This brief gives policymakers and the public perspective on the scope of potential Medicaid spending increases needed to address the opioid crisis. Between 2011 and 2016, spending on Medicaid-covered prescriptions used to treat opioid addiction and overdoses increased from $394 million to $930 million, an average annual increase of 19 percent. Spending grew faster in later years, with a 30 percent increase between 2015 and 2016. Certain states—including Kentucky, Maine, and Ohio—have seen particularly fast growth. These same states, and others, could be particularly hard hit by reductions in Medicaid spending growth under consideration in Congress because of their fast growth and high rates of fatal overdoses.