Recently, President Trump announced a plan to combat opioid addiction, calling for more aggressive prosecution of drug dealers - including the death penalty. While his plan also includes increased education programs and better access to treatment options, it was breaking out the death penalty that caught the media’s attention, as well as mine.
It’s this kind of knee-jerk, quick-fix reaction that got us in this mess in the first place. We thought we could cure all manners of pain - physical and mental - with a miracle drug that could wash it all away. We ended up with more than 64,000 deaths in 2016 alone and it’s getting worse. And the President seems to believe that the threat of the death penalty will magically make what has become a national health crisis disappear.
Traveling the state as I run for Congress in the 8th District, I’ve had the opportunity to hear the concerns of thousands of our fellow citizens. Among all their worries - jobs, healthcare, the economy, education, the environment - perhaps none is more personal than opioid addiction. From the grandmother who’s now caring for her addicted daughter’s children, to the gentleman who’s watched his college roommate and lifelong friend’s life fall apart to the point of homelessness, the stories are many and heartbreaking. And as a doctor and a public health expert who has spent decades fighting disease the world over, from individual treatment to working with Congress to get things done, I can assure that there is no quick fix, no magic cure, no instant solution.
But there are solutions. It starts with our treating this problem as an epidemic, rather than just calling it one. I know what it takes to reverse the course of epidemics to save lives - even epidemics of chronic diseases without a cure. I’ve worked as part of a broad community to turn the death sentence of HIV into a manageable chronic disease, to save lives, reduce stigma, and restore communities. It will take an equally ambitious comprehensive public health response to stop THIS epidemic and stabilize the families and communities that have been ravaged by it. Here is my plan:
1) Build true access to treatment on demand. We must make treatment readily available when folks bring strength and resolution to the fight - and not test that strength further by making them wait. We can do this by using federal reimbursements to incentivize health care systems to purposefully expand access to treatment and provide medication-assisted therapy - something that is in short supply, and even less available in the more rural corners of Washington state. We must also better integrate these services with primary health services, as is being done right now at Confluence Health in Wenatchee. The hospital has put together an opioid epidemic response team filled with physicians, nurses, and pharmacists, trained and certified to be able to address and treat chronic opioid users as well as those dealing with acute pain, so that every patient has access to care.
2) Keep people alive so they can actually get into treatment. You can’t help someone who is already gone. This requires widespread overdose prevention and response interventions and making overdose prevention medications, such as Narcan, available to patients, families of addicts, and first responders. I cannot stand to see one more tragedy - including the tragedy of someone in recovery who has “one bad day” and accidentally overdoses because they don’t realize that their “previous dose” will now kill them because their tolerance is lower. We also need to rethink our criminal justice system to include drug courts and other diversion programs that provide more effective, and less expensive, alternatives to jail and the endless cycle of repeat incarcerations.
3) Turn off the faucet. We must start by preventing new addiction, whether it’s driven by pain control or self-treatment of mental health issues. In the case of addiction that starts by medical prescription for pain control, we need to ensure the proper training of providers, support non-burdensome prescription checks, educate patients, and hold drug companies accountable for identifying abusive prescribing patterns. For those who are self-medicating, we need to continue to work toward making mental health treatment parity a reality: full access and full coverage by insurance providers.
4) Reduce stigma and recognize addiction for the chronic disease it is. This is an enormous problem and it’s one that we all contribute to. We see it in the pregnant women and mothers who are driven from treatment and recovery for fear of having their children taken away from them. The American College of Obstetricians and Gynecologists, whose providers are truly on the front lines, has been raising the alarm against stigma-driven punitive legislation for women with opioid use disorder and their babies, calling for supportive laws that allow social service providers to promote evidence-based solutions that will actually help families. We need to listen to these experts.
Of course, this is just a beginning. A problem this enormous requires an enormous commitment. Our elected representatives must commit to tackling this epidemic with dollars and action, and be accountable for achieving the results that matter: stopping deaths and the destruction of families. Anything less is essentially signing the death warrant of thousands upon thousands of Americans each year and turning their backs on the very people they swore to serve.
Dr. Shannon Hader is currently running for Congress in Washington’s 8th District and is the former Director of the Division of HIV & TB at the Centers for Disease Control and Prevention.