For those of us who remember the 80s and 90s we remember a country, shrouded in shame and secrecy around a disease that was taking its toll on American life. AIDS was mysterious and frightening. With much misinformation, it was viewed as a disease that gay men acquired. It was not uncommon for families to report their young son had died of “cancer” when the whole community knew otherwise. The secrecy, shame, and misinformation we literally killing a generation.
When the disease hit the culture, religious organizations seized the moment to speak about homosexuality as an affront to God and how promiscuity had led us to this point. Their rallying cry became “abstinence”. On its face, it’s not a bad plan: if the disease is transferred through sex, abstinence from sex would stop the disease. Trouble was, people are people and while that simplicity might have been well intended, it was ineffective at best. Here we are, warts and all, nobody is doing “life” perfectly. Ultimately, the crisis wasn’t waning by good intention and Christian ethic. If anything, those efforts were having a counter effect and hurting the cause. Seizing a crisis to orchestrate social controls has a diminishing return, it never goes well. Too many people were seeing the AIDS crisis as an opportunity to infuse the culture with how they felt people should behave, not the most important aspect of any human service, genuine concern. The “abstinence!” Rallying cry went nowhere, HIV infection continued to ravage New York, San Francisco, and Los Angeles and was spilling into more conservative communities with no light creaking through the deep walls of despair.
So what helped? Ultimately what helped was science and honesty, it takes America a minute of relying on an act of providence before we realize the gift from God is the scientific inquiry and the smart people to figure it all out. Then Surgeon General, C Everett Koop made, what was, for the time, shockingly blunt statements. Koop said “barring abstinence, the greatest protection against transmission of HIV is use of a condom”. Koop followed that up with sending information, factual, medical information, to every household in America. With science, with honesty, with clear information, rates of infection started to decline, saving untold numbers of American lives.
So what gives with the opiate crisis? The numbers are rising, not declining. We are at risk of losing a generation of young people as nearly 190 Americans die, daily, from a drug overdose. (https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates). When you consider the two situations, they aren’t so different. Families living in shame and secrecy, communities devastated and traumatized, imposing religion and morality into a public health crisis. Sound familiar?
If we are to solve the opiate crisis, it won’t be done by incarceration, morality, or religion. It will be done by applying the knowledge, values, and skills of public health practice. We say it all the time “addition is a disease” ok, so let’s treat those suffering like patients. Not like criminals, not like behavioral modification puzzles but like humans with individual needs and individual responses to various modalities of care.
Imagine if the opiate crisis had a C Everett Koop. A high level doctor advocating for significant change. What if there was a mailing to every American household giving factual information about various options for care, medication, and treatment? What if that mailing included Narcan and information about how to use it? That would help but what about the condom? Condoms changed the trajectory of the HIV crisis and saved unknown lives, wouldn’t it be great if there was a condiment for the opiate crisis? As a matter of fact, there is. Cannabis is our condom.
As much as America, parents, evangelicals, and Nancy Reagan like the idea of “abstinence” it’s just not realistic for all people. To be fair, it does prevent overdoses, with that said, it would have prevented HIV too and that didn’t go well. For some people, a comprehensive protocol, medically supervised, can include cannabis as a part of a recovery plan. What’s the beauty of it? It helps people in many ways, it helps with the discomfort of detox, can act as a valve to release pressure and keep people away from potentially lethal drugs. Cannabis inclusion can look like harm reduction but it can also look like medicine and enhancement. Here’s the biggest game changer: there isn’t a lethal dose. For people who can keep their drug use to “cannabis only” they have solved a huge amount of consequences from drug use and taken death off the table. Dead people find no recovery. Not ever.
We are constantly looking for ways to reduce harm in our daily lives, that might be an airbag, that could be sun block, it might be a condom and it might be cannabis.