Without a doubt, the nation’s current “opioid epidemic” is a substantial public health problem. In 2015, it was estimated that 12.5 million American’s misused prescription opioids, with over 33,000 people dying from an opioid related overdose and a total economic burden of 78.5 billion dollars attributed to the crisis. These stark numbers have only continued to rise, and in turn we are a nation finding itself grappling with what to do to address the problem and turn the tide.
Justified anger at the maliciousness of those who knowingly flooded the country with a highly addictive and deadly substance has taken hold, unleashing a new wave of angry recovery advocates who have entered onto the scene demanding justice for their loved ones. At the federal level, advocates have already been successful in securing funding to specifically address the opioid epidemic. In 2017, roughly $485 million dollars from the 21st Century Cures Act was distributed across all 50 states to target opioid misuse, and there is much talk of more to be done soon with the anticipation of a federal state of emergency being declared any day now.
As public awareness and political will has increased, it is understandable that many see opioids as the problem and are now turning their attention toward how to reduce access to them as well as provide treatment to those who have been using them. It is a natural line of thought for many to imagine that if access to opioids were to be reduced, so too would be opioid misuse, and that if addiction treatment were to be expanded, people who have been using opioids would be able to stop.
With acknowledging the understandable and natural way in which we are collectively looking at opioids as the problem, it is more important than ever that we do not get lost in this short-sighted and narrow view. America doesn’t have an opioid problem, it has an addiction problem. Our nation doesn’t just all of a sudden find itself drowning in an opioid epidemic, we have long found ourselves embroiled in an addiction epidemic. And the important thing to remember about addiction is this: Addiction is a scavenger disease. It concerns itself not with the substance of the day as it will with ease move onto the next one. The scourge of opioid misuse among middle class white America is evidence not so much that middle class white America has an opioid problem as it is that we have a middle class white America problem which has ushered in addiction. And it is to that problem, good people, to the conditions and climate of middle class white America that have combined to usher in the scavenger disease of addiction, that our attention must be focused more so than on the opioids themselves. But addiction isn’t just a white America problem. It is also imperative that we stop collectively forgetting in the midst of the opioid epidemic that an equal if not higher level of focus needs to be given to poor communities and people of color. These communities have long suffered with the conditions and climate that fuel addiction and found war declared on them by this nation rather than receiving the more compassionate, human response white America seeks today.
At the end of the day, if we continue this narrow focus solely on opioids, we will be missing the bigger picture. If we continue to focus primarily on expanding acute treatment for opioid misuse, we will be missing the bigger picture there as well. Addiction isn’t about the substance of the day - the substance misuse is merely one symptom of a condition rooted in social, environmental and psychological factors. Focusing on the symptom without addressing these factors will not only do little to halt the opioid epidemic but it will also miss the prime opportunity to once and for all face addiction in America. It is time we stop looking so much at opioids and instead look more at the conditions that serve as fertile breeding ground for the scavenger disease of addiction. It is time we stop talking so much about opioids and really talk about how we face addiction in America, for all of America.