It’s likely that you or someone you love has struggled with an addiction. You know the toll it can take on a person, their family, and their community. Imagine that experience times 7 million – the number of Americans over age 12 who are struggling with an illicit drug-related substance use disorder. Americans are now more likely to die of an opioid overdose than a car crash. 

After almost 50 years engaged in a “War on Drugs,” the U.S. is in the middle of a drug use crisis. All too often, people who use illicit drugs are criminalized and stigmatized, with interventions designed mainly to push them from view. As more and more people are impacted by drugs, it is time for new ways of thinking about addiction and recovery. 

Drug addiction is a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. People can be addicted to all kinds of things, including activities like gambling or video gaming; legal substances like alcohol or tobacco; or illegal substances like heroin, methamphetamine, or misused prescription drugs. For this theme, we are focusing on addiction to substances, with an emphasis on illegal substances and misused prescription drugs.

Not all substance use is problematic. But when it advances to a substance use disorder or addiction, it involves functional changes in the brain that can distort people’s body, behavior, judgment, and decision-making. These changes may last a long time after a person has stopped taking drugs.

This more scientific understanding of addiction helps make clear that addiction is not a moral failing or a sign of weakness. Genetics plays a role: genes account for an estimated 40 to 60 percent of a person's risk of addiction. Trauma is another major contributing factor. For example, teens who experience physical or sexual abuse are much more likely to report substance use later in life. But people can find themselves in the midst of an addiction for many reasons. 

Recovery is the process of improved physical, psychological, and social well-being and health after having suffered from a substance use disorder. Recovery is more than just successful control of a substance use disorder. Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. This includes addressing: self-care practices, family, housing, and employment.

People are often considered to be “in recovery” if they have stopped using a substance as a result of a formal treatment program or through support provided through a mutual support group, such as a 12-step group. However, people can enter recovery from their addictions through many pathways, including harm reduction strategies that help people change their use in ways that minimize the harm to themselves and others.

It’s prevalent. More than 7 million Americans struggle with an illicit drug-related substance use disorder. Throw alcohol into the mix and the number rises to 18.7 million adults. Over 70,000 drug overdose deaths occurred in the U.S. in 2017 – more than two-thirds of them due to opioids.

Source: CDC National Vital Statistics Reports

It’s a moving target. Opioids have captured the spotlight, and with reason: even as we’ve seen progress in the past few years on misuse of prescription pain relievers (like OxyContin™ and Vicodin™) and heroin initiation, overdose deaths from synthetic opioids like fentanyl increased 10-fold. But opioids aren’t the only problem. Here in San Francisco, it's methamphetamine that is growing most dramatically, with people dying from meth-related overdoses more than 6 times as often today versus a decade ago.

It’s costly. The use of illicit drugs and misused prescription opioids costs the U.S. more than $271 billion each year due to crime, lost work productivity, and health care expenses. Less quantifiable but just as important are the human costs to individuals, families, and communities. 

The U.S. Surgeon General recently called for a change in the way we approach drug addiction in this country, including reliance on evidence-based strategies instead of outdated approaches based on morality and “abstinence or nothing”. We agree.

Battery Powered  supports a public health approach to addressing substance use disorders. Simply stated, our public health system has better tools to deal with the disease of addiction than our criminal justice system, a view we heard from public health officials and law enforcement officers alike. Furthermore, the criminal justice system has created deeply unequal outcomes for people of color when it comes to drugs. While drug use and sales are similar across racial and ethnic lines, people of color are far more likely to be criminalized than white people.

"The way we as a society view and address [substance] use disorder must change — individual lives and the health of our nation depend on it."

JEROME M. ADAMS, MD
u.s. surgeon General

Our approach is grounded in harm reduction philosophy and backed by evidence. Rather than a punitive approach, harm reduction  acknowledges  the dignity and humanity of people who use drugs. It provides care to minimize negative consequences and promote optimal health and social inclusion. A wealth of studies have demonstrated that this strategy works well to address addiction.

Addiction has serious negative impacts, not only for people who are addicted, but for the people around them. We approach this issue with empathy and compassion for both.

We are focusing on three areas where we can help people and communities affected by drug addiction:

Health and safety. Keeping people who use drugs alive and safe is critical. Many evidence-based strategies exist to improve health and safety, including delaying the onset of substance use in young people, reducing exposure to used syringes, and preventing and reversing overdose. 

Treatment. Our goal is to reduce or end harmful substance use by supporting people to make a self-directed choice about a treatment option that is best for them. For some, this means abstinence. For others, it means medication-assisted therapy or programs to help them change harmful behaviors.

Recovery. Problematic substance use impacts relationships with family, friends, and colleagues. As part of recovering, people often need support to improve their social and family function. This may involve peer support and programs to improve mental health and help people heal from trauma.

By educating each other, reducing stigma, and improving options for treatment, we can reduce drug-related harm and create safer, healthier communities for everyone.