In 2016, I was advocating on Capitol Hill for passage of the Comprehensive Addiction and Recovery Act (CARA). It was the first piece of major legislation on the addiction issue in decades. The funding amount in the bill was small, but it was something. It was recognition and it was a sign that finally, there was hope for a robust response to the addiction crisis from the federal government.
My friends and fellow advocates, Bill Williams and Margot Head, were with me for meetings with legislators. They lost their son to an overdose in 2012. I remarked to them that I couldn’t imagine pounding the pavement and telling my story like they had done, over and over again. They responded: “we’re just at the starting line and we’re wearing comfortable shoes.”
As we look to the current federal response to the addiction crisis, knowing there’s been a 40% increase in fatal overdoses amidst the COVID-19 pandemic, we need to remember that we’re just getting started. While Shatterproof advocates for common-sense policies to save lives, like removing the waiver requirement for prescribing buprenorphine, we also need to double down on what we know works and what needs to be tested.
The federal government and states should not hesitate to invest in innovative solutions that support rather than punish people with addiction. We’re seeing some of this already. In fact, SAMHSA’s recently announced that states can use state opioid response dollars to pay for fentanyl strips. With this announcement, they are sending a clear signal that we need to be doing more to save lives—now. This means widespread distribution of naloxone, mobile crisis units, support and services—not criminalization.
In addition to the announcement about fentanyl test strips, the Biden-Harris Administration released key priorities for year one, which include expanding access to evidence-based treatment, advancing racial equity issues in our approach to drug policy, enhancing evidence-based harm reduction efforts, supporting evidence-based prevention efforts, and expanding access to recovery support services. Notably, the statement highlights the importance of removing barriers to prescribe buprenorphine and recognizes that stigma is another barrier to treatment. The administration has now followed up on this important topic by issuing practice guidelines that will make it easier to prescribe buprenorphine.
We at Shatterproof commend the Biden administration for the steps it has taken to reverse the addiction crisis. But there’s so much more that needs to be done. The addiction crisis is a public health epidemic. In these situations, federal investment and direction is critical. Take the HIV/AIDS crisis, for example. Currently, the HIV/AIDS prevention and response efforts are appropriated at $28 billion per year. This level of investment has made a powerful impact: reported new HIV infections are 36,000 as of 2018, down from 130,000 per year in the mid 1980s.
Congress has provided significant funding increases in response to the opioid crisis and the impact of COVID on addiction. We must demand that this funding be provided, and increased if necessary, until the problem is reduced. But we also must ensure this funding is tied to quality metrics and incentivizes evidence-based solutions. Dollars, while critical, are not enough. We need to allow for effective treatments for stimulant use disorder, like contingency management. We need to remove the buprenorphine waiver requirement permanently. We need to educate families and eradicate stigma. We need to educate medical professionals on the treatment of addiction. And we need YOU to make your voices heard so that these changes happen.
We need more Bill and Margots to fight for these reforms and to remind the people in positions of power of what needs to change. I’ll be wearing comfortable shoes too. Will you join us?
Courtney Gallo Hunter is Shatterproof’s Vice President of State Policy