Addiction initiatives in the U.S. face an uphill battle
Seattle is planning a sobriety incentivization program. It's a well-intentioned approach, but it can only do so much given the constraints of the country's capitalist system.
Creating programs to combat the country’s addiction epidemic is a respectable cause.
But under a capitalist system, the notion that a government is acting out of altruism is a fantasy. And time will tell if that is the case with a recent pilot program introduced by Seattle Mayor Bruce Harrell last week.
The “contingency management” program, which would be administered by a local nonprofit, intends to offer gift cards, prizes and cash rewards to addicts in the program who are able to pass urine tests to prove their sobriety.
“Essential to any long-term neighborhood revitalization is safety and health: The fentanyl crisis on our streets is causing death and disorder – we have an obligation to do more for those suffering from substance use issues and for all neighbors,” Harrell said in a statement.
“There are no quick fixes to this complicated challenge, but our Executive Order takes urgent steps to decrease trafficking of deadly drugs and to deliver new, innovative, and sustainable approaches helping those suffering from substance use disorder.”
In reality, with the health care industry roping in politicians with campaign funds and corporations profiting off of addiction, the concept of ethical consumption is silly.
It is far from unlikely that the pharmaceutical industry in particular, which profits off of medication helping addicts, doesn’t like the sound of governments steering addicts toward treatment centers.
Instead, under the country’s money-hungry system, the transfer of wealth would buoy the rich CEOs off the backs of addicts, who oftentimes are living in poverty while others thrive.
The Long Haul is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
City Councilmember Sara Nelson, a recovering addict, is a staunch supporter of the program and said it could open the door to long-term treatment for participating addicts, KUOW reported.
However, if that journey from addiction on the streets to rehab does come to fruition, that will directly benefit the CEOs of companies who own for-profit treatment centers in particular.
In addition, it doesn’t help that many of the more effective, quality centers don’t accept certain insurance policies, including Medicaid, meaning that those living in poverty have a lower chance of receiving quality treatment.
Treatment centers aside, assuming the program includes all forms of substance use, the incentivization of sobriety in an unsupervised setting could be deadly.
For example, in the case of an alcoholic or benzodiazepine addict, attempting to go cold turkey to reap the rewards presented by the program could die from withdrawal.
While that is less of a concern with individuals addicted to methamphetamine, heroin and other drugs, it remains an issue worth pondering.
The plan also provides ripe ammunition for conversative naysayers, who have already labeled the program as a way to bribe addicts and will likely argue that addicts will cheat drug tests and use rewards to fuel their addiction further.
Now, the concept of helping addicts connect with treatment and potentially overcome addiction doesn’t sound like an issue at face value.
That’s especially apparent because while the government rushes in an attempt to curb addiction and drug-related deaths, the numbers continue to climb exponentially.
Between 2020 and 2021, drug overdose deaths in the U.S. grew from 91,799 to 106,699 — a 16.2% increase, according to the most recent data provided by the National Institute on Drug Abuse.
Drug overdose deaths have steadily climbed since at least 1999, and NIDA data shows that the largest increases came in 2020 and 2021 along with the proliferation of fentanyl.
Those overdose deaths, to no surprise, correlate with an increase in the uses of illicit drugs in general.
As of 2021, about 50% of Americans 12 years old and above reported using illicit drugs in their lifetimes, according to the Substance Abuse and Mental Health Services Administration.
Finally, about 22% used at least one of those substances in the past year, and 14% used a substance in the past month.
Five years earlier, 48.5% of Americans used illicit substances in their lifetimes; 18% used in the past year; and 10.% in the past month.
As for what makes the initiative possible, the pilot program is funded through an $800,000 grant from the Washington State Health Care Authority.
Seattle’s program will be spearheaded by Plymouth Housing, a nonprofit organizations that offers aid to those facing long-term homelessness.
Allowing a nonprofit to run the program is a good idea, particularly one that also aids with housing, as it could decrease the likelihood money-hungry companies take advantage of addicts any more than they already do.
And, after all, there is a correlation between homelessness and addiction.
However, while that argument may carry weight in terms of health outcomes, it does not take into account the ability for capitalist forces to profit off of said addicts.
As with any program intended to bring about positive change in society, there are always two sides of a coin when they have to function within our current system.
If anything, this entire idea should prop up discussions regarding free health care and other social programs, which exponentially increase the reach of efforts created to benefit lower-class individuals or those facing health issues such as the disease of addiction.
Or, more funds could be used for needle exchange programs, which Seattle already offers.
If not that, further investments in housing and mental health, issues that often overlap with drug use, would — or at least should — be universally agreed upon as a good approach.
All of that being said, well-intentioned initiatives such as what Seattle is proposing get peoples’ hopes up that the country is making strides toward equitable treatment and opportunity at all.
But funding is limited for such programs under the current economic and social systems. The end goal cannot be reached unless the barriers upon which this country was founded are eliminated.
How likely is that to happen?
Let’s be honest. I’m not getting my hopes up.
For those interested in contacting me, I can be reached by email at firstname.lastname@example.org or via Twitter @loganhullinger.