Finding a way out will not be easy, particularly at a time of partisan division when national will is so hard to muster. But the need to act is urgent, and the map is increasingly clear: first, we need to recognize that addiction is a disease. The opioid epidemic must be seen as a public-health crisis rather than a moral failure. That means expanding access to medically assisted treatment and counseling, which is widely considered to be the most effective method of getting people off of opioids for good, yet is available to far fewer people than all those who need it. We must enhance efforts to reduce the supply, through the work of law enforcement, by regulating lawful prescriptions and by encouraging other strategies for managing pain. And, finally, we need to confront problems such as the growing economic divide, unaffordable health care and the diminished employment opportunities for those without a college degree which are helping fuel demand in the first place.
An effort of this order will be a massive undertaking. It will require cooperation between the federal government, local officials, law enforcement and public-health leaders—and far more money than has been set aside so far. In early February, Congress allocated $6 billion to help—experts in the field say the amount needs to be at least 25 times that to make a permanent dent.
To see the faces and hear the stories of those with the most at stake is to begin to reckon with the crisis. As Nachtwey once put it: “We must look at it. We’re required to look at it. We’re required to do what we can about it. If we don’t, who will?”