By Thom Little, Ph.D.
SLLF’s motto is “Inspiration, Education, Excellence.” Last weekend, I believe we fulfilled that mission and motto as we presented “Addressing the Opioid Crisis” in collaboration with the Center on Addiction and Johns Hopkins University & Medicine. The all-star faculty inspired the audience to act, educated them so they could act effectively and provided examples of excellent programs from across the country. From September 20-22, 2018, more than 100 legislative leaders, corporate sponsors and nationally recognized experts gathered in Baltimore, Maryland to examine strategies that are proving effective for addressing the opioid crisis that is devastating America.
Over two days, we examined the impact of opioid addiction on health care, employment, the criminal justice system and families, especially infants and children. As I listened to conversations about how addiction might be addressed in these varied areas, I began to notice several patterns – regardless of the area of impact, effective solutions seemed to have five characteristics: the treatment of addiction as an illness rather than a moral failure; cooperation across affected agencies and organizations; the use of individuals in recovery as employees and mentors; the need to address the root causes of addiction rather than just the symptoms; and leaders willing to engage the public and the community in developing solutions. Let’s briefly explore each of these characteristics.
Treating Addiction as an Illness. No more than two out of ten people with addiction receive any type of treatment. While this may be due to a lack of insurance coverage, unaffordability, lack of access in the health care system, or limited availability of services in rural areas, the most likely reason that so few seek help is due to the stigma associated with addiction. Many still look at addiction as a moral failure, a weakness of character or a willful decision, so people are afraid to admit their problem publicly for fear of being judged. Therefore, many do not seek treatment, insurance plans often don’t cover treatment, prisons don’t provide treatment and child welfare systems don’t work with parents with addiction to keep their families intact. If people suffering from addiction were treated like others who suffer from a disease (diabetes, hypertension, etc.), they would be much more likely to seek treatment and health care providers, employers and the state would be more likely to provide it.
Breaking Down Bureaucratic Silos. One thing is clear–the opioid crisis is too big for any single government agency to tackle. As made clear by the panel on West Virginia and Lt. Governors Bethany Hall-Long (Delaware) and Boyd Rutherford (Maryland), an effective strategy must include efforts in the health care, education, criminal justice and child welfare systems. And within those institutions, it must be all hands on deck – individuals with addiction who are arrested need to be treated as people with an illness at each stage of the criminal justice process. School counselors must work with social workers, case managers, therapists, educators and advocates to make sure that children of parents with addiction are given the best care as their parents receive treatment for their disease. Employers, insurance companies and regulatory agencies must coordinate to encourage comprehensive services for those suffering from addiction.
Engaging People in Recovery. They say experience is the best teacher. Therefore, those who have experienced and are recovering from addiction should be very good teachers. Rep. Phil Spagnuolo and Chris Herren, both people in long-term recovery, are evidence of that. Both are on the frontline working with and offering guidance and encouragement to those suffering from drug addiction. In a similar manner, the state of Kentucky has found that people who have successfully completed the START (Sobriety Treatment and Recovery Teams) program make exceptional mentors for those currently in the program and can encourage and relate in a way that others cannot. Further, many employers find that employees in recovery make the most dedicated and conscientious employees.
Addressing the Root Causes of Addiction. While most of the effort to address the opioid crisis in America are focused on treating addiction, we will never end the addiction epidemic until we begin to address the issues that often lead to addiction. Most people turn to drugs as a way of coping with something else- pain, mental illness, abuse and trauma, poverty, etc. Until we address those issues or remove people from those situations, we will never be able to completely prevent addiction. Returning a criminal justice-involved individual to the same environment that led her to drugs in the first place makes no sense. Returning children to parents in recovery without providing ongoing addiction care and training in effective parenting is likely to lead to relapse. Withholding a job from someone because they used drugs in the past is likely to result in more drug use in the future.
It Takes Leadership! All effective public policy takes leadership, but some issues take more leadership than others. Addressing the opioid crisis is one of those issues that takes a lot of leadership because the misconceptions, stigma and stereotypes that surround addiction make it difficult to agree on solutions. Some believe that addiction is a choice, not an illness. Others are convinced that most individuals with drug addiction really don’t want to be helped or that addiction is a moral failure better addressed by prayer or punishment than policy. These were the attitudes faced by leaders in West Virginia when they began, with the assistance of Johns Hopkins University & Medicine, to develop a comprehensive response to the opioid crisis in the Mountain State. Instead of just forging ahead, leaders allowed for online public comments and then held public forums to address and correct many of the misconceptions noted above so they could develop policy based on data rather than anecdote and stereotypes.
As your state or company works to address the opioid crisis, you would do well to heed these lessons and know that the State Legislative Leaders Foundation, Center on Addiction and Johns Hopkins University & Medicine stand ready to help!