Is the U.S. Addicted to Addictions?

Newtown, CT - February 24, 2018

In his most recent column, Joe Fifer, President and CEO of the HFMA (and also Altarum Trustee), noted that while addiction to opioids has appropriately garnered national attention, we can’t and shouldn’t forget other addictions, including to alcohol, that are just as deadly. Two weeks ago we released a report showing that the cost to the U.S. of the opioid crisis since 2001 is $1 trillion, and likely to be an additional $500 billion over the next three years if nothing is done to reverse the trend. To come up with these estimates, we used a model that we had developed as part of a Robert Wood Johnson Foundation grant. That project was focused on the burden caused by children being exposed to lead. We’ve also done it for other public health concerns – a euphemism for addictions.

Look at the list of the most pressing health problems – obesity, smoking, alcohol use, narcotics dependency, and many others. Dig a little and you find that they are partially caused by addictions, and the combined effect on the GDP of the country is devastating. Recent reports by the military indicate that a substantial portion of those who apply to join the armed forces are disqualified because they are physically unfit – obese. And obesity is at the root of many deaths, including deaths from complications of diabetes and cardio-vascular disease. Alcohol claims 88,000 Americans yearly, which is substantially higher than deaths from opioid misuse. Hundreds of thousands of people still die every year because of cigarette smoking. These statistics are easy to find on the Center for Disease Control’s website, because that’s the CDC’s role. It tracks the effects of our vices, our addictions, and other health crises. Except for one – at least until now – gun violence. Guns also seem to be an addiction in the U.S. and yearly claim over 30,000 lives, more than half of which are suicides, revealing another deep rooted public health problem: mental health.

In fact, one could say that mental health, the way in which the brain works, responds to stimuli, is the basis for all addictions. The use of tobacco, alcohol, narcotics, fatty foods and guns are ways in which addictions are expressed or, in many cases, in which depression, anxiety, and other mental health problems are addressed. But these two issues – seeking highs and dealing with mental disorders aren’t the same and can’t be confused. They don’t have the same symptoms and require different treatments, even though they both lead to destructive behaviors, violence and death.

There’s little question that we can do better as a country to help those who need help. The answer cannot ever be to simply accept the status quo. Our report on the social and economic burden of the opioid crisis may create a higher sense of urgency to deal with the issue, and we’re glad if it does. But we must do more. We must develop solutions, test them, refine them and spread them. And we can’t stop at opioid disorders. We have to continue tackling alcohol and tobacco addictions. And beyond all of that we have to help those who feel so desperate, so left out, that turning a gun on themselves or others becomes the solution of choice. From the day of the tragedy in my home town to the one in Parkland there have been over 1600 mass shootings.

Children are dying in streets all over the United States because people drink too much, drug themselves, or shoot wantonly. The human toll is so tragic that we’ve almost become numb to it. We can’t. We won’t.