Jun 24, 2023 5 min read

We traveled to New Jersey last weekend for a memorial service.

The “celebration of life” was for my 40-year-old nephew, who passed away several weeks earlier. My sister and her husband chose a serene outdoor setting to accommodate over 100 friends and family who came to pay their respects.

I was honored to give remarks, along with other family members and close friends. There were more smiles than tears because of the mood set by my sister. She wanted to celebrate her son’s life and his many achievements, not the darker side of his story or the cause of his death. The only hint that the cloud of addiction was involved were the many young people in recovery who attended the service, along with my sister’s Nar-Anon group that has offered support to her and my brother-in-law for many years.

Upon reflection, I knew that I should be pleased that my nephew’s life had been honored in such an uplifting manner. After all, he had achieved a great deal, helped many other addicted people find recovery, and brought happiness to hundreds of people he met along his path. In addition, such ceremonies are primarily designed to console those grieving, not to bring attention to the cause of death.

However, I also knew I could not disregard the manner in which my nephew died. I continue my own recovery from the shackles of alcoholism, and my cousin, who also spoke at the service, is recovering from opioid abuse. It took each of us many years to find sobriety. If one untimely memorial service can be avoided by what I have to say, it will be worth it.

To put matters into perspective, 46 million Americans now suffer from addiction. In 2022, nearly 110,000 people died from drug overdoses in the United States. More than 75,000 of these deaths involved the synthetic opioid fentanyl. This yearly figure is equal to the total number of American combat casualties in the World War II campaign against Japan. Drug overdoses are the leading cause of death for those under age 50.

At the national level, Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, said in a recent statement, “We’ve expanded treatment to millions of Americans, we’re improving access to Naloxone to reverse overdoses, and we’re attacking the illicit fentanyl supply chain at every choke point.” Despite these efforts, the deaths keep piling up.

What is to be done? Addiction has long been a scourge in America, but fentanyl has made it much worse. Fifty times stronger than heroin, fentanyl is commonly mixed with other drugs or made into pills to resemble other substances. Unsuspecting users are unaware that the drug they are ingesting is laced with fentanyl, which makes up a large portion of the overdoses leading to death.

America’s long war on drugs and its “just say no” campaigns have failed to have any impact on drug use. Today, 20% of those in their 20s report having used ecstasy or similar substances, all of which could now contain fentanyl. Gupta, our national drug czar, believes the opioid crisis affects our public health, national security, and economic prosperity like no other issue.

In the short term, there are only two known defenses. First, rapid fentanyl test strips are inexpensive and provide a potential user with results before ingesting any drug that could contain fentanyl. Second, the medication, naloxone, can prevent death if administered quickly following an overdose.

These two harm-reduction strategies, which promote safer and managed use of drugs as opposed to abstinence, can successfully combat fentanyl deaths. It is now time for elected officials to take aggressive action to protect families by investing in solutions that actually save lives.

Both test strips and naloxone should be provided free of charge, in adequate quantities where young people gather or where drug use is probable, including schools. These items should also be made available in pharmacies without a prescription. In order to stem the tide of deaths, it may also become necessary to make fentanyl use legal so that it can be regulated for safety and quality.

On a broader scale, states and local governments must develop programs to reduce drug use in general. This would include the prevention of inappropriate opioid prescribing, monitoring opioid dispensing, and more treatment centers for those who become addicted.

In the longer term, the United States must move beyond recovery treatment centers designed only to change individual behaviors. Research must be done to examine the underlying social determinants of drug use. Our country’s incidence of drug addiction is higher than the rest of the world for a reason. It has little to do with smuggling drugs at a porous southern border. Possible causes include both parents working longer hours, inadequate childcare, the adolescent drug culture, and inadequate educational opportunities.

We need a national effort with all hands on deck to develop a broad understanding of the complex developmental and social issues associated with the increase in addiction. This plan must be as committed as our efforts to defeat cancer, Alzheimer’s disease, and COVID-19. The more than $1 billion that states, including Pennsylvania, have received from pharmaceutical companies from the national opioid settlement offers hope in this regard.

The development of evidence-based programs designed to keep families safe must lead the way. Otherwise, unnecessary celebrations of life like my nephews will continue unabated.

Gary Stout is a Washington attorney.