Addressing the root causes of drug abuse

The COVID-19 pandemic has done nothing to slow the nation’s epidemic of drug abuse, especially opioids like heroin, methamphetamine, and fentanyl. The current WORLD Magazine cover story reports that the problem has only grown: “The American drug crisis,” Emily Belz writes, “is now at its worst point ever.”

Belz cites recent data from the Centers for Disease Control and Prevention indicating that there were more than 100,000 deaths due to drug overdose in our nation in 2020, a sad new record. Those numbers represent nearly a 30 percent jump from the previous year, confirming the American Medical Association’s recent report stating, “The nation’s COVID pandemic made the nation’s drug overdose epidemic worse.”

This heartbreaking number of deaths reveals an ugly truth: The pandemic accelerated the root causes of America’s opioid addiction: loneliness, joblessness, and purposelessness. Belz reports that the experts she talked to offered a number of reasons for the spike, “ranging from general isolation, to government unemployment checks keeping people out of recovery, to the dopamine effects of social media raising addictive tendencies, to the overall feeling of societal uncertainty.”

To solve the drug crisis, we need to recognize that the sickness starts not only in our bodies but also in our culture. And the solution to those social diseases is cultural as well as medicinal.

The last time this country focused on a drug abuse crisis, targeting substances like cocaine and marijuana, our response was aggressive: The government declared a war on drugs that deployed heavily armed cops at home and U.S. soldiers abroad. This time around, our response has been primarily medical rather than criminal: We talk about addiction as a disease and treat it with chemical inhibitors and in-patient therapy.

In the first war on drugs, from the late 1980s into the 1990s, the emphasis was on the supply side of the problem: going after the growers in South America, the traffickers bringing drugs into the United States, and the dealers pushing it on the streets. Besides first lady Nancy Reagan’s “Just Say No” campaign for students, we did little to reduce the demand side of the drug crisis, which is always more difficult.

In the case of opioids, we are doing more than before to confront the demand side of the equation, for instance, through prescriber education and monitoring. Addressing addiction as a medical challenge is a good starting point, and we can reduce demand with more doctors and patients treating opioids with appropriate respect. But the reality is that only a slice of opioid abuse starts with an appropriate, legal prescription for short-term pain management spiraling into addiction. More often, addiction begins in other situations: a stressed-out healthcare worker diverting opioids for a quick release, a short-term pain management prescription followed by a desire for a street drug, or a drug user upgrading from marijuana to heroin. And as the AMA points out, today’s drug crisis is far more about illegal street drugs than diverted prescription drugs.

In these cases, addiction is a symptom of a deeper disease. The good feelings or the numbness from feeling that comes with opioids block out harder realities, like deep-seated loneliness, lack of economic opportunity, and a general absence of dignity and hope. A prescription drug management program or continuing medical education course cannot fix those cultural maladies.

Cultural diseases require cultural cures: faith, family, community, and work. Those are much tougher for policymakers than enacting broadly bipartisan bills funding additional care centers or mental health professionals. But they are needed.

Moreover, cultural cures also work best for supporting addicts through intervention, treatment, and recovery. It’s family, friends, and coworkers who are best positioned to identify when someone is acting abnormally and sliding into addiction. Confronting someone is incredibly hard, a “speak the truth in love” sort of moment that is much more possible in the context of strong, committed relationships. And such a tough conversation with a loved one is far better than hitting rock bottom in a police station or hospital emergency room.

As Belz points out in her WORLD cover story, it is often faith-based programs like Teen Challenge, Addicts Anonymous, or Celebrate Recovery meeting in church basements with peer coaches that can effectively (and affordably) sustain recovery. And engaging addicts in meaningful work is far more likely to prevent relapse than a life of pity parked in front of a television, computer, or gaming screen.

These are just three simple examples of a basic truth: Faith, family, community, and work are what we all need and are the best solution when drugs or other substitutes try to fill those holes in our lives. Lord-willing, when this COVID pandemic passes and policymakers return to dealing with other issues like the opioid crisis, they can focus on the harder work of fixing our culture and not just funding more safe-injection sites.