July 30, 2023 - 8:00am

Over 100,000 people died by drug overdose last year, preliminary statistics from the CDC show. That death toll, essentially unprecedented in American history, is driven by the rise of the synthetic opioid fentanyl, a far-deadlier cousin of heroin responsible for the lion’s share of the fatalities. The problems are new and dramatic, and media stories in recent days have drawn attention to the crisis. So why are politicians acting like everything is fine?

Take the Biden administration’s response. In the Government’s 2022 National Drug Control Strategy, the bible of its drug policy approach, it aims for a 13% reduction in deaths by overdose. If achieved, this would be only slightly below 2020 figures. To reach that unambitious goal, the administration mostly plans to continue what it has been doing up until now, only at greater scale. 

Further evidence the Government struggles with policy creativity comes in its response to the emergence of xylazine, the horse tranquilliser filtering into the opioid supply. Despite having years to prepare a response — xylazine has been an issue in some places since at least 2018 — its proposal earlier this month mostly offers plans to make plans. New tests and tools will be developed, new treatment capacity created. How? Who’s to say. 

Of course, the Biden administration is not alone in failing to do enough on the drug crisis. Congress has taken a few steps, primarily expanding the availability of the drug treatment medications buprenorphine and methadone, and the overdose-reversing drug naloxone.  

These are vital steps, and worth applauding. But it’s hard not to see them as band-aids. Naloxone access does not significantly reduce overdose death. And moderately expanding the availability of medication-assisted treatment does little when people are not being identified for and aggressively shifted into treatment, by court order if necessary. 

There’s a classic line from an old episode of The Simpsons, in which a distressed character cries out, “We’ve tried nothing, and we’re all out of ideas!” A similar dynamic applies to the drug crisis: we’ve tried very little, and ideas are not forthcoming. 

This lack of action is arguably because policymakers still haven’t internalised the monumental scale of the crisis. For decades, policy was concerned with preventing the health harms associated with drug use and addiction. Treatment systems were patchwork, funding sparse, and most attention was dedicated to what are basically philosophical questions: what addiction is, whether drugs should be illegal or legal, and so on. 

It is important not to get bogged down in such disputes amid an unprecedented crisis. Drugs constitute the leading cause of death among Americans under 50: asking about their philosophical status is missing the point. 

Rather, policymakers need to make unprecedented commitments to treating addiction and deterring drug use. The former means continuing to expand funding for treatment, medication-assisted and otherwise, but also working with municipalities to identify those most at risk of overdose and proactively getting them into treatment, before they take the dose that kills them.  

The latter means communicating clearly and unambiguously to the public that the drug supply is poisoned, and that no amount of drug use is safe. It means shutting down open air drug markets and going after drug dealers who kill their clients.  

Such steps may stem the ever-rising tide of deaths. What’s apparent is that what we’re doing now isn’t working. And until policymakers understand that, no change will be possible. 

Charles Fain Lehman is a fellow at the Manhattan Institute and contributing editor of City Journal.