Opioid Addiction: The Public Health Crisis of the Decade

Utter devastation. That’s how people in communities ravaged by the ongoing opioid epidemic characterize the proliferation of narcotics. In rural farming communities and inner-city neighborhoods, opioids have wriggled their way into the lives of thousands, breaking up families and ending lives. At the juncture, the epidemic’s toll is not entirely known. More than 33,000 died from opioid-related deaths last year and current estimates put the total number of opioid-dependent at more than 2.4 million. Federal reports put the economic impact – as a product of lost wages and reduced productivity – at more than 500 billion dollars, representing 2.8% of the total national GDP[1]. Solutions are desperately needed, and the question naturally evolves into what can be done to reverse dangerous trends and provide recourse for those across the country suffering from drug addiction. Its time for local, state, and federal agencies, with the cooperation of private organizations and non-profit advocates, to find a viable, workable remedy.

I do, however, exercise caution when calling for action. I am aware of the “good intentions” that government can have when attempting to manage addiction crises. The crack-cocaine epidemic of the 80s and the federal response remains in my mind one of the most blatant racial injustices since the end of Jim Crow. That for over 30 years, a sentencing disparity between powdered cocaine and crack-cocaine existed remains a complete mystery to me, academics, journalists, and other commentators[2]. This “criminalization” of behavior – behavior that for many was part of an impulse towards addiction – is part and parcel of the massive growth in prison populations and the destruction of communities across America. The great irony in the crack-cocaine epidemic was that once the drug took its toll, the federal government stepped right in to double down in the pilfering of social and civil stability. I say all this not to berate the actions of mistaken government policy. It’s true that the response to crack-cocaine was bipartisan, as so much of the current criminal justice system reflects that unusual legislative cooperation. I do hope, however, that the last few decades have motivated our policy makers – with all their inherent wisdom of what Americans desire – to see the response to drug addiction as a medical problem and not a criminal one.

Given all this, you can imagine my vexation following Jeff Session’s announcement that the Department of Justice acting position was to add more prosecutors to manage an already bloated prosecutorial docket[3]. The idea is certainly in line with the increasing number of lawsuits being brought by cities and counties before drug companies that have been the fuel for the epidemic. But this action by the DOJ worries me and it should worry anyone who understands the American addiction to prison. I’m not sure whether the motivation for managing the crisis ends at keeping drug manufacturers accountable. Call me skeptical. Nevertheless, I don’t see the answer coming from the Department of Justice. Rather, we need an all-hands-in approach and one that incorporates the medical aspects of addiction to truly manage this at an individual level. The current crisis is a public health, not criminal justice issue. I’m tired of a broken legislature. I’m tired of partisan infighting. I’m tired of a do-nothing Executive branch. And most of all, I’m tired of waiting to see when politicians will abandon their political tricks and “status quo” behavior. I want a government that works together to solve big problems despite its ideological distinctions.

What I envision is one that many advocates for rehabilitation and criminal justice reform seek: an end to the drug war and a transitional response that incorporates a medical model of drug addiction. Let me be clear, distributors of heroin and other opioids should be subject to the law and may indeed be best managed by the many octopus arms of the criminal justice system. However, and this is a big however, there is no success in locking up opioid-addicted users and subjected them to the chronic lack of health and social services that prison is so famously defined for. While opioid users can certainly come in all forms, the profile of the average opioid-addicted person in 2018 is overwhelmingly resource-strapped. Opioid addiction treatment is expensive and for those without the resources, addiction will continue. Non-profits, churches, and universities can fill the void only so much. If the federal government is serious about managing addiction, it’s time for an infusion of cash. An allocation of money to set up state and federal facilities could stem the tide of opioid deaths and help control the increase of use. This will serve as an immense and immediate benefit to low-income people and those without proper access to medical care. Not too long ago, my prescription would have not been all that revolutionary. Prior to the de-servicing of state mental facilities, most drug addicted people were hospitalized and treated; not incarcerated. By no means was the mental health system of the 1950s and 60s a model I wish to revisit, but it can provide a workable architecture for solving the big public health crises of the day. The Justice and Accountability Center has been working since 2011 to provide direct services to those recovering from incarceration and aims to advocate for reform that is more rehabilitative in nature. We see mass incarceration, the drug war, and the explosion of prison construction as all harbingers of a system gone awry. Any indication of falling into “old habits” is reason enough to address this. Let’s hope that local and state leaders, as well as the Federal government, is adequately prepared to take on this challenge by reflecting on the past. Big comprehensive ideas are needed to control the opioid epidemic; it is imperative to the safety and health of our fellow Americans.

[1]https://www.whitehouse.gov/sites/whitehouse.gov/files/images/The%20Underestimated%20Cost%20of%20the%20Opioid%20Crisis.pdf

[2] Read more about the Anti-Drug Abuse Act 1986 that ushered in the crack cocaine sentencing disparity here: https://en.wikipedia.org/wiki/Anti-Drug_Abuse_Act_of_1986

[3] https://www.usatoday.com/story/news/politics/2018/05/16/jeff-sessions-adds-300-prosecutors-fight-opioids-crime-and-immigration-offenses/615893002/