Due to growing rates of substance abuse — both in the United States and abroad — each year seems to bring even more disturbing addiction-related headlines than the last. However, there’s actually been quite a lot that happened in 2016 besides the just growing opioid addiction epidemic. In particular, we have a new president-elect, our neighbor-to-the-north has legalized certain forms of prescription heroin, and a study has confirmed that one reason the average life expectancy for Americans is shrinking is the prevalence of alcohol and drug abuse in the U.S. Believe it or not, this is just the tip of the proverbial iceberg.
Addiction is a disease that kills indiscriminately, affecting the entire demographic spectrum. Every life lost to this disease is an unspeakable tragedy that deserves our attention. Each year, many lives are lost to addiction — over half a million in the U.S. alone1 — making substance abuse one of the top causes of premature death. In honor of the many individuals who have lost their lives to addiction as well as those who continue to struggle with this disease, let’s conclude 2016 by taking a look back on some of the year’s top headlines that brought greater awareness to a national and global problem affecting us all.
Drug Overdose a Major Cause of Americans’ Shorter Life Expectancy
In February, the Journal of the American Medical Association published a report on a study of American life expectancy. According to the report, elevated rates of drug-induced deaths in the U.S. is one of three main contributors to the shorter life expectancy of Americans compared to virtually all other developed nations.
“According to the report, elevated rates of drug-induced deaths in the U.S. is one of three main contributors to the shorter life expectancy of Americans compared to virtually all other developed nations.”
The study found that American men live for an average of 76.4 years while American women life for an average of 81.2. By comparison, the average age for men and women, respectively, in countries like Denmark, Japan, Portugal, Sweden and the United Kingdom is 78.6 and 83.4. Consistently, Americans live for two years less than their European and Asian counterparts. Andrew Fenelon — lead researcher of the study and senior service fellow for the National Center for Health Statistics at the Center for Disease Control and Prevention — said, “About 50 percent of the [discrepancy] for men and about 20 percent for women is due to [drug overdoses, car crashes and shootings].”2
Dr. David Katz, who is president of the American College of Lifestyle Medicine and director of the Yale University Prevention Research Center, explicitly stated why this research was so important. “We have long had clear evidence that life expectancy in the U.S. lags behind many of our peer countries around the world, and now we know why,” Katz said. “The nation is slowly, but inexorably, directing more attention to the crisis of drug abuse. Whether or not the cold, hard calculus of epidemiology is enough to provoke meaningful action… remains to be seen.”
Supervised Injection Facilities May Be Coming to the U.S.
Between 2002 and 2013, heroin overdose deaths in the United States have increased by approximately 286 percent, according to statistics published by the Center for Disease Control and Prevention.3 To date, supervised injection has largely been overlooked in the U.S. despite some success that these programs have had internationally. The problem is likely the controversy that surrounds the idea of supervised injection. Rather than helping addicts get sober, supervised injection facilities are based on the philosophy of harm reduction. Individuals can bring their own drugs to these facilities where they can inject their drugs under supervision.4 In effect, this scenario minimizes the dangers involved in intravenous drug use because it reduces the improper disposal of used syringes, the likelihood of injury during injection and the risk of overdose deaths.
While about 100 supervised injection sites are available in countries like Germany, the Netherlands, Australia, Spain and Canada, it’s only recently that supervised injection has gained traction among American legislators. Currently, legislation is either pending or being drafting in the states of New York, California and Washington. But if supervised injection sites are in Americans’ futures, it’s not likely to be approved anytime soon. Those who oppose supervised injection view this strategy as encouraging continued heroin use while providing very little incentive to get sober.
However, Dr. Marianne Jauncey — director of the Sydney Medically Supervised Injection Center in Australia — recalls how her facility was opened only on a trial basis to assess what effects supervised injection would have on the greater community. “If it was going to cause an increase in deaths, or discarded needles, or an increase in drug taking, or an increase in crime,” Dr. Jauncey said, “we would have stopped.”5 Instead, the facility has had immense success and hasn’t had a single overdose death in the 15 years since the doors of the establishment first opened. Although opponents have many reasonable objections, the positive results of supervised injection programs could be promising for the U.S., making this unconventional strategy worthy of consideration.
New Guidelines for Prescribing Pain Medication
By most standards, the current heroin epidemic was set into motion in the 1990s with the advent of OxyContin. The extremely powerful and highly addictive prescription painkiller was the epicenter of the prescription drug problem that overtook the U.S. throughout the 2000s. At the time, there were very few systems in place that prevented individuals from obtaining duplicate prescriptions of opioids by seeing multiple doctors, oftentimes in other states or even on the other side of the country. Almost inevitably, many of the people who became addicted to prescription painkillers switched to cheaper, more powerful, and more accessible heroin, which is the predicament in which we find ourselves now.
However, the U.S. government has continued to devise new ways of ensuring the difficulty of obtaining prescription drugs from physicians for the purposes of abuse. Earlier this year, the Center for Disease Control and Prevention released new guidelines for physicians to ensure that the individuals to whom they’re prescribing controlled substances aren’t misusing them. Perhaps the most important — and long overdue — guideline is for physicians to implement drug testing prior to writing prescriptions to ensure that patients don’t have any unauthorized substances in their system,6 which would indicate substance abuse. As well, physicians and providers are strongly encouraged to cross-reference patients with the prescription drug monitoring databases available to add another layer of security. These databases not only track the prescribing and dispensing of medications, but they typically also include a detailed history of the medications a patient has previously taken.
President Obama Doubles Down on Opioid Addiction
Mitigating the current opioid problem has been a priority to most public officials, but few embody this objective to the same extent as President Barack Obama has throughout the year. In the spring, President Obama requested approval from other branches of government to provide $1.1 billion in funding to expand medication-assisted addiction treatment programs in the United States. Historically, medication-assisted addiction treatment has been somewhat controversial. However, Suboxone and methadone maintenance programs are consistently one of the most successful forms of addiction treatment when it comes to mitigating overdose deaths and the many other risks associated with substance abuse.
$1.1 billion requested by President Obama in 2016
In a statement from the White House, it was said that addressing the opioid crisis is “a priority for [the Obama] Administration.”7 Further, the increased funding for medication-assisted opioid treatment was meant to expand access to treatment nationwide, prevent overdose deaths and increase community prevention strategies.
These efforts continued late into the year with the proclamation of the third week in September as Prescription Opioid and Heroin Epidemic Awareness Week. In the official press release, President Obama said, “During Prescription Opioid and Heroin Epidemic Awareness Week, we pause to remember all those we have lost to opioid use disorder, we stand with the courageous individuals in recovery, and we recognize the importance of raising awareness of this epidemic.”8 Sure enough, many news outlets reported on communities participating in awareness week activities across the country.9
Heated Presidential Campaign of 2016
The campaign leading to the presidential election of 2016 was surely one of the most heated in recent memory. For more than a year, much of the U.S. watched Secretary of State Hillary Clinton and TV personality/business mogul Donald Trump — our democratic and republican candidates, respectively — trade blows in debates and campaign materials. In addition to Secretary Clinton’s email scandal and the questioning of Trump’s morality, there were a number of specific social and cultural issues to be addressed over the course of the presidential campaign, including the present addiction epidemic. Understandably, it became quite important to find out each candidate’s stance on the matter.
Secretary Clinton’s proposal was to allocate approximately one billion dollars annually to the treatment of addiction.10 Over the course of ten years, Clinton had hoped to see no less than $10 billion put toward helping those currently suffering from addiction. Additionally, Clinton had conservative views with regard to bringing the war on drugs to a full close and with legalization. In particular, Clinton opposed the nationwide legalization of recreational marijuana and proclaimed to need more research on the matter before she would consider legalization at the federal level. However, while Clinton may have opposed nationwide legalization, she was in favor of decriminalization, particularly for marijuana for which there are many American inmates serving prison sentences.
During the presidential campaign, Donald Trump echoed many of Secretary Clinton’s sentiments with regard to addiction, legalization and the war on drugs. Many of Trump’s statements on the campaign trails expressed his concern about legalizing marijuana for purposes other than medicinal or therapeutic use. However, since his victory, Trump has expressed very different and somewhat disturbing views. Trump recently had a discussion with Philippine President Rodrigo Duterte during which Trump allegedly praised Duterte for how he has handled the drug problem that has been occurring in the Philippines.11 Reports currently estimates that several thousand Filipinos have been killed as part of Duterte’s zero-tolerance stance on drugs.12 In fact, Duterte openly stated his intention to have all individuals who are involved with drugs in the Philippines either incarcerated or killed.
It’s uncertain whether Trump’s praise of Duterte’s brutal war on drugs was genuine and representative of his own intentions or whether it was part of Trump’s plan to improve relations with the Philippines. Whatever the case may be, this is a development we should continue to track as we head into the new year with the new president.
While these represent only a small sample of the addiction-related headlines from this year, they’re surely among the most important. If there’s anything we can glean from the year’s biggest moments for addiction awareness, it’s that change is in the air. Although addiction has become a bigger problem than we had ever dreamed it could be, we may have never been closer to new, exciting solutions.
It’s with cautious optimism and hope that we look to the new year.
Written by Dane O’Leary