Recently, a state district court in Oklahoma ruled that Johnson & Johnson must pay $572 million to fight the opioid epidemic its marketing practices helped cause.
In the weeks since, it’s become clear that the decision is just the beginning. Most states and almost 2,000 cities, counties, and tribal governments have filed similar lawsuits against opioid manufacturers and distributors. And the Sackler family, owners of OxyContin maker Purdue Pharma, has reportedly been negotiating with state attorneys general on a potential multibillion-dollar settlement to compensate states for the company’s role in fueling the nation’s opioid problem. These are strong signals that funds to fight the opioid crisis will eventually flow into public agencies.
The question is, how should government spend that money? In Oklahoma, the court was very specific: The money from J&J must be used to implement the state’s plan to address the opioid crisis, including education and treatment for addiction and neonatal abstinence syndrome. Settlement money from Purdue, if forthcoming, would probably be used similarly.
These are good investments, but not nearly enough to stem the tide.
As a society, we have been pulling drowning people out of the river, but we have not been doing enough to prevent people from falling in.
To make a real and lasting difference, we must address the trauma, hopelessness, isolation and other social issues that are contributing to an addiction crisis.
Strengthening society’s safety net may not sound targeted enough to solve a problem as complex as addiction. But this approach is in line with a well-known relationship in public health: The more a country chooses to spend on social services and other supports, the less it will spend on healthcare.
People with ready access to jobs, safe housing and nutritious food tend to be healthier. And the evidence suggests that meeting those basic needs, along with positive relationships and social support, also protects people against developing or relapsing into a substance use disorder.
There are efforts nationwide to prevent addiction by shoring up the social determinants of health.
Last year, New York Gov. Andrew Cuomo’s office and Northwell Health, the state’s largest health system, worked with Staten Island Borough President James Oddo to launch a program to prevent substance use by building resilience and coping skills among the island’s school children. At the state level, New York’s 2019-20 budget includes a tax credit program for employers who hire people recovering from substance use disorder. Elsewhere, the Appalachian Regional Commission recently announced $6 million in grants to organizations in Kentucky and West Virginia that offer job training to people in substance use recovery programs.
If court decisions ultimately provide states with resources to help them recover from the opioid epidemic, they should certainly invest in the evidence-based treatment that we know saves lives. But they must do more.
They must have a comprehensive strategy that helps people develop a sense of purpose, build community and resiliency, and live healthier lives.
The education system, foster care and the court system must be incorporated into an overall plan that recognizes we are in a crisis that touches every aspect of our community, rather than operating on their own disconnected tracks. The same goes for infrastructure projects like economic development, neighborhood revitalization and job training. We must also address the generational toll the criminalization of drug use has taken, particularly in communities of color and among people who are already struggling to make ends meet.
Today we are dealing with opioids; tomorrow, if we don’t take a strategic approach, we will be dealing with something else. To recover from this crisis and prevent the next one, we must invest in creating resilient communities.
