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The Senate health bill, deemed “mean” by President Trump himself, proposes a number of budget cuts sure to devastate sick, elderly, and underprivileged Americans, and perhaps no group is more at-risk than the 2.5 million Americans currently struggling with opioid addiction. The bill caps 2018 Medicaid — the single largest payer for mental-health and rehabilitation services in the United States — at just $2 billion, which is barely over two times what the state of Ohio alone spent addressing opioid addiction in 2016.

Further complicating the issue is a new study, published in the Journal of the American Board of Family Medicine, which found that more than half of all opioid prescriptions written annually are given to patients with anxiety and depression. That the two go hand in hand is not necessarily surprising — pain and depression, in particular, have been found to be highly interrelated — but it’s a troubling finding for a nation in which both opioid-prescription rates and anxiety and depression diagnoses are on the rise.

In an interview with the Washington Post, Sites said that while someone without anxiety or depression might report their pain level “as a two out of ten, someone with mental-health disorders — depression, anxiety — may report as a ten out of ten.” This disparity between the overprescription of opioids and the undertreatment of mental illness makes for a dangerous correlation — and with a gutted Medicaid budget, it’s likely to get worse.

The study’s researchers (led by Brian Sites, a professor of anesthesiology and orthopedics at Dartmouth’s Geisel School of Medicine) also found that adults with anxiety and/or depression were more than three times as likely to use prescription opioids as those without: 18.7 percent versus 5 percent, respectively. While some people with anxiety and depression undoubtedly suffer chronic pain, these disorders may make it difficult for patients to accurately rate their own suffering — whether because the pain is made more acute by the mental illness which accompanies it, or because the patient is less able to cope with that pain.