On March 29, 2016 President Barack Obama communicated support for addressing the opiate and heroin crisis in the United States. Joined by physicians and individuals in recovery on a panel at the National Rx Drug Abuse and Heroin Summit in Atlanta, GA, President Obama announced several private and public sector supports including access to treatment, medical coverage and physician training, enforcement to combat distribution, and a number of other services. At the same time, the Centers for Medicare & Medicaid Services finalized “a rule to strengthen access to mental health and substance use disorder treatment.”
These services and supports are specific to opiates and heroin and this is good news for the juvenile justice and substance use disorders fields. Why….? Let me explain.
Although the majority of adolescents present to treatment for alcohol or cannabis problems and disorders, intervening early may prevent the onset of heroin and non-prescription use of pain relievers. Adolescent use of opiates has not significantly changed in recent years; however, for transitional aged youth it has. According to the 2014 National Survey on Drug Use and Health found that as compared to the 2009 rates, past year heroin use among 18 to 25 year olds has significantly increased (0.5 vs. 0.8). Additionally, the Center for Disease Control (CDC) reported a 14% increase in opioid overdoses in one year. Providing the necessary services and supports to adolescents and their families involved with the juvenile justice system, including education of heroin and opiate addiction, has the potential to change these significant increases in use and deaths.
Why else is this good news? If you listen to conversation about this issue – it has a very different tone and message. It elevates opiate and heroin addiction and recovery as a public health versus a criminal issue. Having a national discussion about addiction and recovery in which youth and families are not criminalized for substance use disorders, but rather, offered prevention, support, treatment, and recovery is an important shift and one that is likely to improve health and related outcomes.
It has been argued that shifting demographics and increased use and overdose rates among suburban white youth has been a catalyst for the policy and practices changes. While that is a valid observation, there are a number of factors influencing these changes including our better understanding of addiction, increased identification of individuals in need through screening, brief intervention, and referral to treatment (SBIRT), effective medications and behavioral treatments, increased availability and simplicity of Narcan to reverse overdose, improved community responses, and better training and practices for law enforcement. Yet, we must continue to be vigilant in reducing public health disparities in access to effective treatment and supports. We need to ensure and advocate for fair distribution of resources to all communities affected by heroin and opiates. And, we should use this opportunity to change the paradigm that criminalizes individuals struggling with substance use problems and disorders by increasing the availability of culturally and linguistically responsive evidence-based prevention, treatment, and recovery supports for youth and families.