Election cycles are when the “big issues” come up, right? Healthcare, unemployment, national safety, foreign policy. The major problems are discussed in hopes that we will elect officials that will work towards solving them. (Of course, this is a somewhat idealistic view of what’s supposed to happen in government and elections.) We expect the problems that plague most of the population to be addressed or, at the very least, mentioned. There has been one major topic that has gone almost completely under the radar in campaigns and the media: addiction.
It’s true that one of our presumptive presidential candidates does have extensive drug-related reform legislation, at least on her website. But even with that, it’s not something that our candidates have been asked about or have addressed. Addiction and drug abuse, a leading health risk in the United States, is still invisible on the national level, at a time when the country’s concerns need to be publicized.
The last time drug addiction was at the forefront of national concerns was in the 1970s. In 1971, the Nixon administration referred to drug abuse as “public enemy number one in the United States,” beginning the infamous “war on drugs.” In the 1980s and ’90s, crime rates were high in the country, and drug abuse was again considered central to this problem. The federal government cracked down on the usage, distribution, and trafficking of illegal substances, leading to mass incarceration.
Almost 40 years after the war on drugs declaration, it’s clear that its policies have been unsuccessful. Our prisons are overcrowded, primarily by people of color (mostly Black and Latino men) who are targeted more for crimes because of prejudice, discrimination, and racism. We have considered addiction as a crime for much too long. The country’s drug problem is directly related to a multitude of other national issues — mental health, mass incarceration, racism. These are also problems that we need to deal with differently, both for their own sake and for their relations to addiction.
In federal prisons, 85% of the people are there for drug-related crimes, while 65% meet the criteria for addiction. A mere 11% report receiving any treatment during their time in prison. This only leads to repeat offenses and additional jail time, when in actuality treatment is needed not punitiveness.
The war on drugs did lead to decreased addiction initially, but data collected by the Centers for Disease Control and Prevention’s database shows the increase in the country’s fatal drug overdoses over the last 15 years. Among these statistics, opioids—drugs either made from or that simulate the effect of morphine—have lead to the most deaths. Before 2000, opioid deaths were around 3,000 a year. In 2014, just opioid deaths alone have lead to over 15,000. Heroin alone, which is an opioid, contributed to around 10,000 of those opioid overdoses.
There is already a way to decrease the number of deaths due to opioid addiction. It’s called naloxone. The drug blocks the receptors of the brain that are attracted to opioids during an overdose, effectively countering opioids and defending the body against the respiratory depression that causes overdose fatalities. The World Health Organization has listed naloxone on its list of essential medication for over ten years. Naloxone has been on the market for over forty years, but it lacks the widespread distribution that’s needed.
Naloxone is dubbed a “miracle drug.” Think of the benefits that could come when every first responder has naloxone on them. Think of all the lives that could be saved. Access to the drug has become somewhat of a priority for some states. In 2010, there were only 188 naloxone programs in the U.S., located in 16 states. Four years later, the number of opioid reversals increases from about 10,000 to over 25,000 as states have expanded their programs and access to the drug. In 2014, it was reported that there were still 20 states that have no program in place to distribution naloxone. This is due, in some part, to the lack of federal funding for naloxone.
These numbers show the importance in state and local government in the fight against drug addiction. And it’s true, local governments realize the effect of addiction in their communities because they are losing people. Small scale legislation is crucial to the fight against addiction, but national support and support from the capital is crucial. Naxolone is just one example of the way that states are beginning to change the way we talk about addiction. But naloxone is not enough. We want to get to the point where overdoses are not occurring at the dangerously high rate that they currently are.
Ithaca, New York, is one city that is has moved towards radical and revolutionary drug addiction legislation. Mayor Svante Myrick has opened a safe injection facility, the first program of its kind in the United States. The site would allow access to clean syringes alone with injections of illegal substances under medical supervision, all without the fear of prosecution or arrest. Other countries, namely Australia and Canada, have already supported sites like this. Studies show that show that supervised injection services lower overdose rates, while not increasing drug injecting, drug trafficking, or crime in surrounding environments. However, these sites violate federal law that restricts any area which is used specifically for distribution or usage of a controlled substance. This federal law, the Controlled Substance Act, reflects the language of many state laws as well. Maryland and California have already begun to move toward legislation that would reform these laws, allowing for safe injection sites to become widely available.
In addition to these safe injection sites, Maryland has also been working toward lowering its incarceration rates by treating addiction through treatment programs. Because of Maryland’s alternative routes of state treatment of drug offenses, it has lowered its cost of each offender from $20,000 to $4,000. Currently, less than 2 cents of every taxpayer dollar is spent on prevention and treatment of addiction, while much more is spent on the cost of incarceration.
Right now, an addict has three life choices: a support group, rehab, or jail. None are mutually exclusive, but we often consider them in levels of severity. Support groups for the lucky ones, rehab for those that “really need it,” and jail for those that are too far gone. This stigma around addiction needs to be broken, realizing that no one is too far gone for help and that jail is never a viable option for addiction. The beginning of helping addicts starts by realizing that they need help. Local governments are already starting to change this, working towards more supportive and treatment-based policies. But this is a national issue, and needs to be treated as such.