Opioid epidemic did not pause for Covid; we must act to save lives

Sen. Elizabeth Warren spoke at a Dorchester Reporter sponsored forum in April 2018.

Long before the first COVID-19 case was confirmed in the United States, the country was already battling another large-scale public health crisis: the opioid epidemic. Like the COVID-19 pandemic, the opioid epidemic has disproportionately hit Black, Brown, American Indian, and Alaska Native communities.

The coronavirus pandemic has actually made the opioid crisis worse and accelerated its devastation. Congress has a responsibility to take immediate action to tackle these twin crises. It can start by passing my Comprehensive Addiction Resources Emergency (CARE) Act to end the opioid crisis and save lives.

The opioid epidemic has plagued the United States for nearly a decade. For years, giant pharmaceutical companies pushed mountains of prescription opioids into circulation, exposing millions of Americans to potent and highly addictive painkillers, leaving them vulnerable to developing addictions to more dangerous and illicit substances like fentanyl - which is exactly what happened. By 2018, rates of opioid overdose deaths were four times higher than they were in 1999. As of today, nearly 750,000 Americans have died as a result of the opioid crisis and countless families have been torn apart.

Though some companies are now beginning to face the consequences of the profit-fueled epidemic they created, the suffering of thousands of communities across the country continues to this day. American Indians and Alaska Natives have some of the highest overall opioid overdose death rates and prescription opioid death rates. While data has shown rates of opioid overdose deaths are improving nationwide, Black and Brown communities are being left behind. In Massachusetts, recent data shows that while rates of fatal overdoses are declining overall, they are actually increasing for Black and Hispanic people. These are the same communities still grappling with the fallout from the failed War on Drugs that criminalized addiction, supercharging mass incarceration and tearing apart families and neighborhoods.

The COVID-19 pandemic has only magnified the severity of the opioid crisis. People with a history of substance use disorder (SUD) are more likely to suffer from comorbidities that increase their risk of COVID-19, and as economic insecurity and mental health challenges have increased during the pandemic, over forty states have reported increases in opioid-related overdoses in recent months. Social distancing measures, though essential to preventing the spread of COVID-19, have made it harder for individuals suffering from SUD to access life-saving medication assisted treatment, while the economic downturn has made it even harder for people to afford care. Black and Brown communities have substantially less access to health care services, particularly behavioral health and addiction treatment services, than white Americans — an inequality that is also true for American Indian and Alaska Native communities. Meanwhile, the federal government — despite having a trust responsibility to do so — has failed to provide sufficient and direct funding to tribal nations and tribal organizations for SUD treatment. This means that the pandemic’s impact on SUD access will hit people of color and Indian Country hardest.

We’ve seen this devastating impact in Boston and communities across the Commonwealth. We must take bold steps to address this crisis and these health disparities before they further ravage the country and our neighborhoods. I have a plan for that.

In 2018, I introduced the CARE Act with the late Congressman Elijah Cummings — landmark legislation modeled off the Ryan White Comprehensive AIDS Resources Emergency Act of 1990— to finally treat the opioid epidemic like the public health crisis it is. Our comprehensive bill, now led by Congresswoman Carolyn Maloney, would provide $100 billion over ten years to the states, cities, and tribal governments hardest-hit by the epidemic for prevention, treatment, and recovery services. The bill would allow states and localities to develop evidence-based addiction treatment practices and harm reduction programs.

Funds would go directly to communities in Massachusetts, and across the country, that have borne the brunt of this epidemic--making it easier for state and local governments to respond with approaches tailored to their needs. It would also provide over $800 million per year directly to tribal nations and organizations. Critically, it would also fund research at the National Institutes of Health (NIH) and Centers for Disease Control and Prevention (CDC), helping the federal government better understand how this crisis is affecting communities of color and the nation as a whole. Here’s another really important piece: our bill will hold companies that flooded towns and cities with pills accountable by making them pay up so every person can get the treatment and care they need.

We can’t afford to neglect the opioid epidemic, nor the communities it is affecting the most, while we continue to combat COVID-19. The CARE Act would ensure that every American can get the treatment they need without experiencing the stigma that so many with addiction face and would take meaningful steps to address the racial inequities in our health care system. Congress should pass the CARE Act and give communities like Dorchester the resources they need to fight back against the opioid crisis in the midst of this pandemic and beyond.