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Addressing America’s Opiate Crisis Should Involve Making People Responsible For Their Behavior

How long and to what degree must Americans backstop people suffering the entirely predictable result of their own self-destructive behavior?


Sheriff Richard K. Jones of Ohio’s Butler County says his deputies won’t carry Narcan, a drug that can almost miraculously reverse overdoses of heroin and opiate pain medications that might otherwise be fatal. At nearly $40 a dose, the drug (known generically as naloxone) is too expensive to keep using on the same drug abusers, Jones says.

“All we’re doing is reviving them. We’re not curing them. One person we know has been revived 20 separate times,” he told NBC. It’s “sucking the taxpayers dry.”

Naturally, the sheriff is being pilloried for wondering how long and to what degree society must backstop people suffering the entirely predictable result of their own self-destructive behavior. Beyond that, the situation serves as a spectacularly apt metaphor for America’s approach to social disorders and welfare spending generally.

When Helping Hurts Everyone

As a nation, we’re committed to alleviating suffering, and have been for decades. The non-partisan Congressional Research Office puts welfare spending at a bit over $1 trillion a year, the largest single budget item.

Reasonable people can disagree about exactly what constitutes “welfare” spending and how successful it is in all its hydra-headed forms. And we can argue about the definition of “success,” whether it means curative efforts or mere hold-the-line palliative work that eats resources and temporarily eases suffering while ignoring underlying problems of morality, ethics, and behavior.

But as we dispute these matters, we continue to excavate an infrastructure hole the American Society of Civil Engineers estimated in March is deep enough to swallow, oh, $3 trillion or so, and growing faster than we can shovel money into it. So it seems fair to wonder if all our welfare spending isn’t the Narcan of government outlays—endlessly serving the same people, doing nothing to alter their behavior, and sucking up vast sums that would do more good for more people if applied elsewhere. Are we being undone by our best impulses to help those who can’t or won’t rein in their own worst?

Don’t Socialize Some People’s Bad Decisions

The scourge of opiate addiction has hit particularly hard here in the Midwest, where we like to think of ourselves as industrious and sober. People who would never have imagined themselves seeking out a drug pusher find themselves returning to their doctors again and again to maintain their access to their drug of choice. When the supply dries up, some turn to the illegal, expensive, but readily available alternative, heroin.

Ironically—and significantly—we were started down this path by well-meaning doctors who thought they were helping. Just as the devil can quote scripture for his purposes, it seems he can also turn our best intentions to his own ends.

This summer George Washington University in the nation’s capital hosted “America’s Opioid Crisis: A National Town Hall.” Attendees talked treatment, for the most part. The convening organization was the Hazelden Betty Ford Institute for Recovery Advocacy, and the experts taking part were drawn heavily from the helping industry; several are recovering themselves or have lost loved ones to addiction, some are members of a law enforcement unit working out of uniform so as to seem less “threatening.”

Interestingly, Hazelden’s own material reports that overdose deaths quite often involve the use of more than one drug. Often the other drug is some sort of benzodiazepine, used for anxiety disorders. In other words, many of these people are already in treatment. Given that, it seems apparent that some new approach is needed — maybe something on the order of the author Tom Wolf’s “great re-learning” that would get back to the fundamental truth that our bad choices are as undeniably and individually our own as the consequences.