What if Washington treated addiction and mental health as urgent public health crises?

Many people think addiction only happens to dysfunctional people from dysfunctional families, or to hopeless people living on the street. But our addicted population is spread across every segment of society: rich and poor, white and black, male and female, old and young. If America is going to reverse the epidemic of opioid addiction specifically and drug and alcohol addiction more broadly, we need to start treating it like the national emergency it really is.

 

We need better public awareness with a concerted effort that includes full-spectrum prevention, stronger prescription-drug controls, more-robust law enforcement and consequences for the suppliers and dealers of drugs, and far more access to quality treatment for the users. Some will say this is too expensive, but the costs of the opioid epidemic—in terms of health care, its corrosive effects on our economic productivity, and other impacts on society—extend far beyond the loss of life.

 

Step one: Criminalize the suppliers (drug companies and dealers).

• Demand accountability from the companies, doctors, and dealers who aid and abet the crisis of addiction so that simple injuries or mental ailments don’t become a gateway, or worse: a death sentence.

 

Step two: Expand use of drug courts to help push users toward treatment.

• Allow defendants to avoid prison and expunge a drug-related felony by following a program of sobriety, peer-led meetings, work, and in many cases Medical Assisted Treatment—all supervised by a judge, over two to three years. 

 

Step three:  Make jail a recovery pod, a place where solutions can begin.

• When necessary, leverage jail as an opportunity to detox and begin a journey of recovery.

 

Step four: Ensure funds from dislodged from drug companies help create recovery-ready communities.

• Resuscitate the neighborhoods and small, rural American towns that have fallen victim to the opioid epidemic using funds from dislodged drug companies.

 

Step five: Make solving addiction a priority for the CDC using evidence-based approaches.

• Explore the hypothesis that if we legalize drugs, we can better regulate them. Evidence suggests that a combination of decriminalizing within limits may bring down the costs and increase the safety of the drugs, but the limits are critical to ensure we don’t cause more overdoses or add to homeless numbers.
• Be wary of cases such as Colorado’s 2019 law that, among other things, made possessing four grams or less of most drugs only a misdemeanor—including fentanyl. For context, fentanyl is often mixed into other substances but four grams of pure fentanyl will yield roughly 2,000 deadly doses. Denver’s drug-overdose numbers are now higher than ever and homelessness is at a 10-year high
• Consider raising the marijuana age limit to 25 to reduce receptivity to drugs like opioids based on theories about under developed brains being more susceptible to dependencies.

 

Step six: Ensure health care covers the full treatment needed for addiction.

• Ensure effective treatment for addicts including craving-reducing drugs, time, counseling, mutual support, and transition training. It takes most addicts well over a year of skilled, intense inpatient treatment to have a chance of recovery.

 

Step seven: Develop “safe-use zones”

• Learn from places like Portugal and parts of British Columbia and institute areas that dramatically reduce opioid overdoses due to the presence of trained users of naloxone (and overdose-reversing drug), and provide access to treatment for those ready to seek help.