To End Opioid Crisis, We Must Rely on More than "Just Say No"

Hayne Yoon Former Federal Policy Director
Oct 27, 2017

Yesterday, a national public health emergency was declared as a response to the opioid crisis that is ravaging communities across the country. 

Between 1999 and 2015, the number of opioid deaths in the U.S. quadrupled, and 2016 saw a new record of 33,000 opioid overdose deaths that year—an average of about 100 deaths per day.

While this announcement allows certain waivers of federal regulations and grants increased flexibility to states in terms of how they can use federal funding, it stops short of a promised declaration of a national emergency. It also remains unclear how much federal support will be made available for critically important access to treatment, particularly for incarcerated people.

Almost one quarter of already-incarcerated individuals with substance use disorders struggle with opioid use, and many are particularly vulnerable to overdose and death once they are released from the justice system.

Proven, evidence-based treatment for addiction—and strategies such as medication-assisted treatment (MAT)—can significantly reduce deaths, especially when they are available at various stages of the justice system. MAT programs use medication (methadone, buprenorphine, and naltrexone) in addition to counseling and behavioral therapy to treat substance use disorders.

If state and federal policymakers are serious about implementing meaningful reform to mitigate one of the worst drug crises in American history, they need to invest critical funds in promising treatment approaches and compassionate care, and not rely on high-profile advertisement campaigns like the failed “Just Say No” strategy.

These evidence-based strategies are already successfully being implemented in some of the places hit hardest by the opioid crisis.

A report Vera will release in the coming weeks describes how West Virginia, which leads the nation in opioid use and overdose deaths, is both an epicenter of the opioid crisis and a promising case study of how the justice system can improve its response. As a result of the state’s participation in the federal Justice Reinvestment Initiative (JRI), West Virginia passed the Justice Reinvestment Act and a series of other laws from 2013 to 2016 that paved the way for a significant investment in community-based treatment, including MAT programs throughout the criminal justice process.

While recent efforts nationwide are still at an early stage, the key to their success will rely in part on removing the stigma and lack of understanding around addiction that forces an emphasis on abstinence-based programs, rather than MAT programs. Put simply, America's approach to the opioid crisis isn't working because it treats addiction as a crime rather than as a public health problem. To successfully end the crisis, that must change.