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America’s crisis isn’t opioids—it’s ignorance

I grew up in Florida, within miles of the epicenter of what we now call a national opioid crisis. I got hooked on prescription painkillers in Florida, buying green and blue tablets from the pill mills that spread through Miami. I learned to shoot heroin in Florida. I ate at the homeless shelters there, begged for change at the gas stations, and tried one treatment center after another. I experienced the opioid crisis up close and personal: I lived it.

After leaving Florida in 2013 and finding sustained recovery four years ago in California, I’m still experiencing the effects of the epidemic. Now, I see it from the other side. I work in policy, pushing for recovery related reform at the national level. I work hand-in-hand with grassroots groups across the nation to ensure that our voices are heard. This year, I’ve learned that if recovery is not represented at the decision-making table, it quickly falls by the wayside.

I’m able to be such a vocal activist in part because I’m white. I’m the guy in the Warby Parker glasses, the hoodie, and the backpack, trying to force change everywhere I go. I see few advocates of color at the table and at higher levels of leadership — especially when funding is in play. I do my best, but I can’t speak for a community I’m not part of. I can call out systematic problems that exclude people who are in need. The fact is, in our focus on fixing America’s “opioid problem,” we’ve fallen into the same old ignorant patterns. White, suburban, middle-class opioid users are receiving an overwhelming amount of media attention. People who look like me are in the limelight: the addiction crisis is hot right now, but only certain aspects of it actually make it to the mainstream.

We’ve ignored communities of color, alternate pathways to recovery, harm reduction, and substances other than opioids. As a result, meth is on the rise, as well as benzos such as Xanax. Well-intentioned advocacy from both policy leaders and grassroots groups has actually created more victims because it fails to include all people with substance use disorder. The divide between policy and the day-to-day struggle of people in active addiction is widening. Who cares what legal protections we have if they don’t actually save lives? What’s the point of creating progressive health care systems if those systems aren’t accessible to everyone who needs them?

Furthermore, the media misrepresents small steps forward as the “finish line” while sensationalizing opioid use in specific regions. Instead of becoming more inclusive, our definition of recovery is narrowing. That squeezes out the most vulnerable members of our communities, while those with more privilege—who fit the mold of the “model addict”—get sympathy and support on their journeys to wellness. That means that, on the same day, a headline about the opioid crisis in Appalachia shares a page with a story about Senate leadership unanimously backing the new opioid bills. It doesn’t make sense. These stories are linked. They are one and the same. The average addict looks nothing like the rural poor of West Virginia—the drug epidemic affects one in three American homes. Yet, just as the media chose to sensationalize the crack epidemic as a “black problem,” addiction is once again becoming “someone else’s problem.” When we see addiction represented as something that happens to other people, we don’t deal with the problem that’s in our own backyards, living rooms and classrooms.

Yet, there are examples of people working hard to address the crisis without shame, stigma, or discrimination. Dayton, Ohio recently made headlines for cutting its overdose rate in half by focusing on giving help freely, to anyone who needed it. The city removed barriers to treatment by investing in public health, supporting harm reduction measures like fentanyl test kits and clean syringes, and offering diverse options for recovery support.

Miami-Dade County in Florida—the place where I hit the bottom of my addiction—is making incredible strides too, by making naloxone available literally everywhere and putting it in the hands of people who already use opioids. The county is also the home of the state’s first and only syringe exchange program. These two places are reversing the opioid epidemic by treating it like a public health crisis—and not shutting out people in need because they “don’t fit” the way we see addiction in the media or in budgeting meetings. Instead of assuming that a rising tide of recovery will lift all boats, they decided to build a boat that has a seat for everyone.

This year, the drug crisis worsened, even as we made incredible strides forward in leadership, policy, and breaking the stigma of addiction. Clearly, what we’re doing isn’t working broadly, for people of diverse backgrounds and needs. We can’t leave them behind and then pat ourselves on the back. We need to look at movements like AIDS activism and focus on helping people survive. Not just white people, not just straight people, not just wealthy people, not just employed people, not just housed people. All people.

I’m as guilty as the next person of losing sight of that goal. I, too, spent a lot of this year focused on opioids, and how they affected only the people I know. In 2019, I want to do better. We have a larger problem than opioids: we have a problem with our perception of addiction, our education about the illness and our response to this crisis. That includes the community of pain patients who are being pushed out of the discussion on opioids and penalized by stricter prescribing guidelines. In fact, we can find common ground between recovery advocates and pain patients, instead of leaving anyone on the sidelines.

This is not a problem that can be solved by separating and specializing it to death. We have the data, the tools, and the evidence that are proven to work. We need to use them and make them accessible by actually meeting people where they are. In 2019, I’m committing to making harm reduction and saving all lives my focus. You can’t help someone if they’re dead. All the well-crafted legislation in the world won’t bring back the fathers, mothers and children who we’ve lost to drug-related causes. What we can do is bring help to those in need. We can give them their dignity. We can see them from the other side of the crisis, and meet them wherever they are.

The issue isn’t opioids: it’s ignorance. What are we actually trying to fix? Are we solving the problem, or simply eliminating the people we don’t think deserve help?

I’ve looked at this epidemic from both sides. I know where I stand. I hope others will stand with me, and lend their voices to a movement that includes everyone and offers real, meaningful solutions. This doesn’t have to be complicated. Simple measures like making naloxone widely available, offering 24/7 access to safe injection sites with fentanyl test kits and clean syringes, and connecting people with help the minute they need it ensures that they can get through 2019 alive. Together. In one piece, recovered.

Ryan Hampton is a person in recovery from heroin addiction and author of “American Fix: Inside the Opioid Addiction Crisis—and How to End It,” published by St. Martin’s Press. He’s a nationally recognized activist and founder of the nonprofit advocacy organization The Voices Project.

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