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Opioid addiction is a mental health crisis, not a crime wave

Every opioid death is preventable, because addiction is treatable. But we need to shift from a culture of shame to one of treatment.
Image: Children walk by drug users passed out along a street in a South Bronx neighborhood
Children walk by drug users in the South Bronx in a neighborhood with the highest rate of heroin-involved overdose deaths in New York on Oct. 6.Spencer Platt / Getty Images

Last year, roughly 64,000 people died from drug overdoses in the United States — the largest annual increase in drug-related deaths ever recorded in our history. Overdoses are now the leading cause of death for Americans under 50. In New York City, we lost a record 1,374 people to drug overdoses in 2016.

And every single one of those deaths was preventable, because all addiction is treatable.

As a nation, we're failing: failing those with substance use problems, failing those with mental health problems, and failing their friends and family. Cheap heroin and dangerously potent synthetic opioids like Fentanyl are flooding our communities and killing our loved ones and neighbors, even as many people are still ashamed to seek help, afraid of being labeled as weak or undisciplined or simply criminal. And when people talk about overdoses, they still talk in hushed whispers or make ignorant condemnations that don't acknowledge the humanity of the people about whom they are talking.

We need more than prison sentences or policy interventions: We need a culture change. We need to shift from a culture of shame and punishment to one of healing and wellness. And in communities, like ours in New York City, that are suffering, that shift means new policies.

We in government have a responsibility to build a system that treats diseases as diseases, even those that are stigmatized. More than 40 percent of people who struggle with addiction also have another mental health challenge of some kind — and most of those people never end up seeking treatment or services. In many cases, people turn to substances as a way to self-medicate for these untreated illnesses or to help them cope with the trauma or emotional distress they face in their lives.

Image: Heroin users in the Bronx
Heroin users prepare to shoot up in the Bronx on Oct. 7.Spencer Platt / Getty Images

Those of us in public health need to make it as easy to get treatment for a mental health challenge as it is for any other ailment. When you wake up with bad allergies or a toothache, you know where to go and whom to talk to. It's not as simple or straightforward for anxiety, depression or substance misuse. But it should be.

In New York City, we're doing all we can to move in the right direction. Any New Yorker can call 1-888-NYC-WELL, a free and confidential 24/7 mental health helpline staffed by trained counselors ready to guide people to the care they need. And we have expanded mental health services dramatically to help more people get care where they live, learn, worship and work.

But while we focus on prevention, we can't take our eyes off of intervening when a crisis is happening. We need to get naloxone in the hands of as many New Yorkers as possible.

Anthony received naloxone training in late 2015. About six months later, he was out shopping with his family on Stillwell Avenue in Brooklyn when he saw a woman, blue in the face and slumped over in a chair at a deli. The people around her thought she had overdosed on opioids, so Anthony rushed to his car to grab his naloxone kit. Within minutes of administering a dose of the nasal spray, the woman was responsive again. He saved her life.

Naloxone is a life-saving medication, like an EpiPen is for allergic reactions. We have provided naloxone kits to our emergency responders, police officers and hospital or shelter staff, but the chance to save lives doesn't just lie with our first responders. We are distributing thousands of kits to organizations that serve our communities, like after-school programs, recreational centers and houses of worship. And we've worked to make naloxone available at more than 700 pharmacies across the city.

Image: Jeff, a heroin user, is interviewed by students
Jeff, a heroin user, is interviewed by students in New York as part of a project on overdoses in August.Spencer Platt / Getty Images

Coupled with the fact that naloxone is available without a prescription at CVS pharmacies in 41 states and Washington, D.C., everyone who has someone in their lives struggling with an opioid addiction can be prepared to intervene if tragedy strikes.

And access is working: I joined a special ceremony last week to honor Anthony and 66 other New Yorkers who used naloxone to save a life. In total, the honorees in that room saved 255 lives with naloxone — with one person alone saving an incredible 40 lives.

Changes like these require more than government policy: They begin with open and honest conversations. In New York City, we're working with everyone — parents, children, clinicians, faith leaders, teachers, community service providers — to sustain a citywide conversation about mental health, substance misuse and how we can all be healers.

Like Anthony, any one of us can save a life. But by working together, we can change our culture. We can end the opioid epidemic, and we can prevent future crises, too.

This is no easy task, and it can't happen overnight. But we are making real progress in New York City, and I invite every city and state to join us.

Chirlane McCray is the First Lady of New York City and leads the city's mental health and substance misuse efforts.