We Have a Problem

Just as many of us were gathering to celebrate the holidays with families and friends, the Centers for Disease Control and Prevention released its annual report on the toll of the opioid crisis in 2016. While drug overdose deaths are up a shocking 21 percent from 2015, the death toll is even higher among fifteen- to twenty-four-year-olds.

These grim numbers show an escalating deadly crisis that is far from under control and that is taking a particularly brutal toll on our teenagers and young adults. Yet, despite the dire consequences, this public health epidemic is mired in a fragmented and tepid national response.

As a social scientist who has spent decades tackling major public health issues such as HIV/AIDS and addiction, I see a clear and distressing pattern in how our country addresses these crises. Our cultural disposition is to initially place blame and responsibility solely on the afflicted—or addicted—individual.

This accusatory mindset leads to a disproportionate emphasis on criminalizing the behavior, rather than addressing it as a societal problem that we all must own. We stigmatize and shame. We punish and incarcerate. We expect the addicts to find their own solutions. It is their problem, not ours. This approach further contributes to these public health crises spiraling out of control, as we now see with opioids. We only unite in a belated societal call to action when a crisis reaches epic proportions. It is time to break this dangerous pattern.

We witnessed the same initial condemnation of a public health epidemic in the early days of the HIV/AIDS crisis. At the onset, much of the public blamed the individual for his or her diagnosis.

Both with HIV/AIDS and opioid addiction, the result is not just loss of opportunity and life. It is also the erosion and dissolution of entire communities—from lost wages to unaffordable health care costs and broken families.

In my native country, the Netherlands, as well as in other European countries, the response to opioid addiction is pointedly different. Addiction is seen from the start as a mental health issue that requires education, outreach, treatment, and sustained collaborative action. Officials seek to rehabilitate and heal drug abusers, not to discard them. The culture supports a collective effort in which everyone plays a role in turning the tide.

Even though there is finally a long-overdue national awakening to our opioid epidemic, the financial and social impact of a crisis that has been brewing unchecked is daunting. But what keeps me up at night is the long-term impact the crisis could have on our youth. An entire generation is growing up believing that prescription pills are more often than not the go-to remedy for all ills. The line has blurred between legal and illegal use.

When we treat addiction from the very beginning as an illness rather than a crime, we can then take a more comprehensive and collaborative approach. At Emory, we are working with businesses, government, and public health agencies, particularly in the Southeast, to bring together stakeholders across the region to share ideas and combine efforts. Because of our unique role in society, universities can—and must—be leaders not only in education and research, but in helping build a national consensus around how we address public health crises.

That consensus begins with an understanding that what our society lacks in the early stages of a public health epidemic is a collective willpower. As long as the problem is “theirs” and not “ours,” we will waste precious time, resources, and, most important, lives in criminalizing instead of stemming the crisis.

Just as we finally came together to bring the HIV/AIDS epidemic in the US under control, we are now slowly making a paradigm shift in our societal commitment to fight the opioid epidemic.

But when this crisis abates, we must step back and face our initial base instinct to adopt an “us-versus-them” mentality when it comes to public health issues. We cannot wait until a public health crisis has caused monumental damage and touched every segment of our society until we make it our own.