Threats Loom Over Hard-Won Gains in Combating the Opioid Crisis

Not long ago, the opioid epidemic appeared insurmountable. Between 2020 and 2023, over 400,000 Americans lost their lives to drug overdoses—more than double the fatalities caused by firearms or car accidents. However, 2023 marked a turning point with overdose deaths declining by over 25 percent, driven in part by innovative public health initiatives that expanded access to lifesaving treatments such as Narcan and Suboxone. This progress signals a hopeful easing of the crisis.

Nonetheless, recent federal legislation threatens to derail these advances. Cuts to Medicaid embedded in the law, designed to reduce taxes for wealthier Americans, will strip millions of their health coverage. While many medical conditions will be affected, individuals battling opioid addiction are particularly at risk since nearly half of non-elderly adults with opioid dependence rely on Medicaid for treatment. Without insurance, many are likely to discontinue therapy and relapse. Estimates from academic researchers suggest that over 150,000 Americans could lose access to essential opioid treatments due to these policy changes.

The recent decline in overdose fatalities should be celebrated and serve as a foundation for further action. The opioid epidemic has contributed significantly to the stagnation of American life expectancy in recent decades. While life expectancy in the 1980s was comparable to that of other developed nations, the United States now ranks lowest among wealthy countries, a disparity driven in part by the unprecedented surge in overdoses starting in the early 2000s.

Although political leaders have acknowledged the opioid crisis as a devastating national tragedy warranting intervention, current policies are undermining the progress made. This disconnect highlights a failure to uphold commitments to support the working-class communities most affected by addiction.

The nation’s political response to the opioid epidemic has historically lagged behind its severity. Following the introduction of OxyContin by Purdue Pharma in 1996, overdose deaths doubled from 1999 to 2006. However, substantial legislative action was delayed until 2016, and it was not until 2017 that a national emergency was declared. Despite these measures, experts have characterized the response as insufficient, barely scratching the surface of the crisis.