Campaigning for the imminent primary in New Hampshire, a state greatly affected by the opioid addiction and overdose crisis, presidential candidates have been falling over each other to express their sensitivity, empathy and proposed solutions.
It seems everyone—from Clinton and Sanders to Cruz to Trump—has a bold-but-vague, or utterly unimaginative plan that limply “prioritizes treatment” yet conveniently leaves out an array of vitally important additional components. The White House recently added to that conversation by announcing that they are seeking over $1 billion in federal funds over the next couple of years to beef up drug treatment for people struggling with opioids.
It’s great that the country is talking about opioids and overdose. But—just once—I would love to hear any of these politicians mention some concrete steps that we can all take today. Things that are free. Things that are simple, easy and quick. Things at least we can all get started on while we wait for the flow of federal funding and the next round of sensitive musings from presidential candidates. Things like this:
1. Let’s encourage all high schools and colleges to include an overdose prevention and naloxone education component in their “drug awareness” programs. We can require that, but it may take passing legislation, which is time-consuming. So let’s start by simply asking our high schools and colleges to educate our young people about overdose prevention, recognition and response in the context of their existing drug education programs.
2. Let’s encourage more physicians to become licensed to prescribe buprenorphine, an effective treatment for people with opioid use disorder. Smart states could subsidize the cost of that training for one year by offering a rebate to participating physicians. States can either pay through the nose to incarcerate heroin-dependent people or they can pay far less to get a doctor to start providing treatment to them. Check in with those physicians periodically to assess their comfort and success in treating opioid-dependent people. Is your healthcare provider licensed to prescribe it? Ask them, and explain why it’s so important in your community.
3. Check this list. All areas hardest hit by fatal opioid-related overdose need to first be made aware of the scope of the problem. Counties that don’t know that they’re disproportionately impacted by overdose deaths can’t be expected to work quickly to address it. Share the information with your community and your local public health department. Once they’re aware, they can start drilling down in the data to determine which zip codes are seeing the highest rates of opioid-related arrests and deaths. Then we can start targeting solutions in those communities—like providing naloxone directly to people who use drugs and increasing overdose prevention education in local schools.
4. Which brings me to methadone. Methadone clinics are routinely protested and refused by the same communities which need them the most. Yet they unequivocally save lives, and are more effective at doing so than abstinence-based treatment for opioid addiction. If we’re serious about tackling these problems, we must start loudly supporting expanded methadone access in our own backyards.
5. Start drafting comprehensive 911 Good Samaritan and naloxone access laws. Yes, this is legislative and will take some time. But start now, or seek out those engaged in existing efforts to lend your support. You might live in a state that does not make it simple and easy for people to get naloxone in their own community. You might live in a state that doesn’t yet have a law protecting people who call to report a drug overdose in progress from arrest for drug law violations—or that has such a law, but it doesn’t go far enough in terms of who it protects. Ask your lawmakers to do more—and if you really want to start a major conversation about great policy, ask your lawmaker to follow the bold lead of Maryland Del. Dan K. Morhaim’s visionary plan.
6. Start talking with young people about boredom, self-esteem, jobs, trauma and opportunity. It’s so easy to point the finger at heroin as being the root cause of all the problems, but of course it’s not. Chaotic drug use is not itself always the root problem—it’s often the highly visible and distressing symptom of deeper issues. Those issues for many young people can often include boredom, low self-esteem and poor self-concept, a lack of meaningful work at a living wage, and the absence of any evidence that their lives will unfold and blossom into something bigger. And for many young people, sexual, physical or emotional trauma can drive them to self-medicate their distress with drugs. Those are all big problems to solve. They will take time. But the conversation with young people about what’s driving drug use in your community should start today.
7. Encourage all drug treatment providers to make medication-assisted treatment, overdose prevention education and naloxone available to their clients. We all need to live in the 21st century, where research and science and medicine can help us achieve the best possible outcomes. Relapse is a reality for many, many people leaving treatment. Let’s work within that reality. Legislation might be effective, but right now, we can start asking our local treatment providers if they provide those lifesaving things to their clients and encourage them to do so. And while we’re at it, let’s have those same conversations with correctional facilities.
8. Talk to our kids about drugs. I mean, really talk to them. Be open, candid, vulnerable, compassionate and smart. Teach them about polydrug overdose and how easy it is to accidentally overdose when you mix things like alcohol and prescription opioid painkillers. Teach them to avoid powders if possible, because it’s easier for someone to mess with a powder than a pill. Teach them to never swallow or smoke or inhale something if they don’t know exactly what it is, how it will affect them, and where it came from. Teach them that you don’t want them making stupid choices that can kill them and that more than anything, you just want them to be safe and alive. If they feel they can be really honest with you, and there are no negative consequences for their honesty, you’re already halfway there.
9. Support your local syringe access program. Those hardworking folks have dedicated their professional lives to promoting the health, safety and dignity of people who use drugs. They distribute naloxone, they teach overdose prevention, they provide support for all of those young people injecting heroin and other opioids. Their work greatly reduces HIV and hepatitis C transmission. They help keep people alive during their darkest times. None of them are rich, but all of them are good. Go meet them. And bring them cookies.
10. Learn more about harm reduction, a health-centered approach to drug use. Harm reduction advocates are a thriving, international community of people from all walks of life and all professions that believes that nothing could be more important than helping people who use drugs reduce their risks of things like contracting diseases and dying. We also have strong feelings about ending the war on drugs. Talk to us and learn more.
Meghan Ralston is a drug policy consultant in Palm Springs, CA. She is the former harm reduction manager for the Drug Policy Alliance.