Why haven’t we taken any meaningful steps to solve the opioid crisis, one of the greatest public health threats of our time?

Millions of people abuse opioids each year. Their victims cross every socio-economic category. Hundreds of thousands have died. Their impact has been felt for years, yet we have no national collective plan to respond.

To begin to address it, we need a strategic national dialogue, a more effective legal strategy, a willingness by a dysfunctional Congress to come together, and a long-term commitment to do the right thing.

Prosecutors around the country are trying to lead the way as they strike individual settlements with opioid manufacturers such as Johnson & Johnson. But these arrangements sidestep accountability on a broad national scale, which would be far more costly to these companies in the long run. 

Piece-meal agreements with opioid manufacturers are a distraction, not the answer. We need bold and coordinated action. As we learned from the landmark 1998 master tobacco settlement:

There’s strength in numbers

The weight of a unified group of Attorneys General ultimately forced the tobacco industry to redress the impact of tobacco use and publicize the dangers of smoking for young people. It wasn’t achieved by striking small, disjointed settlements with individual manufacturers, but through a collective agreement with the major tobacco companies.

Settlement resources must help all of the victims

The tobacco agreement gave states wide latitude to decide how to best use settlement resources, and states were given the authority to use the funds as they saw fit. But the funds didn’t always address the problem they were intended to serve. Some states used funds to plug budget holes and failed to address the needs of victims. Opioid settlements must mandate that resources will be used in support of victims and begin the process of rebuilding impacted families and communities. 

Settlements themselves must go well beyond one-time payments

The tobacco settlement required individual companies to make initial payments totaling more than $10 billion — and pay nearly $200 billion to states over 25 years. Some companies are obligated to pay states annually in perpetuity.

Phillip Morris alone has paid over $85 billion to states since 1997. Today’s opioid manufacturers should help the addicted and must be compelled to pay far more than a simple one-time fee. The companies that knowingly flooded the country with highly addictive drugs owe it to the nation to contribute to efforts that can turn the tide on this epidemic moving forward. And they need to be held accountable for the problem they created. 

Over 10 million Americans — some of them as young as 12 years old — misused opioids in 2018 alone. More than 130 people died every day from opioids in 2016 and 2017. The companies responsible must be forced to pay a significant portion of the long-term plan that’s needed to address it. 

We need a comprehensive public health approach and a national call-to-action if we have any hope to course correct. Settlement resources are essential — but they’re only one part of the solution. We must accept the fact that it took years for the problem to take root, and the road to rebuilding healthy families and resilient communities will belong. There is not a moment to waste.

We need to advance treatment, care, support, and prevention programs to ensure people receive the help they need. 

We need laws that protect those who rely on opioids to treat severe chronic pain — and ensure those who need opioids are not denied access because pain control is a science that requires further research and support.

We need investment by community leaders to create local support and prevention groups to de-stigmatize addiction and pull it out of the shadows.

We need training and support for public health professionals to treat the addicted and their families. 

We need better training of law enforcement to spot the warning signs and work with their local communities to ensure victims know where to go to receive help.

And above all, we desperately need our elected leaders to make it their New Year’s resolution to stop digging in and start leaning in to pass meaningful legislation to address this public health crisis. 

Dr. Lyndon Haviland, DrPh, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy and former Chief Operating Officer of the American Legacy Foundation.