The health news last week from the federal government was startling. Overall, mortality is up and life expectancy has fallen for the first time since 1993, particularly for Americans under age 65. It appears that the progress in longevity that we have come to expect is reversible.

Some of the deaths may be linked to obesity. But experts are also looking at what might be called the hopelessness epidemic –  the explosion of drug use and suicide, linked to a number of causes, including economic despair. But that’s not the whole picture. Much of America’s middle-class is now suffering from opioid addictions that some studies trace to uses that began with legal drug prescriptions.

Consider that heroin deaths now outnumber gun homicides for the first time, according to the Centers for Disease Control. “The epidemic of deaths involving opioids continues to worsen,” CDC director Tom Frieden said, referring to prescription opioid painkillers such as hydrocodone and oxycodone. “Prescription opioid misuse and use of heroin and illicitly manufactured fentanyl are intertwined and deeply troubling problems.”

Speculation abounds about what is causing this epidemic, but many believe it is at least partly fueled by poverty. And The Washington Post reported that the counties where Donald Trump’s candidacy outperformed the 2012 run of Mitt Romney, for example – largely rust-belt enclaves where jobs have long stagnated – had the highest drug, alcohol and suicide mortality rates. They were the poorest counties, the most economically hopeless.

While none of these relationships are causal, they are important considerations for designing responses. Remedies clearly need to focus on treatment and prevention rather than criminalization. And in that regard, we need to learn a lesson from “the War on Drugs,” which developed into a campaign against criminals and ended up putting thousands of nonviolent offenders in prison for decades.

The opioid epidemic deserves a smarter response. It’s easy to punish people and lock them away and declare progress. It’s also easy to make prescriptions for opioids harder to fill. But what about those already addicted, who in many cases were provided prescriptions for things like post-operative painkillers but received no guidance on how to safely wean themselves from the drugs? While we clearly need to give patients the treatment they need, we can no longer ignore the imperative of providing meaningful education and guidance about the ravaging effects of addiction.

And it’s vital to offer people the economic hope that will lift them out of their depression – both financial and psychological. If this epidemic is the result of poverty and hopelessness, then a raised standard of living and hope for the future must be part of the solution.

We call on the incoming administration to coordinate our national criminal, economic and health policy planning in order to address the opioid epidemic. 

Lives depend on it.

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