“You never let a serious crisis go to waste. And what I mean by that it’s an opportunity to do things you think you could not do before.”
Rahm Emanuel Wall Street Journal, November 19, 2008.
The opioid epidemic started at the turn of the century, continues to have a devastating impact on many individuals and communities throughout the United States. The statistics are overwhelming. The personal stories are heart-breaking. According to the CDC, between 1999 and 2017 more than 400,000 people have died from a drug overdose, becoming a leading cause of injury and death in the United States. In 2017, around 68% of the more than 70,200 drug overdose deaths involved an opioid. Countless more individuals have suffered severe medical, social, psychological and legal problems associated with opioid use. In addition to the toll on individuals, the opioid epidemic has impacted rural, suburban and urban communities, rich and poor, republican and democratic, all racial groupings. In the same period, the “War on Drugs,” waged against illegal drug users has had devastating consequence on individuals, their families and communities. Efforts by government to stem drug use has militarized local police forces, and has introduced more vehicles for government intrusion into the private life of citizens. Individuals suffering with pain, have been forced to forgo treatment that has helped them function. Most tragically, many of the opioid overdoses leading to the user’s death and serious morbidity are preventable. Many of the social consequences were predictable and avoidable. And perhaps most importantly, the political, social and economic conditions that contribute to the epidemic rarely addressed.
During the past decade I have followed the many efforts by the federal, state and local government, the media, academicians, book authors, non profits, citizen groups, health care institutions, experts, law enforcement and stakeholders of all sorts to address the challenges associated with opioids. It is not for the absence of awareness of the challenge of lack of narratives and theories to explain the roots and persistence of the epidemics devastation. Nor is the response lacking a scientific understanding of addiction, the political will to legislate, litigate, incarcerated, fund, the response to the epidemic. It is not due to an absence of a physical barrier with Mexico, data, resources, emerging best practice. In the past few years, congress passed in a bipartisan manner legislation to address the challenges related to opioid use, allocating billions of dollars to various initiatives. Thousands of legal cases against the manufacturers of pharmaceutical opioid products and the distributors are presently taking place in various venues around the country. The stated goal for the lawsuits is to have these companies compensate and pay for their actions “treat” the consequences of the defendants on communities throughout the country.