recommendation from The American College of Surgeons. Recommend best practices for prescribing opioids in Rhode Island includes accessing the Rhode Island Drug Prescription Monitoring Program (PDMP). Finally, it is important to recognize that addiction is neither a moral failing nor a character flaw. Rather, it is a chronic disease much like heart disease. Even our legislators should be morally offended by supporting a misguided tax on a chronic disease to balance their budget.

Rather than relying on added taxes, our lawmakers should promote more sensible solutions such as supporting efforts by our law enforcement agencies to purge our state of illegal drugs and by encouraging continued education of patients about the potential risks surrounding prescription opioid medications.

This tax would do nothing to address the core problems of inappropriate use and illegal distribution of opioids.

Dr. Stephen Skoly is a practicing oral & maxillofacial surgeon and Chairman of the Rhode Island Center for Freedom and Prosperity. The above is his written testimony to the RI Senate Finance Committee about S0798, which was heard and “continued” last night.

  • Monique Chartier

    Sheesh. One tries to be tactful. But the idea of an opioid tax to address the opioid addiction crisis is just insane. To begin with, it’s not at all clear that the opioid user would end up being the one to pay the tax. And if s/he is, IT WILL NOT BE A DETERRENT IN ANY WAY. They will simply pay this additional small amount without thinking or any impact on behavior.

  • Rhett Hardwick

    Never let a crisis go to waste. When the opioid crisis abates, which it surely will, will the tax go away?

    Never let a crisis go to waste! When our blue blood ancestors engaged in the “China Trade”, it was a “triangle trade”. The Euro/American vessels would go first to India and load up with opium. Thence to China where it was traded for silk, tea, china, etc. China developed an “Opioid Crisis”, the Chinese attempted to end the trade by military means. The Euro/Americans won that one. As a result we claimed the ports of Hong Kong, Shanghai, etc. Great, huh?

  • ShannonEntropy

    ITA with Monique

    An opioid tax will be as effective in reducing the opioid epidemic as NY’s Big Gulp® tax was in eliminating sugary drinks

  • Joe Smith

    legislators seeking to disincentivize use by taxing the products that they believe have contributed to growing rates of addiction and overdose.

    That’s why governments tax inelastic goods; if they wanted to eliminate use, they would tax elastic goods (see the misguided yacht tax of 1990..); even the taxes on “guns” or “ammo” is about raising revenue, not reducing the amount of the product(s) in any significant way.

    I only believe the government is interested in eliminating consumption through a tax when they estimate the tax revenue generation to be, well, zero…otherwise, it’s merely about taking more consumer surplus from a “disfavored” group to generally use in support of a “favored” group..