On May 12, 2015, two police officers from Newark, NJ, rang our doorbell. They told us that our 25-year-old son, Alex, had died. “Heroin,” they said, “probably yesterday morning.” We had many horrible days during Alex’s years of mental pain and addiction, but this day stands out the most in my memory.
The overdose crisis is called an “epidemic.” The metaphor is reasonable. Researchers in the American Journal of Public Health found that more than one in eight Americans have had their lives destroyed by a drug overdose death. In the last 12 months, nearly 110,000 Americans died of an overdose. I’ve heard President Biden’s drug envoy, Rahul Gupta, compare these deaths to a 737 crashing into the Potomac every day. Whatever the true number, the number of deaths and misery from overdoses is enormous. And the outrage is much lower than we would expect given such a high death toll.
For the first time in years, I have reason to hope. I’ve been writing about addiction and loss since 2015.. When Alex died, I was a sociology professor at Rutgers University. I had spent much of my career researching patterns of inequality along gender and race lines. My sociological training spurred me to better understand the damage the overdose crisis had done to my family and society at large.
I write to let people know what it feels like to ride the hellish merry-go-round of addiction. I write to warn. If it happened to my family, it can happen to anyone. Look at your child and imagine them injecting heroin or taking fentanyl. It’s hard to imagine. Until it doesn’t happen.
After Alex died, I decided to channel my grief into action. I found writing therapeutic, even though the grief never went away. I researched theories and treatments for opioid use and the rising number of overdose deaths. We know a lot more today than we did 10 or 20 years ago. We know that most people who use addictive substances do not become addicted. We know that current treatments are mostly ineffective. We also know that addiction is mostly a result of self-medication. But we know a lot less about why drugs destroy some lives and not others. Until we analyze that “why” question, we will continue with piecemeal interventions that pursue conflicting goals.
By connecting the personal with the sociological, I learned more about the broader range of factors associated with mental illness and substance use disorders. Rather than focusing on individual-level choices and brain diseases, I look at the larger social context in which individual-level actions take place.
The two common – and generally ineffective – solutions to the addiction problem are 12-step programs (AA, NA) and criminalization (drug courts, incarceration of users). But people and their problems are more complex than these approaches realize. For some, 12-step programs work, but for many others, they don’t. Fortunately, 12-step approaches are no longer the only solution. The smartest path is to explore multiple paths to recovery, which were almost nonexistent during Alex’s active addiction. And despite the growing realization that the war on drugs has failed, politicians who want to make headlines about tough measures on crime will never admit it. Relying on incarceration will only lead to more dead Americans, especially young Americans.
Health activists have fought for and begun to popularize policies that prioritize health care over criminal justice approaches. This is called harm reduction. Although many Americans misunderstand this, these practices have been around for years. Seat belt laws, helmets, drivers not allowed to drink alcohol, and anti-smoking efforts are examples, as is wearing masks during Covid. During the HIV/AIDS epidemic, syringe distribution reduced deaths. Today, fentanyl test strips, Samaritan Protection laws, and overdose prevention sites have proven effective in reducing overdose deaths. These strategies make the most sense when we view people suffering from addiction in the same light as people battling diabetes or lung cancer.
How can we promote recovery? How can we prevent deaths? Incarceration doesn’t work. Tough love doesn’t work.
Here are suggested solutions:
- We need to meet drug users where they are and provide them with life-sustaining medical care until they are ready to stop or reduce use. This would require reforming ineffective treatment systems and introducing proven medications for substance use disorders.
- Easy access to safe medications would also be needed. Narcan should be widely available so that more overdoses can be reversed wherever they occur.
- And looking further afield, we should also decriminalize and regulate drugs; ensure that all Americans have insurance long enough to support recovery and equal to benefits for physical ailments; and guarantee housing to anyone in need. Recovery is not possible without a place to live.
We need to turn away from failure. We need to try a different path. We need to recognize that drug users who become addicted are human. They are us.
I envision a world where compassionate, paradigm-shifting damage control is practiced. Alex might have survived if we lived in that world. If only.
Understanding how to solve the problem requires understanding the bigger, systemic picture and recognizing the constructive role that government and private partnerships can play in developing solutions. Then we can truly hope again.
About the author: Patricia A. Roos is the author of Surviving Alex: A Mother’s Story of Love, Loss, and Addiction (patroos.com), to be published May 17, 2024, by Rutgers University Press.
