We all deserve peace of mind.
All people deserve to feel safe, to be able to support themselves and their families, and to feel at home in their communities.
The need to solve the substance use disorder crisis has never been greater.
Stigma and outdated policies are fueling overdose deaths and fracturing our families and communities. Proven prevention, harm reduction, treatment, and recovery solutions that can save countless lives are not reaching our loved ones in need.
More than 1 million lives lost to overdose since 1999.
Leading cause of death for Americans under the age of 50.
Fewer than 1 in 10 receive treatment.
The solutions have never been clearer.
Substance use disorder is a medical condition that is as preventable and treatable as diabetes. Our 3-part agenda to educate the public and adopt common-sense policies is built on what scientists and people affected by substance use disorder know works.
1. Prevent
We can protect our loved ones from becoming dependent on drugs and alcohol.
2. Treat
Treatments exist that can save tens of thousands of Americans from overdose deaths every year.
3. Support
When people with substance use disorder have jobs, housing, and food on the table, they can stay healthy.
Step 1: Prevent
We can help safeguard our families with solutions like these.
A teenager who uses drugs or alcohol before she’s fifteen years old has a 6 times greater risk of developing substance use disorder than if she waits until she’s out of high school. To keep her safe, we can:
Invest in the Nurse-Family Partnership.
The Nurse-Family Partnership provides first-time mothers with visits from nurses during pregnancy and the first two years of their babies' lives. The nurses teach mothers healthy childcare practices and ensure they have stable jobs, safe housing, and food. These mothers raise children who use alcohol and drugs more than half as frequently than children who do not receive this support. And, the Nurse-Family Partnership returns $5.71 in government savings for every $1 invested. The Nurse-Family Partnership supports mothers in 40 states, but the government does not provide enough funding for the program to reach all mothers and babies in need. We can broaden local, state, and federal funding of the program to ensure all new mothers and babies have a healthy start.Expand Communities That Care prevention programs.
Communities That Care brings together schools, nonprofits, and local governments to build community practices proven to help children develop strong emotional resilience. Used in hundreds of communities across the United States, these programs reduce early substance use by two-thirds among middle and high schoolers. And, they save $5.31 in criminal justice and healthcare costs for every $1 invested. We can expand Communities That Care to all cities across the country. Every child deserves the support of her community in preventing substance use disorder.Take action now →
The opioid overdose crisis started in part because pharmaceutical companies gave doctors and dentists trips, meals, speaking fees, and bonuses for prescribing opioids. The pharmaceutical companies also claimed the medications were not addictive, when evidence showed they were. Teenagers who have a dental procedure and receive an opioid prescription have a 15 times greater risk of developing opioid use disorder than teenagers who are counseled to take ibuprofen or acetaminophen. To ensure our prescriptions are safe, we can:
Pass Healthcare Provider Gift Ban laws.
These laws prohibit drug companies from providing financial incentives to doctors and dentists. Six states currently have these laws, and compared to other states, their prescribing rates of newly marketed drugs are 83% lower. The remaining states and federal government can pass Healthcare Provider Gift Ban laws. We should all be able to trust that our prescriptions are based on medical necessity, not financial incentives.Take action now →
When a teenager starts to use drugs or alcohol, or a mother injured on the job starts to become dependent on opioids, we can catch that use early and intervene before it turns into substance use disorder. To increase early detection, our family care doctors can screen for increased substance use during regular check-ups and provide referrals to treat that use just as they would for diabetes or heart disease. Early screening can cut alcohol and drug use in half, and it saves $2,200 per patient per year in medical costs. We can:
Expand early screenings and referrals to treatment.
These laws require all health systems to screen for substance use disorder and to have procedures for connecting patients to care. Medicare covers early screening, and state Medicaid and private plans can cover it as well, but most doctors still do not screen for substance use disorder. We need health systems to ensure all patients benefit from this screening. Just as our doctors check for high blood pressure and cholesterol, they should check for signs of substance use disorder. Early intervention saves lives.Take action now →
Step 2: Treat
We can help people with substance use disorder get better with solutions like these.
The father who wants to stop drinking should be able to visit his medical provider and receive medical treatment to achieve his goal just as he would with diabetes or heart disease. When doctors, nurses, and physician assistants treat substance use disorder, three-quarters of overdose deaths can be prevented. Medical providers can treat substance use disorder. The withdrawal that people with substance use disorder experience involves vomiting, diarrhea, tremors, headaches, muscle pain, abdominal cramps, life-threatening seizures, anxiety, and depression. Medical providers, in coordination with behavioral health professionals, are capable of treating these symptoms. More than 46 million Americans have substance use disorder, and it is growing at a faster rate than heart disease, cancer, or diabetes, but less than 1 in 100 of our country's doctors specialize in treating the condition. To ensure people with substance use disorder receive medical treatment, we can:
Adopt the federal Substance Use Disorder Workforce Act.
This bipartisan law will create 1,000 medical residency positions in substance use disorder medicine and psychiatry across the country. Right now, there are just 59 substance use disorder fellowships in the United States, making it difficult for medical students to specialize in the field. Creating these residency positions will increase the number of doctors who specialize in treating the advanced stages of substance use disorder. Substance use disorder is the leading cause of death for Americans under the age of 50. We need to ensure we have enough doctors to treat the condition.Take action now →
We have medications that can save tens of thousands of American lives every year from opioid overdoses, but due to current federal law, only about 1 in 10 people with opioid use disorder receive them. The use of these medications, which include buprenorphine and methadone, is similar to the use of insulin to treat diabetes, and they are the standard of care for opioid use disorder according to the U.S. Surgeon General. Still, they are not reaching most patients. End Substance Use Disorder led a nationwide coalition to pass legislation to dramatically increase access to medications for opioid use disorder. Read more here:
Learn about the Mainstreaming Addiction Treatment Act.
This bipartisan bill will prevent overdoses, increase access to treatment, and reduce stigma by removing barriers that prevented healthcare providers from prescribing a lifesaving medication for opioid use disorder.Click here to learn more about this major victory.→
Pass the Reducing Barriers to Substance Use Treatment Act.
This law would bar state Medicaid programs from requiring pre-approval before people can access buprenorphine. These pre-approvals can take weeks. People seeking care for opioid use disorder are dying while they wait for treatment. States can expand on this law by prohibiting private insurance companies from imposing such barriers. The federal government has already passed this policy for Medicare, but the 275 million Americans who are not on Medicare are still at risk. These laws are also endorsed by the American Medical Association.Take action now →
An individual with substance use disorder may have experienced trauma that contributes to their condition. Treating that trauma, in conjunction with receiving medical care for the substance use disorder, can help them get better. According to the U.S. Surgeon General, the best behavioral healthcare for substance use disorders, particularly those involving methamphetamines and cocaine, involves individual counseling based on cognitive behavioral therapy, contingency management, and family education from psychologists, social workers, or counselors. But, only 1 in 3 counties have enough behavioral health providers. Substance use disorder counselors are among the lowest paid healthcare providers in the country. A licensed social worker who has a Master's degree and has undergone 2,000 hours of post-graduate training earns less than the manager of a fast food restaurant. As a result, many psychologists, social workers, and counselors choose not to provide substance use disorder treatment because the reimbursement rates are so low. To ensure all people with substance use disorder have access to a trained counselor, we can:
Pass the federal Mental Health Parity Compliance Act.
Federal law requires that insurance plans cover substance use disorder treatment, but some insurance plans do not cover visits to behavioral healthcare providers or they reimburse those visits at such low rates that the providers lose money treating substance use disorder. As a result, many psychologists, social workers, and counselors choose not to see patients with substance use disorder. The bipartisan Mental Health Parity Compliance Act strengthens the enforcement of these federal laws to require insurance plans to adequately cover the treatment for substance use disorder that the U.S. Surgeon General recommends. If we want psychologists and counselors to treat substance use disorder, we have to reimburse them at fair rates for those services.Remove fail-first insurance requirements.
Some insurance companies employ “fail first” policies, which require that people with substance use disorder fail outpatient treatment first before they can access inpatient care, even when their doctors recommend inpatient treatment. Patients are dying while they wait for the level of care their doctors recommend. We can require insurance companies to cover all levels of substance use disorder treatment.Take action now →
Everyone should have access to treatment regardless of how much money they have. But right now, only 1 in 10 people with substance use disorder have received treatment, many because they cannot afford it. To help them access care, we can:
Expand Medicaid.
Almost half of nonelderly people with substance use disorder need Medicaid. In states that have expanded Medicaid to cover people with substance use disorder, their overdose deaths have decreased by thousands of lives in just the first year of coverage. These patients' medical costs have also decreased by 26%. Expanding Medicaid saves lives and money. Too many of our loved ones are dying from overdoses because they cannot afford treatment. We can ensure that everyone can access and afford the care they need to heal.Take action now →
More than 100,000 Americans die from overdoses every year. We can prevent overdose deaths and connect people with substance use disorder to treatment in three ways:
Equip First Responders.
Cities, states, and the federal government can require all emergency rooms, first responders, and pharmacies to carry naloxone, a drug that reverses opioid overdoses. The U.S. Surgeon General has called for widespread use of naloxone, an FDA-approved medication that prevents people experiencing overdoses from dying. The medication does not result in increased drug use. Most of the hundreds of thousands of overdose deaths in the United States over the last ten years could have been prevented with this medication.Enact Overdose Prevention Center laws.
States and cities can expand overdose prevention centers, where people with substance use disorder receive supervised care from medical professionals. These facilities also promote healthy needle disposal and exchange, preventing the spread of infectious diseases. Studies show that nearly 3 in 5 people who visit these centers enroll in treatment, and these centers decrease overdoses by more than one-third.Adopt Good Samaritan laws.
States and the federal government can encourage people to call 911 when someone overdoses. Forty-four percent of overdoses occur with a bystander present. That bystander often does not call 911 because he does not want to be arrested for drug possession. Tragically, the person who overdoses then dies. Many states have passed “Good Samaritan” laws that provide that, if a person calls 911 to report an overdose, they will not be arrested for drug possession. We can expand these Good Samaritan laws to all states and the federal government. Overdoses are the leading cause of death for Americans under the age of 50. Our laws should protect our children from overdoses.Take action now →
Step 3: Support
Stable jobs, safe housing, and enough food help people with substance use disorder stay in recovery. We can empower them to stay healthy with changes like these.
In order to heal, a person with substance use disorder needs a safe home and food on the table. Doctors refer to these needs as “social determinants of health.” They are as important to the treatment of substance use disorder as medical care. But a person in recovery may not be able to provide for themselves because they have a criminal record for drug possession. That record will bar them for life from jobs, housing, education aid, and food support, even if they receive treatment. Studies have shown these policies have moved up to 5 million Americans into poverty. To help our loved ones, we can:
Pass Clean Start laws.
States and the federal government can help our loves ones stay healthy by clearing their criminal records of non-violent, drug-related offenses and allowing them to access housing, education aid, and food support programs without restriction. Seven states have some form of automatic record expungement, including for minor marijuana offenses. And, 36 states have removed at least some bans on food support and basic services for people with substance use disorder. These policies decrease recidivism, increase employment, and save taxpayer money.Require insurance plans to cover certified recovery coaches.
Peer recovery coaches are licensed professionals who help people in treatment for substance use disorder stay in recovery. They assist individuals in obtaining healthcare benefits, securing jobs, and finding safe housing. People who have a peer recovery coach, in conjunction with other substance use disorder treatment, achieve long-term recovery more than individuals who do not have this support. States and the federal government can require that insurance plans and Medicaid cover the use of peer recovery coaches for substance use disorder. At least 36 states provide for Medicaid coverage of peer recovery coaches. We can expand this coverage to all insurance plans and states.Take action now →
People with substance use disorder need medical care from doctors and behavioral health professionals. They cannot easily receive that care if they are arrested and put in prison. To help them stay in treatment and out of poverty, we can: