When you find someone stealing from your home, you don’t give them the keys and tell them to guard your house. That’s essentially what Francis Collins, director of the National Institutes of Health (NIH), is proposing with the agency’s strategy to address the opioid crisis. This week the NIH press office revealed its plan to invest in creating more drugs and devices to counteract the effects of opioid addiction—to the delight of drug and device companies and the dismay of opioid experts.
Even as a growing list of state and local governments file suits against drug makers for their role in distributing and marketing addictive painkillers, the NIH proposes to give companies the opportunity to further profit from a problem they helped create. As many opioid experts have pointed out, opioid addiction is a problem that cannot be solved with drugs alone.
Research from economists Ann Case and Angus Deaton suggests that the lack of economic opportunity is a significant contributor to addiction and other “deaths of despair” such as suicide. “This is a complex bio-psycho-social disease,” said Anna Lembke, a professor of behavioral science at Stanford. Drug interventions, said, “really are only looking at the biology piece.”
We need holistic solutions to the opioid crisis. The first step is to get doctors, who have been the main targets of drug company marketing, to prescribe more judiciously. Addiction services can be few and far between for many addicts, and out of reach for people who are uninsured or on Medicaid. That’s a problem that can be solved with greater public investment in treatment centers, which have been shown over and over again to produce a big return on investment in terms of reduced rates of addiction, reduced crime, and less spending on other medical treatments.
But if we’re really going to address the opioid crisis, we need as a nation to acknowledge the deeper causes raised by Case and Deaton. That will require investing in education and jobs to improve public health, not just in new drugs and medical devices.