America’s drug addiction epidemic is a real emergency. Let’s treat it like one. 


January 5, 2024

Editor’s note: Don Mathis is a certified peer recovery specialist and certified community health worker at Voices of Hope Maryland.  He is a former CHN board member.  

In the ongoing, often testy, talks between Congress and the Biden Administration about fiscal year 2024 funding levels and programs, several words emphasize immediate and urgent priorities. President Biden’s national security funding proposal (aid for Ukraine, Israel, U.S. border) and his domestic priorities funding proposal focus on “emergency funding requests, critical needs, and urgent and strategic investments.” 

Some congressional critics, ultra-conservative think tanks, and certain media vehemently dispute the need for domestic funds and services. Not real emergencies, they say. For those of us committed to social justice and providing essential human services that these funds support, it’s disheartening to hear the bogus, self-righteous arguments made in opposition to our advocacy efforts. 

This dispute raises serious questions. What is a genuine national emergency?  When the Biden Administration and Congress insist on emergency funding, are they merely exaggerating or are they deliberately promoting bogus funding priorities? Are these real or phony emergencies?    

Let’s examine one. President Biden’s domestic supplemental emergency request includes $1.55 billion for “Countering Fentanyl,” funds for State Opioid Response grants to provide drug treatment, harm reduction, and recovery support services.  Is America’s drug addiction (substance use disorder) epidemic really an emergency? 

The data show it is. The American Medical Association calls it “a national epidemic.” In 2022, 110,000 people in America died from a drug overdose and for every fatal overdose, there are many non-fatal overdoses. 93% of people with substance use disorder (SUD) did not get treatment. The recent, widespread, easy availability of more lethal drugs such as fentanyl, xylazine (an animal tranquilizer), high-potency methamphetamine, and nitazenes (a variety of opioids stronger than fentanyl) is responsible for more than 300 deaths per day, struggling families, increased homelessness, more children in foster care, and negative impacts on the education, workforce, health care, and human services systems.  

Behind the statistics and the nightmarish drug scene are real people. Here are two: 

Charlene’s Story.  At age 14, Charlene started drinking vodka and smoking weed, soon moving on to illicit pills, heroin, then fentanyl. By age 32, she was an avid IV drug user, supporting her habit by prostitution, theft, and drug-dealing. She attempted inpatient treatment three times but wasn’t able to stay sober. She lost custody of her first two children and her third child, born prematurely, died while Charlene was in jail. She knew then she had to leave her old behaviors behind or else she would overdose on fentanyl. 

With support from federally-funded and state-administered drug treatment services, Charlene completed her Intensive Outpatient Program and then her Outpatient Program (thanks to Medicaid). She became an active participant in a nonprofit recovery community organization (RCO) where she now lives in the organization’s recovery house with other women in recovery. \ The RCO enrolled her in its methadone program and also participates in a state-funded peer support program. She attends 12-Step Recovery Fellowship meetings and is building relationships with her two children. Through a U.S. Department of Labor-funded American Job Center with a program to help people in SUD recovery enter the workforce, Charlene has a full-time, private sector job. The lesson here:  federal programs save lives; rebuild families. However… 

Duffy’s Story.  Duffy lived with his mother in a small trailer in a rural area. Mom had alcohol use disorder and they struggled financially. He was considered by his teachers and school counselor as a likeable kid, but he dropped out of high school to work. He had few skills and started smoking weed with friends. His SUD progressed to injecting heroin and fentanyl. At age 25, he entered and completed a 28-day drug treatment program, but he didn’t have a place to live. The stigma around his SUD kept him from going back to his mother’s trailer and her stigma against asking for help for Duffy and her was a consistent barrier. A nonprofit recovery community organization (RCO) that gets no federal funds gave him a full scholarship to a sober living house with other men in recovery. Duffy never got the food aid (SNAP) he needed nor was there a local workforce program for people in recovery like the one that helped Charlene. He never got medication (methadone, buprenorphine) he needed to treat his opioid addiction. A bookkeeping error at the sober living house resulted in Duffy being kicked out of the house.   

Duffy died from a fentanyl overdose at age 28. A week after his death, the bookkeeping error was discovered; he never should have been thrown out of the house. The lesson here: especially in rural areas, there is a lack, often absence of services and programs such as those proposed in President Biden’s emergency supplemental funding request. 

Epilogue. There are Charlenes and Duffys in every state, every zip code, from all income and education levels, family structures; racial, ethnic, and gender groups.  13.1 million people in America have a SUD; the fastest growing group is young adults 18-25 (9.7 million people). Looks like an emergency to this writer. 

During the next two months, Congress will decide on funding levels for State Opioid Response grants; treatment, harm reduction, and recovery programs. Our nation deserves more Charlenes and fewer Duffys.