As someone who was once caught in the black-hole traction of an addiction to heroin, I’ve listened closely to the rhetoric about what has become an epidemic of overdose deaths in the U.S. Despite the urgency of dealing with this scourge, it feels like the most progress we’ve made in the last few years is to talk about it.
That’s not to say that having this conversation is inconsequential: We needed to bring opioid addiction into the light. But with 400,000 overdose deaths in the last 20 years and more than 70,000 in the last year alone, it’s time to take dramatic action to save lives and make recovery attainable for anyone who wants it.
The opioid pandemic is in a unique policy position. It is one of the few political issues in our public sphere about which Democrats, Republicans, and independents agree. Which is why, despite my left-of-center personal politics, I was encouraged when President Trump entered the White House talking about solving the epidemic. Though the White House has given the epidemic some airtime — creating a public education campaign to increase awareness, and supporting the SUPPORT for Patients and Communities Act (H.R. 6), which provides funding and guidelines for advancing addiction medicine — we need more than marketing to turn the tide.
Last month, the White House stated that it was time to “start talking about solutions.” I disagree: The time to start doing that was years ago. Fentanyl, which has become a major player in overdoses since Trump took office, is our nation’s deadliest killer, yet little has been done to combat it.
Solving this public health crisis means providing billions in funding, creating a continuum of care for people seeking treatment for addiction, and a serious overhaul of the systems that keep people sick, moving them in circles from detox to treatment to emergency rooms and back again without ever providing evidence-based treatment and behavioral support that results in sustained recovery. Getting our national overdose rate to zero will require comprehensive policy reform.
Sen. Elizabeth Warren (D-Mass.) and Rep. Elijah Cummings (D-Md.) are attempting to do just that with the Comprehensive Addiction Resources Emergency (CARE) Act (S. 2700), which would begin treating the opioid crisis like the public health emergency it is. Co-sponsored by a broad coalition of senators and representatives and endorsed by more than 200 organizations, the CARE Act would allocate $100 billion over the next decade to biomedical research, improved training for medical professionals who work in addiction medicine, community organizations that work on the front lines to help people with substance use disorder, and states and counties hard hit by the crisis.
CARE is a comprehensive, detailed plan that could actually work. It’s modeled after the successful Ryan White Act that provides HIV care and treatment services to low-income people living with HIV — but it requires substantial political support. Warren, who’s running for president, has suggested various plans and policies as part of her campaign platform. CARE is one of them.
“If the CARE Act becomes law, every single person would get the care they need,” Warren wrote in a Medium post last month, adding that the funds would come from an additional tax on the super-rich.
If $100 billion sounds expensive, compare that with the cost of not dealing with the crisis head-on. The president’s Council of Economic Advisers estimates that the opioid crisis cost $504 billion in 2015 alone. A new study in the journal Medical Care estimates that the federal government lost $26 billion in tax revenue between 2000 and 2016 because of adverse effects on the labor market due to opioid misuse.
Every $1 invested in addiction recovery treatment yields $7 in return. Although taking on the epidemic may be costly at first, it will yield big dividends for our economy — but only if we address every aspect of addiction, from the individual who struggles with substance use disorder to the policies signed into law by our elected leaders.
I struggled with heroin addiction for more than a decade before I became a person in recovery. It took years of relapses, waiting lists, near-fatal overdoses, and ineffective “treatment” to find meaningful care. Asking anyone to wait six weeks or longer to get help for a potentially fatal illness is inhumane and immoral — yet people with substance use disorder struggle to find sympathetic, informed, evidence-based care that’s available when they’re ready.
I lost years of my life going in circles, begging for help. I was homeless, broke, and desperate. I will never get those years back. I have many friends who didn’t make it out of that whirlpool. They drowned — the help they needed, that they reached for, wasn’t there.
I believe that the CARE Act can change that.
Recovery shouldn’t be a numbers game and it shouldn’t be a matter of luck. The CARE plan supports commonsense recovery that is available on demand, anytime an individual is ready to get healthy. Instead of being stuck on waiting lists, people will be able to get their lives back on track sooner. They’ll be able to participate again. They won’t have to sit on the sidelines, like I did, hoping my chance would come along before addiction killed me.
With this in mind, I’ll be joining Cummings this week and meeting with congressional leaders in support of the CARE Act on Capitol Hill. Since I know what the personal costs of untreated substance use disorder can be, I’m supporting the CARE Act because we need a realistic plan to help the millions of Americans who struggle with full-blown addiction. It’s not about telling people to “just say no.” It’s about giving them an option to “just say yes” to recovery.
One of my worries about the CARE Act is that it is being linked to Warren’s presidential bid. I believe that it transcends her politics.
Few public health issues cut through all demographics the same way, but addiction doesn’t care about the color of your skin or the amount of money in your bank account. It doesn’t care what you believe in or who you voted for in 2016 or who you plan to vote for in 2020.
The CARE Act represents a vital strategy for fighting the largest public health crisis in modern American history, regardless of Warren’s presidential bid. We need to put politics aside and save the hundreds of thousands of people with addictions whose fates currently hang in the balance. In these increasingly divided times, we have the opportunity to unite around one incredibly important goal: ending the addiction crisis. We can take that opportunity to the ballot box in 2020, but we can’t let that ballot box stop us from taking action now.
Ryan Hampton is a person in recovery from heroin addiction, author of “American Fix: Inside the Opioid Addiction Crisis—and How to End It” (St. Martin’s Press, 2018), and founder of The Voices Project, a nonprofit advocacy organization for people affected by addiction.