When President Trump declared the opioid crisis a national public health emergency in October, he distinguished himself from his predecessors, who have called drug abuse “public enemy number one” and “the greatest domestic threat facing our nation today.”
For the first time in America, we are properly tackling drug addiction as a public health issue requiring public health solutions, rather than a public safety issue necessitating heavy-handed and ineffective criminal penalties.
We are finally in the right ball park. Now we need to make sure we have the right game plan.
Even with the shift in focus to the public health ramifications of addiction, American political leaders, health-care providers and justice officials have a difficult time combating drug abuse. The problem is that they don’t understand the perspective of the person taking the drug.
To those using them, drugs aren’t a problem – drugs are a solution to their problems. Drugs help people deal with fear, anger, shame, isolation, depression, and other real and deep problems many of us experience on a daily basis.
We all occasionally attempt to resolve, or at least escape, these core dilemmas through inappropriate or ineffective means. Illicit drug use is a particularly destructive and dangerous choice, but it is still an attempt to fix a problem.
For the many people who are unable or unwilling to do the time-consuming work of resolving painful, life-controlling issues, drugs offer some form of immediate relief. There’s a reason a drug dose is called a “fix.”
If the solution is providing relief, the seemingly remote prospect of criminal penalties is just not an effective deterrent. Telling people to just “say no” – language Attorney General Jeff Sessions invoked on the day President Trump issued his declaration – ignores their real and pressing problems.
So how did Americans get so bad at choosing healthy solutions to life’s problems? And, how did our government get so bad at choosing solutions to the problem of drug abuse in our communities?
Though drug dependence is an extreme solution, it’s an outgrowth of an attitude common to all of us. For most issues we face, we expect to find a quick and easy patch. That’s the key message we get from ads for all sorts of products.
And in fact, the United States is one of only two developed nations (New Zealand is the other), that permits direct-to-consumer marketing of prescription drugs like opioids.
Our core institutions also seem to be created for and fueled by failing government solutions. Prisons are a prime example. When someone commits a crime –very often related to a drug addiction –we incarcerate him or her.
The experience of being in prison often leaves more individuals than ever plagued by fear, guilt, shame, anger and disconnection.
It’s only logical that people whose internal problems have worsened will quickly turn to more doomed solutions. The evidence bears this out. Two-thirds of released prisoners will be arrested again within three years, cycling back into an ineffective and expensive system.
Yet, we still manage to be surprised that spending years locked in a small cell does not transform people with drug addictions into model citizens. We still manage to think that people with a drug addiction are basically different – defined by their poorly chosen solution, instead of their basic human dignity.
We remain addicted to drug enforcement and criminal justice policies that we cannot afford and that do not deliver on their promise of relief.
Declaring opioid addiction to be a public health emergency is an important step in the right direction, especially if it draws public attention and funds toward a crisis that is harming large numbers of Americans, their families and their communities. But, as the last 45 years of the War on Drugs testify, there is no quick fix for addiction.
We must go much deeper in our search for healing. Real solutions will be based on the dignity and potential of each man or woman caught in substance abuse, recognizing their worth and potential for change.
We must demand lasting change instead of easy answers. And we must relentlessly pursue public policy solutions for the underlying problems – including restorative criminal justice reform, drug courts, drug treatment, and mental health care – that heal our neighbors instead of causing more harm, before it’s too late.