“I’m desperately missing my sister.”
What was different about this email was that this stranger wanted to know if I remembered her sister or what her sister had written to me a few months earlier. She explained that her sister recommended my book to their mom to explain what she was going through. Their mom wanted to thank me for helping her understand and for making her daughter feel seen.
She also told me her sister recently died of an overdose.
A buzz of sadness and memory raced through me as I searched back through my DMs, looking for her sister’s message. I found it. She’d told me she was struggling, that she felt so ashamed, that she was trying to get help. She thanked me for writing the book. She’d said I’d given her hope. We exchanged a few messages, and she died a month later.
As I read over our messages back and forth, I felt gutted. I didn’t know her, but I knew her pain. That could have been me. I’d overdosed when I was in my years of active addiction. A friend’s rescue breathing saved me. If she hadn’t been there, I’d be dead.
That was 23 years ago. I cannot count the number of friends I’ve lost since then to addiction, not to mention people like this young woman who reached out, who didn’t make it.
And the numbers are accelerating.
The Centers for Disease Control and Prevention’s National Center for Health Statistics just released provisional data showing more than 100,000 drug overdose deaths from April 2020 to April 2021. Let that number land: 100,000 deaths.
The thing is, these deaths are preventable. Our drug policies are killing people.
I’ve been hopeful, seeing the Biden administration’s movement toward embracing harm reduction. Secretary of Health and Human Services Xavier Becerra said in a recent interview that the HHS would be supporting clean needle exchange programs and the dispensation of fentanyl testing strips.
This is a significant step forward, but it was concerning that the Biden administration appointed Rahul Gupta as the nation’s new director of the Office of National Drug Control Policy. This is the guy who was a key player in shutting down West Virginia’s largest needle exchange program and has backed legislation that would effectively terminate all of West Virginia’s harm reduction programs. All the while, the state has had a boom in HIV outbreaks and drug overdose deaths. After being sworn in last week, Gupta appears to be shifting his stance, saying in an interview with NPR, “I believe what we are doing right now is to continue to improve and increase the number of harm-reduction practices that have clear evidence behind them.”
This is hopeful. However, meanwhile, the Drug Enforcement Administration is fining pharmacies for dispensing Suboxone and Subutex, drugs used for medication-assisted treatment, a treatment protocol proved to double the chances of a person entering long-term recovery and reduce the risk of overdose by 50%.
People in need of pain medication are denied prescriptions and cut off from a safe, regulated supply, so some turn to the illegal market to treat their pain. In the past five years, with the focus on punishing Big Pharma, opioid prescriptions have decreased by more than 40%. Drug overdose deaths, the vast majority opioid-based, have doubled. There is a direct correlation.
Oh, and naloxone, a simple, cost-effective way to reverse an overdose, is in short supply and has increased in price. Pre-pandemic, harm reduction groups bought generic naloxone for about $2.50 per unit. Now, if they can get it, it costs $37. The brand name Narcan costs $75.
When we limit prescriptions, fine and prosecute medical providers and pharmacies, what are we doing? We’re making the problem so much worse.
First and foremost, and I will shout this until the day I die, we need to hammer home the message that addiction is a public health issue. It is not a moral failing.
Again. Addiction is a public health issue. It is not a moral failing.
What do we do with other public health issues? We use evidence-based solutions. We don’t incarcerate people.
What works is harm reduction. Because people can’t recover if they’re dead. Because people need a nonjudgmental path to recovery. This is about health care, not enabling.
What works is decriminalization. We should be diverting the funds used to jail people in for-profit detention centers and instead invest in health.
What works is treating those struggling with addiction like human beings. Tough love rarely helps. Connecting people to communities, providing them with health care and stable housing, that works.
What works is early intervention in the way of mental health services that are free and preventative, especially with young people. Imagine the difference we could make by spending tax dollars to ensure young people are given the tools and help they need to thrive.
I was 8 years old the first time I took an opiate — an expired painkiller I found in our medicine cabinet with a “May cause drowsiness” label. I was depressed and suicidal and desperate for an exit from my feelings. I began using heroin at 13 and went on to struggle with addiction for more than 15 years. I needed mental health care. What I didn’t need was “Just say no.”
The United States has spent over a trillion dollars on the “war on drugs.” And look at where we are. What have we accomplished? We have driven people away from obtaining legal, regulated pain medication to the illegal drug market, where the supply is unregulated and flooded with fentanyl. We have achieved racially biased mass incarceration.
By 2022, the U.S. is expected to spend $41 billion on drug treatment and prevention (if Congress approves the funding). And for that mass incarceration, 1 in 5 being incarcerated for a drug offense, we spend $182 billion each year.
Our drug policies have failed, and people are dying at an ever-increasing rate. Our focus needs to shift to what needs to be done to save lives. We should be concerned with treating the health of human beings, not fighting a war.