Last weekend we traveled to New Jersey for a memorial
service. The “celebration of life” was
for my forty-year-old nephew, who passed away several weeks earlier. My sister
and her husband chose a serene outdoor setting to accommodate over one hundred
friends and family who came to pay their respects.
I was honored to give remarks, along with other family
members and close friends. There were more smiles than tears because of the
mood set by my sister. She wanted to celebrate her son’s life and his many
achievements, not the darker side of his story or the cause of his death. The
only hint that the cloud of addiction was involved were the many young people
in recovery who attended the service, along with my sister’s Nar-Anon group
that has offered support to her and my brother-in-law for many years.
Upon reflection, I knew that I should be pleased that my
nephew’s life had been honored in such an uplifting manner. After all, he had
achieved a great deal, helped many other addicted people find recovery, and
brought happiness to hundreds he met along his path. In addition, such
ceremonies are primarily designed to console those grieving, not to bring
attention to the cause of death.
However, I also knew I could not disregard the manner in
which my nephew died. I continue my own recovery from the shackles of
alcoholism, and my cousin, who also spoke at the service, from opioid abuse. It
took each of us many years to find sobriety.
If one untimely memorial service can be avoided by this commentary, it
will be worth it.
To put matters into perspective, 46 million Americans now
suffer from addiction. In 2022, nearly 110,000 people died from drug overdoses in the United States. More than
75,000 of these deaths involved the synthetic opioid fentanyl. This yearly
figure is equal to the total number of American combat casualties in the WWII
campaign against Japan. Drug overdoses are the leading cause of death for those
under 50.
At
the national level, Dr. Rahul
Gupta, director of the White House Office of National Drug Control Policy, said
in a recent statement, “We’ve expanded treatment to millions of Americans,
we’re improving access to Naloxone to reverse overdoses, and we’re attacking
the illicit fentanyl supply chain at every choke point.” Despite these efforts,
the deaths keep piling up.
What is to be done? Addiction has long been a scourge in America, but fentanyl
has made it much worse. Fifty times stronger than heroin, fentanyl is commonly
mixed with other drugs or made into pills to resemble other substances.
Unsuspecting users are unaware that the drug they are ingesting is laced with
fentanyl, which makes up a large portion of the overdoses leading to death.
America’s long war on drugs and its “just say no” campaigns have failed
to have any impact on drug use. Today, 20 percent of those in their twenties
report having used ecstasy or similar substances, all of which could now
contain fentanyl. Gupta, our National Drug Czar, believes the opioid crisis affects
our public health, national security, and economic prosperity like no other
issue.
In the short term, there are only two known defenses. First, rapid
fentanyl test strips are inexpensive and provide a potential user with results
before ingesting any drug that could contain fentanyl. Second, the medication,
naloxone, can prevent death if administered quickly following an overdose.
These two harm-reduction
strategies, which promote safer and managed use of drugs as opposed to
abstinence, can successfully combat fentanyl deaths. It is now time for elected officials to take aggressive
action to protect families by investing in solutions that actually save lives.
Both test strips and naloxone should be provided free of charge, in
adequate quantities where young people gather or where drug use is probable,
including schools. These items should also be made available in pharmacies
without a prescription. In order to stem the tide of deaths, it may also become
necessary to make fentanyl use legal so that it can be regulated for safety and
quality.
On a broader scale, states and local governments must develop programs to
reduce drug use in general. This would include the prevention of inappropriate
opioid prescribing, monitoring opioid dispensing, and more treatment centers
for those who become addicted.
In the longer term, the United States must move beyond recovery treatment
centers designed only to change individual behaviors. Research must be done to examine the
underlying social determinants of drug use. Our country’s incidence of drug
addiction is higher than the rest of the world for a reason. It has little to
do with smuggling drugs at a porous Mexican border. Possible causes include
both parents working longer hours, inadequate childcare, the adolescent drug
culture, and inadequate educational opportunities.
We need a national effort with all hands on deck to develop a broad
understanding of the complex developmental and social issues associated with
the increase in addiction. This plan must be as committed as our efforts to
defeat cancer, Alzheimer’s disease, and COVID-19. The more than $1 billion that
states, including Pennsylvania, have received from pharmaceutical companies from
the national opioid settlement offers hope in this regard.
The development of evidence-based programs designed to keep families safe
must lead the way. Otherwise, unnecessary celebrations of life like my nephews
will continue unabated.