美国国家公共电台 NPR Counting The Heavy Cost Of Care In The Age Of Opioids（在线收听）

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The declaration of an opioid emergency by President Trump has put the focus on the need for treatment. And now some communities are asking who will pay. NPR's Allison Aubrey reports on the rising costs of treating the epidemic.

ALLISON AUBREY, BYLINE: Like a lot of communities around the country, Baltimore has seen an uptick in deaths from opioids.

LEANA WEN: Here in Baltimore City I see the impact of the opioid epidemic every single day. We have two people in our city dying from overdose every day.

AUBREY: That's the city's health commissioner, Leana Wen. Part of her strategy to tackle the problem is to make the lifesaving drug naloxone, known by the prescription name Narcan, available to all residents.

WEN: If somebody is having an opioid overdose, they have stopped breathing. And Narcan can be given as a nasal spray. And within 30 seconds or so of getting Narcan, that person can be walking and talking again.

AUBREY: Wen says they've prevented a lot of deaths by getting this drug into the hands of more people. But now, she says, her city has a problem.

WEN: We're out of money for purchasing Narcan. We're having to ration this medication. And every day I have community members, community leaders, faith leaders contacting us because they want to have Narcan available in order to save people's lives.

AUBREY: People can purchase the drug at pharmacies, but at a cost of about $125 many people can't afford it. So Wen says she'd like a commitment from the Trump administration to help pay. And she'd like the administration to negotiate with manufacturers to decrease the price of the opioid antidote.

WEN: We know that treatment works, but we don't have the money for treatment.

AUBREY: How to pay for drugs is not the only issue. A recent study of urban hospital systems finds a significant spike in the cost of treating people who end up in intensive care after an overdose. Here's the study author, Jennifer Stevens.

JENNIFER STEVENS: These are patients who have already survived to admission and have significant complications from an overdose itself.

AUBREY: Stevens is a critical care doctor at Beth Israel Deaconess Medical Center in Boston. She says when opioid users have been unconscious for an extended period, they can come in in really bad shape.

STEVENS: You can have kidney injury or failure. And you can have aspirated and given yourself a big pneumonia that requires a ventilator to help you through that.

AUBREY: Stevens says the number of overdose patients needing treatment in the ICU has increased about 34 percent between 2009 and 2015. And the average cost of care has shot up from about $58,000 to $92,000 per person.

STEVENS: So that's an increase of nearly 60 percent.

AUBREY: Stevens says it's not just the costs that are rising. The mortality rate of overdose patients admitted to the ICU is up, too. Her study found that opioid deaths in the ICU nearly doubled during the study period.

STEVENS: In spite of everything we can do we're still seeing a rise in mortality. And I should say that's certainly - it's a call to arms that everything that we're doing isn't enough.

AUBREY: These new numbers reinforce what's now clear - the epidemic has achieved a new sense of urgency. Allison Aubrey, NPR News.

(SOUNDBITE OF THE XX SONG, "A VIOLENT NOISE")