For those of us who treat or study addiction, living through an epidemic is nothing new. In the last 25 days, about 800 Americans have died of coronavirus, but during that same period, an estimated 4600 have died from drug overdose. In 2017, I wrote a blog piece titled: “We should be marching in the streets over the state of opioid use disorder treatment.” Although we now suffer nearly 70,000 drug-related deaths per year and roughly half a million people have died from opioid poisoning since 1999, federal and state governments have done very little to make sure that patients with opioid use disorder have access to the type of medical treatment that is best able to prevent death and promote recovery. This past year, I was fired for criticizing the way that Missouri is spending its money, prioritizing long-standing relationships with counseling providers rather than injecting new money into the medical settings best equipped to give patients with OUD rapid access to care.
As the whole world mobilizes against coronavirus, I get it. Left unchecked it could match in six months or fewer the mortality caused by opioids in the past 20 years. We have every reason to contain it aggressively through social distancing and to mobilize all our energy, resources, and ingenuity to minimize the impact that social distancing will have on our economy. But as the US prepares to invest four trillion dollars in this effort, I am both heartened and saddened: heartened to see our typically gridlocked government take bold bipartisan action, and saddened to reflect on the nearly half a million families who have watched a love one die from opioid use disorder without similarly bold action to save their lives.
With relatively modest financial investment and sensible policymaking (#XtheXwaiver) we could ensure that every American could walk into a primary care office and receive same day medical treatment for opioid addiction with a referral to specialty care if needed. That access along with community awareness about the accessibility and effectiveness of treatment would likely bend the curve of an epidemic that has been ravaging American families and communities for the past 20 years. What coronavirus has taught us is that money is not the problem. When the stock market is threatened, our representatives can marshal unimaginable sums of money. But when it’s the lives of people addicted to drugs, they can’t ensure even the most basic access to inexpensive, outpatient medical care.
Right now, we should all be at home preventing the spread of the coronavirus. But when this quarantine is over, we should be marching in the streets over the way our leaders are betraying us with their lukewarm and ineffective response to the epidemic of drug-related deaths.