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States Looking To Tax Opioids Pin Hopes On November Elections

https://khn.org/news/states-looking-to-tax-opioids-pin-hopes-on-november-elections/

After almost slapping a tax on makers of opioid pills earlier this year, Minnesota lawmakers are set to try again when they meet in January.

The drug manufacturers that helped create the opioid addiction crisis should help fix it, said state Sen. Chris Eaton, whose daughter died of an overdose.

“I’m definitely going to pursue it” in the next legislative session, said Eaton, a Democrat. “Whether it has a chance or not kind of depends on the election.”

Lawmakers in at least 10 other states intend to consider opioid taxes in upcoming legislative sessions. Many pin their hopes on the November midterm elections.

If Democrats retake governorships and legislatures this fall, lawmakers and policy analysts predict other states would be more likely to follow New York, whose groundbreaking opioid tax to raise $100 million a year took effect July 1.

November results “are absolutely going to drive some of this,” said Tara Ryan, vice president of state government affairs for the Association for Accessible Medicines, which represents makers of generic medications and opposes opioid taxes. “If the Democrats take the elections, like some people say they will, it could definitely change the votes.”

California, Delaware, Iowa, Kentucky, Maine, Massachusetts, Montana, New Jersey, Tennessee and Vermont are all eyeing renewed attempts to pass opioid taxes, officials in those states say. The proceeds would mostly pay for addiction treatment and prevention.

“We’ll be back come January,” said Tim Ashe, president pro tempore of the Vermont Senate, which overwhelmingly passed a tax measure this year that faded in the House and was opposed by the state’s Republican governor, Phil Scott, who is up for re-election.

New York’s law taxes manufacturers and distributors according to an opioid medication’s strength and will direct proceeds toward addiction treatment, prevention and education. The tax is expected to amount to roughly a dime per lower-strength opioid pill and higher for more powerful ones.

“I think it’s a good idea,” said Andrew Kolodny, an opioid-policy researcher at Brandeis University and frequent critic of the pharma industry. “The human and economic costs of these meds are enormous.”

Adding to the momentum is frequent support from Republicans, who are normally reluctant to tax businesses.

“I’m probably the No. 2 or 3 most conservative individual in the legislature, and I’m standing up there proposing a[n opioid] sales tax,” said Montana Republican Sen. Roger Webb.

But an industry backlash is growing. An association representing pharmaceutical distributors sued in July to block the New York law, arguing that those businesses were unfairly targeted.

Pharma’s main trade group has also fought hard against such measures, arguing they drive up the cost of medicine and unfairly penalize patients with chronic pain.

“We do not believe levying a tax on prescribed medicines that meet legitimate medical needs is an appropriate funding mechanism for a state’s budget,” said Priscilla VanderVeer, spokeswoman for the Pharmaceutical Research and Manufacturers of America, or PhRMA.

New York’s law prohibits passing the tax on to consumers and other purchasers such as insurance companies, but enforcing that could be tricky, according to legal experts.

The Association for Accessible Medicines opposes all opioid taxes but especially objects to that measure because it taxes drugs per pill rather than according to revenue. That puts most of the burden on makers of cheap generics and largely spares brand-name sellers, whose marketing helped fuel the addiction crisis, Ryan said.

Drugmakers will prove to be tough opponents regardless of electoral outcomes, said Regina LaBelle, a visiting fellow at Duke-Margolis Center for Health Policy who worked on drug strategy in the Obama White House.

“These types of taxes face an uphill battle in state legislatures as powerful forces, including industry and industry-funded groups, ally against them,” she said. Pharma-funded chronic-pain patients can be a powerful lobby, she said.

Surging mortality rates caused by fentanyl, heroin and other illegal opioids give pharma companies a chance to deny blame, even if many of those victims became addicted through prescription pills, LaBelle said.

Drug overdoses killed more than 70,000 people last year, a record, according to new, preliminary estimates from the Centers for Disease Control and Prevention.

Dozens of cities, counties and states have sued opioid makers and distributors, arguing the companies downplayed the dangers of addictive pills and ignored signs they were being abused on a massive scale. Often compared to litigation against tobacco companies in the 1990s, the cases could produce billions of dollars in government revenue to fight addiction and overdose.

But that could take years. Through opioid taxes and related measures, states could quickly supplement addiction-prevention funds made available by Washington, which many consider inadequate and unpredictable.

Members of Congress have pushed more opioid legislation this summer, but the House’s package so far has no clear path to becoming law.

Federal funding “is a drop in the bucket,” said Patrick Diegnan, a Democratic New Jersey state senator who backed an opioid tax this year. “We really basically have to put in place the infrastructure for treatment. It will cost a lot of money.”

Minnesota’s proposed opioid tax had bipartisan support this year, passing the state Senate by a huge margin. But under heavy pressure from drug companies, a measure in the Republican-controlled house failed at the end of the legislative session in May.

In the governor’s race this fall, Tim Walz, a Democratic congressman, faces Jeff Johnson, a county commissioner who upset former Gov. Tim Pawlenty in the Republican primary.

Minnesota recently got Washington’s permission to bill Medicaid, the state and federal program designed for low-income people, for psychiatric hospital stays for those with intense addiction-treatment needs.

But none of the moves so far will furnish resources adequate to relieve the crisis, argue patient advocates. Many see an element of justice in making opioid companies contribute.

“Why is it important for the drug industry to pay reparations?” said Lexi Reed Holtum, executive director of the Steve Rummler Hope Network, a Minnesota advocacy group named for her fiancé, who died of an overdose in 2011. “No matter what, this is going to go on for decades to come.”

KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Why doesn’t the DEA use all the money they confiscate from “bad guys” to help fund the treatment of those who are substance abusers ?

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Pain Warriors ~ the Movie – needs your financial support

Tina called me today and she has an anonymous donor who has offer to MATCH any donations to help the fund raiser to get to $12,000… If the fund raiser doesn’t get to $12,000 within SIX DAYS… the fund raiser will CLOSE and all donations will be refunded and this fund raiser will have FAILED… Because they failed to raise just $2800 more.

Tina has FIVE YEARS of work – without pay – dedicated to making this film a reality.  Not to mention that more than $100,000 that has already been expended to date in creating this film/project.

For those paying attention…  It is plain that few outside of the chronic pain community are fighting for all the abuse that the community is experiencing.  The drug manufactures, doctors, pharmacies/pharmacists are – at best – standing on the sidelines with their hands folded.

We have Insurance companies, PBM’s, healthcare corporation and others who are deciding what treatment that pts can or can’t have. Some are developing a “cookie cutter” plans of treatment that are applied to everyone … regardless of what could be the most appropriate therapy for a particular pt.

A few investigative reporters have done multiple segments on various TV stations regarding the plight of the chronic pain community, but it as if they were produced and broadcasted into a VACUUM…  One broadcast seldom seems to “seed” the interest of another investigative reporter in a different market place to do their own story.

It would seem that the chronic pain community has been left to FEND FOR THEMSELVES and to TELL THEIR OWN STORY. The completion of this film is just the first step in that journey… and unless another $2800 is raised by 09/18/2018 all the efforts to date could end up in FAILURE.

As one old saying goes … “… it is time to FISH or CUT BAIT …”

click here to make donation

  https://www.seedandspark.com/fund/pain-warriors-the-movie#story

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If you think the big retail pharmacy chains and hospital corporations are concerned about your safety, think again. Today’s pharmacists are struggling to keep patients safe while meeting the ever escalating demands of their employers. In her book “Your Pharmacist is a Whore, How pharmacists lost control of their profession and why you should care”, Kim Ankenbruck, a 34 year pharmacy veteran, points out the danger you face every time you get a prescription or medication order filled. While pharmacists are incredibly detail oriented and excellent multitaskers by nature, the current workplace is chaotic and stressful due to the increased demands of upper management, coupled with staff cuts and the promotion of non pharmacist personnel over the pharmacists. At the end of the book, Kim provides contact information and sample letters you can send to both government agencies and the CEO’s of the various chain pharmacies. The letters bring up many of the issues experienced by patients, as well as holding the powers that be accountable for their part in these shortcomings and demanding that they clean up their act. This book is a call to action for pharmacists and patients to stand up and push for positive change in the healthcare system, as well as an informative behind the scenes look at the profession and business of pharmacy.

https://www.amazon.com/dp/1726324648/ref=cm_sw_r_fa_awdo_t1_KgeMBbFC6YM90

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I sent yours, can you forward mine? Please read 28th amendment Please Read, and forward. This will only take 1 minute to read! 28th Amendment, 35 States and Counting. It will take you less than a minute to read this. If you agree, please pass it on. It’s an idea whose time has come to deal with this self-serving situation: OUR PRESENT SITUATION ! Children of Congress members do not have to pay back their college student loans. Staffers of Congress family members are also exempt from having to pay back student loans. Members of Congress can retire at full pay after only one term. Members of Congress have exempted themselves from many of the laws they have passed, under which ordinary citizens must live. For example, they are exempt from any fear of prosecution for sexual harassment. And as the latest example, they have exempted themselves from Healthcare Reform, in all of its aspects. We must not tolerate an elite class of such people, elected as public servants and then putting themselves above the law. I truly don’t care if they are Democrat, Republican, Independent, or whatever. The self-serving must stop. Governors of 35 states have filed suit against the Federal Government for imposing unlawful burdens upon their states.It only takes 38 (of the 50) States to convene a Constitutional Convention. IF??? Each person that receives this will forward it on to 20 people, in three days most people in The United States of America will have the message. Proposed 28th Amendment to the United States Constitution: “Congress shall make no law that applies to the citizens of the United States that does not apply equally to the Senators and/or Representatives; and, Congress shall make no law that applies to the Senators and/or Representatives that does not apply equally to the Citizens of the United States …” You are one of my 20.

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On Wednesday, Dr. Oz had a show on the fastest growing cancer in women, thyroid cancer. It was a very interesting program and he mentioned that the increase could possibly be related to the use of dental x-rays and mammograms. He demonstrated that on the apron the dentist puts on you for your dental x-rays there is a little flap that can be lifted up and wrapped around your neck. Many dentists don’t bother to use it. Also, there is something called a “thyroid guard” for use during mammograms. By coincidence, I had my yearly mammogram yesterday. I felt a little silly, but I asked about the guard and sure enough, the technician had one in a drawer. I asked why it wasn’t routinely used. Answer: “I don’t know. You have to ask for it.” Well, if I hadn’t seen the show, how would I have known to ask? We need to pass this on to our daughters, nieces, mothers and all our female friends and husbands tell your wives !! I just did, now you send it on to your list. Someone was nice enough to forward this to me. I hope you pass this on to your friends and family.

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I first made this post one week ago. I have been following and communicating with Tina since close to her beginning of her journey in making this documentary.  Since I made this post, a total of 21 – TWENTY ONE – more people have come forth with a donation – for a GRAND TOTAL OF SEVENTY NINE DONATIONS, but the fund is still only at 57% of goal and if  80% EIGHTY PERCENT of goal is NOT REACH IN THE NEXT WEEK… the fund raiser will close and ALL THE MONEY RAISED will be RETURNED TO THOSE WHO HAVE DONATED and basically the effort to fund Tina’s chronic pain documentary WILL POSSIBLY IMPLODE.  Possibly along with Tina’ s advocacy for the chronic pain community, because a very small fraction of 1% of the 10 million chronic painers who could afford to contribute $10 ONE TIME … DID NOT BOTHER !!! There is a saying in “medicine” passive pts can experience POOR OUTCOMES… The same could apply to those pts who fail to advocate for themselves…  expecting other to advocate for them… but sooner or later… those advocates will stop advocating on the behalf of others who fail to advocate for themselves and those suffering/dealing from chronic pain will find themselves ALL ALONE, ABANDONED and those who are against anyone being prescribed opiates  WILL WIN !!! Guess who the LOSERS WILL BE ?

They claim that 90% of those family with a chronically ill person are struggling financially.  Tina has been working on this film on chronic pain for nearly FIVE YEARS and financing to date has been by a “generous angel”. She started a fund raiser https://www.seedandspark.com/fund/pain-warriors-the-movie#story to raise the final $15,000 needed to complete the editing and final production.

She herself is a disabled chronic pain pt and the fund raiser is limited to 30 days – which HALF has already passed and has only 58 people who have donated money and has raised only 37% of her goal.

There is claimed to be 100 million chronic pain pts and that means that 10% – TEN MILLION – should be financially able to donate something. After the next 15 days and 80% of the goal is not reached the fund raising program will automatically close and all the money currently donated will be refunded back to those who donated  and put Tina’s FIVE YEARS of work  at risk of possibly going down the drain.

She needs 0.001% out of those TEN MILLION people/families to EACH DONATED at least $10 to meet her goal.

This chronic pain pt has DONATED FIVE YEARS of her life to create this movie to benefit the chronic pain community and ONLY FIFTY EIGHT people/families have stepped up to support her effort.

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A Tribute to Rev. Ronald (Doc) Myers, Sr, MD

www.doctorsofcourage.org/a-tribute-to-rev-ronald-doc-myers-sr-md/+

Doc Myers’ personal fight ended September 7, 2018 as he left this earth and joined his heavenly Father in heaven. This is a brief tribute to his efforts in support of Chronic Pain Patients across the country.

The New York Times says, “There aren’t many doctors like Ronald Myers, a jazz-playing, Baptist-preaching family practitioner whose dream has always been to practice medicine in the kind of place most other doctors wouldn’t even stop for a tank of gas.” (1/12/90)

A 1985 graduate of the University of Wisconsin Medical School and residency in Family Practice at L.S.U. Medical Center, Doc Myers was a leading national advocate for health care to the poor and disenfranchised. In 1990 he became the first ordained and commissioned medical missionary to serve in America’s poorest region, the Mississippi Delta, in the history of the African American church. Dr. Myers provided health care to the poorest Americans through clinics in Tchula, Belzoni, Yazoo City, Indianola, Greenville and Tupelo, Mississippi. He went on missions outreach to Kenya and Israel.

As an activist for patient rights, Dr. Myers was the Founder & President of:

1. The National Juneteenth Observance Foundation (NJOF)
2. The National Juneteenth Christian Leadership Council (NJCLC)
3. The National Juneteenth Medical Commission
4. The American Pain Institute (API)

He was also:

1. Founder of the National Day of Reconciliation and Healing From the Legacy of Enslavement, observed on the “18th of June”
2. Founder of the World Day of Reconciliation and Healing from the Legacy of Enslavement, observed on the “20th of August”.
3. Organizer of the annual PAIN PATIENTS ADVOCACY WEEK
4. Board Member of the National Black Evangelical Association (NBEA)
5. Founder of Black Doctors Matter.
6. Artistic Director of the Mississippi Jazz and Heritage Festival
7. Creator of the National Association of Juneteenth Jazz Presenters (NAJJP)
8. Founder and Director of the Fellowship of Creative Christian Jazz Musicians (FCCJM).

Rev. Ronald V. Myers, Sr., MD was a family practitioner in Mississippi. He lost his license because of attacks on him by the state of Oklahoma. The charges were dropped, but his license was never restored to active status because of fines levied on him by the Board of Medicine for the unfounded investigation they led against him. In other words, “Pay us for attacking you without just cause.”

Dr. Myers’ family includes his wife, Sylvia, 5 children, 11 grandchildren and 2 great grandchildren.

Doc Myers led his last Pain Patient Advocacy Week in Washington, DC on April 23-30, 2018. He wasn’t feeling up to par when he came to Washington, but he used all the energy he had to lead the movement.  Possibly because of that self-sacrifice, he did not have the reserves when he returned home, and his health deteriorated over the next few months.  He is truly a martyr to the cause, and Chronic Pain Patients should lift him up forever for the support he gave.

You can listen to his interview from Pain Patient Advocacy Week in 2017 HERE:

If you would like to leave a tribute to Doc, please leave a comment below.  Eventually this segment will be moved to Doc’s own page as an ambassador on the membership site.

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America has an opioid crisis. Forty-nine states have authorized a PDMP (Prescription Drug Management Program) in order to get a handle on and control the predicament and Missouri is the lone holdout state. Does the Missouri legislature not care about people who are dying as a result of opioid abuse? Should not physicians and pharmacists be closely watched (in order to reduce the amount of drugs prescribed and dispensed)?

The truth is: America does, indeed, have an opioid problem, however, a PDMP has not been effective in controlling the abuse of prescription drugs in 49 states and a PDMP will not reduce the deaths related to the drugs. The reason: prescription drugs are not the problem.

According to the CDC (Center for Disease Control) in Atlanta, GA, deaths due to the abuse of fentanyl has skyrocketed. Fentanyl, a synthetic opioid, is the culprit for an inordinate number of deaths in recent years, however, fentanyl prescribed by physicians has not been, and is not, the problem.

Illicit (illegal) fentanyl is being produced in makeshift laboratories (predominately in China and Mexico). These producers are concerned only with quantity, not quality (and, of course, the “almighty” dollar). As with the production of the illegal, fake marijuana, K2, illegal fentanyl can have wide variations (as much as 50 % greater concentrations in the same batch) in the potency and its ingestion can have (and has had) fatal results.

Key points:

Illegal opioids is the culprit in the many unnecessary deaths in Missouri and across these United States!
Enacting a PDMP, whether a full-fledged one like the other 49 states have or the well-meaning, but “half-cocked” Executive Order (EO) 17-18 issued by former Governor Greitens has not and will not decrease the deaths caused by illegal drugs!
Illicit fentanyl is an illegal drug!

So, what harm has the PDMP EO 17-18 done? Plenty!

Over 8,000 letters were mailed to Missouri physicians and pharmacists demanding them to curtail the prescription of, and dispensing of, opioids. (Remember, according to the CDC, the rise in deaths due to opioids is not/was not due to the over prescribed drugs!) The result of these letters (this attempt to take away the physician’s ability to treat their patient(s) in a manner deemed best by the doctor) has all but emasculated the physicians receiving the letters. Doctors are afraid of potential discipline meted out, by the state, against them.

The Greitens EO may have been fueled by decisions made by the CDC. In a paper entitled “Prescription Opioids and Chronic Pain” written by Richard A. Lawhern, Ph.D., supports this supposition. Here’s a portion of Lawhern’s writing:

“In March 2016, the Centers for Disease Control released updated guidelines for prescription of opioids in adult, non-cancer chronic pain. Outcomes of these guidelines have been horrific for millions of patients. The CDC guidelines recommended that general practitioners should perform an analysis of risks and benefits before prescribing more than 90 Morphine Milligram Equivalent Daily Dose (MMEDD). Although originally phrased as voluntary, the Guidelines became a statutory requirement on the Department of Veterans Affairs, three months before CDC published its final guideline (emphasis added). Non-VA Hospitals and doctors across America quickly interpreted the Guidelines on safety review as a mandatory maximum dose standard.” (emphasis added)

“Fearing sanctions by the US Drug Enforcement Agency or State authorities if they prescribe opioids to people who need them, doctors are leaving pain management practice in droves. Availability of pain management specialists is dropping in most areas of the US and Canada. Pharmacies are limiting inventories of opioid medications, and challenging doctors’ prescriptions on grounds of corporate policy. Patients with legitimate prescriptions are being turned away.”

“Medical evidence underlying the CDC Guidelines is extremely weak, absent or biased.”

For those of us who may not be reliant upon medicines for pain management, the thought of a PDMP or attempts by the state to control how physicians treat their patients may not mean much. For chronic pain sufferers, however, the inability to obtain the proper medication used to keep in check the pain and suffering caused by long-term ailments can be devastating. And, believe it or not, thanks to the Greitens EO 17-18, chronic pain sufferers are now being targeted for treatment tapering (the decrease of vital medication used to allow them to live a normal life).

Fortunately, many of those identified as “chronic pain sufferers” continue to work. Unfortunately for them, due to the continued enactment of the Greitens EO 17-18, the eventual elimination of the pain-controlling drugs may force them to stop working.

Do we realize that allowing the state to “play doctor” will actually cost taxpayers more money? (When chronic pain sufferers drop out of the workforce due to their inability to control pain, they will be added to the state’s welfare rolls – and we will be required to provide sustenance for them. Forcing anyone to endure pain unnecessarily is inhumane! Creating an atmosphere that purposely compels people to give up their ability to provide for themselves and their families with the only alternative being welfare is the total antithesis to our constitutional republic!

We can do better than this! We must do better than this!

Meetings with Governor Parson has not yet produced any action to rescind Governor Greitens EO 17-18. I believe Governor Parson wants to do the right thing. Perhaps, he will listen to the voices of hundreds, if not thousands of Missourians.

Will you, please take time to contact Governor Parson to request a full rescinding of Executive Order 17-18? Please urge him to restore the physician’s ability to treat their patients in a manner that’s best for the patient. In addition, encourage Governor Parson to focus on (and fund) controlling illegal drugs (wherein the real problem lies).

Governor Parson’s contact information:
Phone: 573-751-3222
E-mail: mo.gov/contact-us
Snail mail: Room 216
201 West Capitol Avenue
Jefferson City, 65101

Please, make the call!

For additional information, please follow this link: http://www.jpands.org/vol23no1/lilly.pdf

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Opioid Tax Proponents Pin Hopes on November Elections

http://www.governing.com/topics/health-human-services/khn-opioid-tax-proponents-pin-hopes-on-november-elections.html

After almost slapping a tax on makers of opioid pills earlier this year, Minnesota lawmakers are set to try again when they meet in January.

The drug manufacturers that helped create the opioid addiction crisis should help fix it, said state Sen. Chris Eaton, whose daughter died of an overdose.

“I’m definitely going to pursue it” in the next legislative session, said Eaton, a Democrat. “Whether it has a chance or not kind of depends on the election.”

Lawmakers in at least 10 other states intend to consider opioid taxes in upcoming legislative sessions. Many pin their hopes on the November midterm elections.

If Democrats retake governorships and legislatures this fall, lawmakers and policy analysts predict other states would be more likely to follow New York, whose groundbreaking opioid tax to raise $100 million a year took effect July 1.

November results “are absolutely going to drive some of this,” said Tara Ryan, vice president of state government affairs for the Association for Accessible Medicines, which represents makers of generic medications and opposes opioid taxes. “If the Democrats take the elections, like some people say they will, it could definitely change the votes.”

California, Delaware, Iowa, Kentucky, Maine, Massachusetts, Montana, New Jersey, Tennessee and Vermont are all eyeing renewed attempts to pass opioid taxes, officials in those states say. The proceeds would mostly pay for addiction treatment and prevention.

“We’ll be back come January,” said Tim Ashe, president pro tempore of the Vermont Senate, which overwhelmingly passed a tax measure this year that faded in the House and was opposed by the state’s Republican governor, Phil Scott, who is up for re-election.

New York’s law taxes manufacturers and distributors according to an opioid medication’s strength and will direct proceeds toward addiction treatment, prevention and education. The tax is expected to amount to roughly a dime per lower-strength opioid pill and higher for more powerful ones.

“I think it’s a good idea,” said Andrew Kolodny, an opioid-policy researcher at Brandeis University and frequent critic of the pharma industry. “The human and economic costs of these meds are enormous.”

Adding to the momentum is frequent support from Republicans, who are normally reluctant to tax businesses.

“I’m probably the No. 2 or 3 most conservative individual in the legislature, and I’m standing up there proposing a[n opioid] sales tax,” said Montana Republican Sen. Roger Webb.

But an industry backlash is growing. An association representing pharmaceutical distributors sued in July to block the New York law, arguing that those businesses were unfairly targeted.

Pharma’s main trade group has also fought hard against such measures, arguing they drive up the cost of medicine and unfairly penalize patients with chronic pain.

“We do not believe levying a tax on prescribed medicines that meet legitimate medical needs is an appropriate funding mechanism for a state’s budget,” said Priscilla VanderVeer, spokeswoman for the Pharmaceutical Research and Manufacturers of America, or PhRMA.

New York’s law prohibits passing the tax on to consumers and other purchasers such as insurance companies, but enforcing that could be tricky, according to legal experts.

The Association for Accessible Medicines opposes all opioid taxes but especially objects to that measure because it taxes drugs per pill rather than according to revenue. That puts most of the burden on makers of cheap generics and largely spares brand-name sellers, whose marketing helped fuel the addiction crisis, Ryan said.

Drugmakers will prove to be tough opponents regardless of electoral outcomes, said Regina LaBelle, a visiting fellow at Duke-Margolis Center for Health Policy who worked on drug strategy in the Obama White House.

“These types of taxes face an uphill battle in state legislatures as powerful forces, including industry and industry-funded groups, ally against them,” she said. Pharma-funded chronic-pain patients can be a powerful lobby, she said.

Surging mortality rates caused by fentanyl, heroin and other illegal opioids give pharma companies a chance to deny blame, even if many of those victims became addicted through prescription pills, LaBelle said.

Drug overdoses killed more than 70,000 people last year, a record, according to new, preliminary estimates from the Centers for Disease Control and Prevention.

Dozens of cities, counties and states have sued opioid makers and distributors, arguing the companies downplayed the dangers of addictive pills and ignored signs they were being abused on a massive scale. Often compared to litigation against tobacco companies in the 1990s, the cases could produce billions of dollars in government revenue to fight addiction and overdose.

But that could take years. Through opioid taxes and related measures, states could quickly supplement addiction-prevention funds made available by Washington, which many consider inadequate and unpredictable.

Members of Congress have pushed more opioid legislation this summer, but the House’s package so far has no clear path to becoming law.

Federal funding “is a drop in the bucket,” said Patrick Diegnan, a Democratic New Jersey state senator who backed an opioid tax this year. “We really basically have to put in place the infrastructure for treatment. It will cost a lot of money.”

Minnesota’s proposed opioid tax had bipartisan support this year, passing the state Senate by a huge margin. But under heavy pressure from drug companies, a measure in the Republican-controlled house failed at the end of the legislative session in May.

In the governor’s race this fall, Tim Walz, a Democratic congressman, faces Jeff Johnson, a county commissioner who upset former Gov. Tim Pawlenty in the Republican primary.

Minnesota recently got Washington’s permission to bill Medicaid, the state and federal program designed for low-income people, for psychiatric hospital stays for those with intense addiction-treatment needs.

But none of the moves so far will furnish resources adequate to relieve the crisis, argue patient advocates. Many see an element of justice in making opioid companies contribute.

“Why is it important for the drug industry to pay reparations?” said Lexi Reed Holtum, executive director of the Steve Rummler Hope Network, a Minnesota advocacy group named for her fiancé, who died of an overdose in 2011. “No matter what, this is going to go on for decades to come.”

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