Part 1: Addiction and Recovery in America

Opioid use has risen dramatically. To reverse this trend, the solution lies in our approach to substance use

Derek Wolfe, MD
The Healing Forest Project
3 min readAug 11, 2016

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The opioid epidemic in the United States has left the nation searching for answers.

The numbers are staggering: Nearly two million people “abused or were dependent on prescription opioids” in 2014. From 1999 to 2014, the number of deaths from prescription opioids quadrupled.

National Institute on Drug Abuse

One of things that makes prescription painkillers terrifying is the chemical connection they have to heroin — which is also an opioid. When access to painkillers dries up or the price simply becomes too high, heroin can become the drug of choice for opioid users. Four out of five heroin users today started their opioid addiction by using prescription drugs first. And now, 78 Americans die every single day from opioid overdoses.

78 Americans die every day from opioid overdoses.

The dramatic rise in opiate addiction has left the Obama Administration with no choice but to address it — and it has tried. As part of President Barack Obama’s Fiscal Year 2017 budget proposal, $1.1 billion will go toward fighting the opioid epidemic, with much of the funding focused on working with states to improve access to medication-assisted treatment — a form of treatment where patients use medication to help decrease and eventually eliminate their dependency on opioids. President Obama also recently signed the Comprehensive Addiction and Recovery Act that takes similar, but less expansive steps to his budget proposal since there is no guaranteed funding.

Of course, neither CARA or Obama’s proposal addresses the millions of Americans who have reported dependencies on substances other than opioids. Alcohol addiction, for example, remains a persistent epidemic as well. According to the Substance Abuse and Mental Health Services Administration, an estimated 17 million people reported to be “dependent on or abused” alcohol in 2014. Of that 17 million, only approximately 1.3 million people received treatment for their alcohol use in 2014 and nine of 10 “did not perceive a need for treatment for their alcohol use.” In the United States, 88,000 individuals die every year from alcohol-related causes, according to the National Institute on Alcohol Abuse and Alcoholism.

And yet, where is the urgency? These statistics demonstrate that seeking ways to reduce opioid overdoses is only the beginning to addressing addiction in the United States. Promoting recovery from all forms of substance use has to be part of the conversation.

There are 23.5 million people in recovery in the United States, but a dark cloud still overhangs the discussion of substance abuse. For decades, the perception of substance abuse was that of a moral failure of the individual — being labeled an addict made you lesser than the average person. It may be why mutual aid groups like Alcoholics Anonymous and Narcotics Anonymous are just that: anonymous. The combination of anonymity and public perception has made it difficult to change the conversation, reduce the stigma on local and national levels, and work to answer questions like these:

After people get sober, how will they make the transition into long-term recovery? What role does community — even among people in a community that aren’t directly connected to addiction through their work or personal lives — have in working to ensure the long term health of former addicts? And what should healing look like?

What role does community — even among people in a community that aren’t directly connected to addiction through their work or personal lives — have in working to ensure the long term health of former addicts?

Obama’s budget proposal and CARA address none of these questions, with no initiatives to aid in creating support systems for addicts attempting to get into recovery. There are no calls for more affordable housing or greater access to entry-level jobs that give those in recovery a chance to work again even if they have a criminal record. Current restrictions on housing and employment are a discriminatory product borne of viewing substance abuse as a moral failure.

Fostering communities supportive of recovery needs to be a national priority, and it requires looking beyond just getting people sober. A supportive community is one that gives substance abusers their lives back and a chance to assimilate back into society without facing the backlash of stigma. To achieve this, a Healing Forests need to be grown.

To read Part 2, click here.

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Derek Wolfe, MD
The Healing Forest Project

University of Michigan ‘16 - CMU College of Medicine '21 - HFH Psychiatry Resident