If you don't support Medicare-for-All, you're supporting the opioid crisis

Lawsuits are not going to solve the opioid and overdose crisis, particularly when the proceeds rarely reach those affected. Radical, structural reform is needed to stop this public health emergency from worsening

It comes as a surprise to no one that the United States – and even many parts of the world – is in the midst of a crisis that has claimed 400,000 lives over the last two decades. Currently almost every state and legal jurisdiction in the US has filed suit against pharmaceutical companies, seeking fiscal relief for the role these companies have played in the crisis related to distribution, manufacturing, and marketing of opioid medications as “non-addictive”.

Federally, many of these lawsuits are joined into a master settlement case currently slated to start proceedings in October in Minnesota. Lawsuits in Oklahoma have recently been settled (Purdue settled for $270 million with the state back in March) or decided by a Judge following a trial, as happened on Monday in the Johnson & Johnson case with a settlement order in excess of $572 million.

If you are like me and many others in the substance use recovery community, your first question is likely: “Where is this money going and will it actually be used to help the communities impacted most?” In the case of the Oklahoma Purdue settlement, we have our answer: not really.

Most of the funds will be used to support new academic centers, with very little going back to the communities impacted to fund substance use disorder treatment and recovery supports. While it is too early to tell in the Johnson & Johnson case, it will likely be more of the same – new academic centers, a promise to set aside resources for medications for treatment and exorbitant fees for legal teams. Very little (if any) will actually make its way back to helping the families, individuals, and communities that need it most.

If these lawsuits are the answer to solving the opioid crisis, then why do resources so rarely make their way back to supporting the very things that help to reduce overdoes and support long-term recovery? While the lawsuits are a great mechanism for holding pharmaceutical companies accountable, they are not real solution for the American cities, towns, and people who desperately need access to healthcare and recovery support services. After all, Purdue has settled in opioid related cases before (well in advance of recent suits and settlements).

Real, sustainable solutions to the opioid and overdose crisis in the United States require much more nuance and diversity than lawsuits. This is even more evident when those lawsuits are limited to pharmaceutical companies and do not currently extend to insurance, medical providers or private prison operations, all of whom are also culpable in the current crisis.

These solutions require not only vast amounts of fiscal and human resources, but will ultimately require an equally vast and radical series of systemic changes to our public and private systems in the United States. This includes not only how and when pharmaceutical companies market their approved medications and how such medications are vetted by the Food and Drug Administration, but more importantly, our healthcare system writ large.

True sustainable change will ultimately come when every individual in the United States has equitable access to comprehensive healthcare, not from ad hoc funding from special grants or lawsuits. While billions of dollars from current lawsuits would theoretically help our communities, they pale in comparison to the estimated $100 billion needed to truly turn the tide on the crisis. Even then, what does funding in such a manner do to address the next public health epidemic? The answer, ultimately, is very little.

Creating a mechanism for every individual to access the healthcare they need, whenever they need it, without regard or the need for payment, is the type of system transformation the US needs. We need Medicare-for-All in order to address the opioid and overdose crisis, but also to improve the lives of all Americans – with a substance use disorder, living in recovery, or otherwise. If you don’t support Medicare-for-All, you’re helping to uphold a system which has enabled this public health emergency to happen and continue to worsen.

In the midst of an ever-present election season, now is the time to continue asking who we support, what our communities need, and how can we solve our issues together? Democrat, Republican, or Independent, substance use disorders and recovery should be non-partisan issues. But this is a politically-influenced crisis, which politicians from both parties have either actively contributed to or looked the other way from. For it to end, our political choices matter now more than ever.

2020 is the next opportunity to vote for systemic healthcare change that our healthcare system desperately needs. Lawsuits are not enough. Priority number one for anyone who has made addressing the opioid and overdose crisis should be guaranteeing universal healthcare – helping our communities heal won’t come from lawsuits. It will come from sparking true systems change in our country.

Robert D. Ashford is a recovery scientist at the Substance Use Disorders Institute at the University of Sciences and the Executive Director of Unity Recovery. He was an appointee to the Philadelphia Mayor’s taskforce to combat the opioid epidemic and is a person in long-term recovery.