The title actually says it all, but let me elaborate. As an undecided voter, I've got a pretty straightforward litmus test for anyone who wants to be President in 2016--and when you've finished reading this, hopefully you will, too. In short, I want to know what the candidate is going to do about our alarming, widespread, and worsening addiction problem. I don't mean in the abstract. Not vagaries, platitudes or political doublespeak. We need a real plan, with some bold, visionary and legitimate ideas that demonstrate resolve and seriousness. Concessions or half-measures from anyone beholden to special interests--pharmaceutical, alcohol, or otherwise--just won't cut it.
The gravity of our national addiction problem cannot be overstated, nor can it continue to coexist with a sustainable society. Lurking in the depths while simultaneously running amok in a murderous frenzy, addiction is both an anchor on the dreams of our future, and a killer on the loose today. What does that mean? It means we need solutions. We need action. We need candidates who can deliver both.
While it may be tempting to dismiss me as a single-issue voter with a narrow view of the world, consider whether there is one other issue whose poisonous vines stretch so broadly across every inch of our national landscape: public health, the economy, national security, civil rights, crime, family life, and education. All of these issues--and probably more--are directly implicated in our destructive relationship with alcohol and drugs, and not in some minor or tangential way. Here's why:
Public Health: Addiction is the largest public health crisis facing our nation, plain and simple. As a threat to our physical wellbeing and leading cause of mortality, addiction ranks near the top, year after year. Approximately 21.5 million people aged 12 or older have a substance use disorder, including 17 million people with an alcohol use disorder, 7.1 million with an illicit drug use disorder, and 2.6 million who had both an alcohol use and an illicit drug use disorder. Over 100 Americans died from overdose deaths each day in 2013, and drug overdose was the leading cause of injury death--greater than both car accidents and homicide. 46 Americans die each day from prescription opioid overdoses; two deaths an hour, 17,000 annually.
One in ten deaths is caused by excessive alcohol consumption. But it's not just the direct physical impacts of addiction that we need to worry about--the broader health effects are stunning. Simply put, no other illness leaves its fingerprints all over so many others. Cardiovascular disease, stroke, cancer, HIV/AIDS, hepatitis, lung disease and mental disorders are all caused or affected by addiction, and begin to make its true death toll virtually impossible to calculate.
The Economy: If it's true that the electorate sometimes votes its pocketbook, the entire political spectrum should line up behind any candidate willing to take on addiction--an apolitical disease that Hoovers a truly hefty sum from our national wallet every year.
According to a new estimate from the Centers for Disease Control, excessive drinking alone costs the U.S. a quarter-trillion dollars per year! Sadly, the problem has only been getting worse. The last time the CDC made a similar calculation, our collective thirst was blamed for approximately 25 billion less in damage to the economy. The increase, about 2.7 percent annually, has outpaced inflation, with 40 percent of the whopping total cost being shouldered by the government. That means your taxes, and mine. Also, those are just the numbers related directly to excessive consumption of alcohol, mostly in the form of binge drinking. The total price tag for all issues related to all forms of substance abuse is estimated to be 600 billion per year. Still think this shouldn't be a major campaign issue?
National Security: The United States' demand for illicit drugs is a major factor in the rise of transnational organized crime, and according to the National Security Council, it "fuels the power, impunity, and violence of criminal organizations around the globe." In a recent interview, the DEA Chief shared the common sense observation that money from the illegal drug trade is sometimes used to fund terrorist organizations overseas, and James Clapper, Director of National Intelligence, has many times warned that Mexican drug cartels and other organized crime syndicates in Latin America represent a direct danger to the national security of the United States. Clearly, any Presidential candidate who doesn't have a plan for addressing our appetite for drugs doesn't have a real plan for keeping us safe, either.
Civil Rights: As Americans, freedom from discrimination is supposed to be one of our most fundamental civil rights. Unfortunately, millions of citizens struggling with the disease of addiction face significant discrimination and stigma in all areas of daily life. From hushed whispers of judgment to loud insults of ignorance, the stigma of being an alcoholic/addict continues to permeate our culture. Despite the fact that it is illegal to discriminate against people in recovery from alcoholism and drug addiction who are seeking jobs, housing, education, and public services, it happens, and happens often.
As a recent Johns Hopkins study revealed, Americans are significantly more likely to have negative attitudes toward those suffering from drug addiction than those with mental illness, and don't support insurance, housing, and employment policies that benefit those with addiction. According to the study's author "We see very negative attitudes, a strong desire for social distance, high levels of discrimination and low support for policies that could improve access to treatment." If you want to be President, you should have a plan for safeguarding the rights of all Americans--even those with addiction.
Crime: The link between addiction and crime is clear and longstanding. While the vast majority of alcoholics and addicts do not engage in criminal behavior, addiction was involved in the crimes of roughly 85 percent of the U.S. prison and jail population. Let that number sink in for a moment. That means that if you subtract from our jail and prison population those who committed crimes while under the influence of alcohol or other drugs, committed crimes to get money to buy drugs, or were incarcerated for an alcohol or drug law violation, only 15 percent would remain. Maybe that wouldn't be such a compelling fact if our jails and prisons weren't bursting at the seams, and if we didn't incarcerate 25 percent of the world's prisoners while only having 5 percent of the world's population.
Also, it's worth noting that the federal prison system now consumes more than $6.7 billion a year, or roughly 1 in 4 dollars spent by the U.S. Justice Department. That's a 600 percent increase over the last quarter century. If we had been treating addiction like the disease that it is over the last few decades--instead of moralizing and criminalizing it--I'm pretty sure we could have found a more constructive use for that money. Crumbling infrastructure, anyone? While bipartisan efforts to reform sentencing and reduce prison populations have been gaining traction recently, the more pressing need is for leadership around the way we view, treat and prevent addiction. If you want to be President, you should have the insight and intelligence to understand that the first step to reducing crime is to pry us free from the stranglehold drugs and alcohol have on our country. What might those 85 percent of American inmates have done with their lives if the destructive force of drugs and alcohol hadn't intervened? We'll never know, but with the right leadership we can avoid having to ask the same question about future generations.
Family Life: With the emphasis that most political candidates place on the importance of families and family values, they should be expected to have a plan for addressing the thing that unravels more American households than just about anything else--untreated addiction. By obliterating stability, exacerbating domestic violence, fueling neglect, unleashing chaos, and furthering the cycle of poverty, addiction to drugs and alcohol is the death knell of countless families every day. If maintaining and strengthening our most fundamental social unit is truly as important to us as our recent national dialogue suggests, perhaps our Presidential candidates should spend less time opining about how to define it, and more time developing a plan to defend it from its most aggressive and universal predator.
Education: Compared to many other developed nations, America is losing at the education game. In the all-important areas of reading, math and science, we're on a downward slide, and don't even crack the global top 20. Roughly 20 percent of all U.S. high school students drop out without graduating, and in many urban areas that figure is 50 percent or higher. So what do our failing grades have to do with addiction? Oftentimes a lot. A number of recent studies have documented the long understood fact that substance use both causes, and is caused by, academic failure and dropout. This is hardly surprising when you consider the powerfully disruptive impacts that drugs and alcohol can have on developing brains, or the ubiquity and ready availability of substances should a struggling student chose to numb out and self-medicate, rather than experience the pain of failing at life before they're even old enough to vote.
Also, and it goes without saying, but it's hard to get an education when you're in the criminal justice system instead of the classroom. Unfortunately though, that's where a lot of would-be students end up as a result of drugs and alcohol. In fact, four of every five children and teen arrestees in state juvenile justice systems are under the influence of alcohol or drugs while committing their crimes, test positive for drugs, are arrested for committing an alcohol or drug offense, admit having substance abuse and addiction problems, or share some combination of these characteristics. Is this fact alone, or the issue of youth addiction more broadly, solely responsible for our sinking educational ship? Of course not, but adolescence is the critical period for the initiation of substance use and its consequences. Nine out of 10 Americans who meet the medical criteria for addiction started smoking, drinking, or using other drugs before age 18, and one in four Americans who began using any addictive substance before age 18 are addicted, compared to 1 in 25 Americans who started using at age 21 or older. How many potentially successful students have we lost along the way due to addiction? The number is staggering.
Now, returning to where I started, I said that I have a litmus test for anyone who wants to be president: what are they going to do about our addiction problem? If, after reading this, you're still not convinced that it's the central question we should be asking all candidates, then let me rephrase: what are they going to do to improve public health, the economy, national security, civil rights, crime, family life, and education? Do they have a legitimate plan for making meaningful improvements in those areas? Because if they do, they'll necessarily have to tackle addiction along the way. I can live with that.
The opinions expressed are solely those of Patrick R. Krill.