The Federal Under-Response to the Overdose Epidemic

Using some already appropriated funds, the White House Office of National Drug Control Policy is allocating $2.5 million to support public health approaches to the heroin epidemic. Meanwhile HHS Secretary Burwell is asking Congress for $133 million to respond to the overdose epidemic and a bipartisan group of legislators has proposed their own $80 million Comprehensive Addiction and Recovery Act.

Blessings on all their heads, but it says a lot about Washington D.C. these days that we are responding to the biggest epidemic in a generation with such small-scale federal actions. Overdoses are killing more Americans each year than the AIDS epidemic did at its peak (in 1995 AIDS claimed 41,700 American lives). The federal government responded to HIV/AIDS on the massive scale required, both at home and abroad. Federal appropriations to respond to HIV/AIDS were in the billions, with the result being the saving of millions of lives.

But in this era where lack of faith of the federal government is widespread and the bulk of Members of Congress will not open the federal pocketbook even in the face of a historic emergency, even the biggest proposal is but a fraction of what was spent to respond to AIDS. Those who are showing the courage to rise to the challenge of overdose deaths are being forced to fight a dragon with a rubber sword.

Will 2016 bring anything different? So far only one Presidential candidate has grasped the nettle: Hillary Clinton. She has just rolled out a $10 billion multi-year initiative on addiction, which reflects that she appreciates the scale and gravity of the problem. With some noble exceptions, the national media responded mainly by…covering her emails more. But her plan may resonate in New Hampshire, where I am informed that some polls show that addiction is outpolling the economy when voters are asked what issues concerned them most. Clinton deserves credit for her leadership. The other candidates in the race should also lay out their vision given that addiction and overdose could well be the biggest public health problems that the next president has to face.

[Cross-posted at The Reality-Based Community]

Keith Humphreys

Keith Humphreys is a professor of psychiatry at Stanford University. He served as a senior policy advisor at the White House Office of National Drug Control Policy from 2009 to 2010.