We can get better than an “F” in life expectancy and health. A new study --U.S. Health in International Perspective: Shorter Lives, Poorer Health -- compared life expectancy and health in the United States with sixteen “peer” nations, and found that the United States ranked last in life expectancy and fared worse than its peers in life threatening health areas. One of the major contributors to our “F” rating is the failure of our substance abuse policy over the last four decades.

Substance abuse plays a leading role in seven of the nine health areas found to cause this nation to lag behind our peers : 1) adverse birth outcomes, 2) injuries and homicides, 3) adolescent pregnancy and sexually transmitted diseases, 4) HIV and AIDS, 5) alcohol and drug related deaths, 6) heart disease, and 7) disability. Substance abuse kills one hundred and sixteen thousand Americans, including thirty five hundred children, each year, and has stricken twenty three million more who are at risk of losing their lives or suffering devastating effects if they do not receive specialized care. Without recovery, they are not only a risk to themselves -- they are a risk to their children, born and unborn, their family members, and their communities.

In order to combat this health crisis, the United States may be emerging into a new era in substance abuse policy by focusing on recovery from this disease. Past federal substance abuse policy has relied upon criminalization, prevention and treatment, and has been ineffective. Similar to gun control laws, criminalization (better known as “The War on Drugs”) and prevention seek to stop the supply and use of illegal drugs . Yet, drugs do not misuse people -- people suffering from addiction misuse drugs - and if one drug is in short supply, another will take its place. In addition, without diminishing the sanctity of any life lost to this disease, the use of illegal drugs accounts for only about sixteen thousand of the one hundred and sixteen thousand deaths from alcohol and drug abuse each year. Moreover, although treatment serves an often critical purpose, funding is extremely limited, treatment is expensive, and such medical care usually lasts for a relatively short period of time. Addiction, however, is a chronic illness, like diabetes, for which there is no medical cure. As a result, according to the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration, recovery can be achieved and maintained through an individualized approach including ongoing medical care as needed, continued participation in 12 Step recovery programs, and assistance reentering society, such as sober housing, childcare and work training.

We are at an urgent crossroads in fighting this epidemic. In a recent speech at the Betty Ford Treatment Center, Gil Kerlikowske, the Director of the National Drug Control Policy, announced that we can and must make progress against this health crisis by allocating some of our substance abuse resources to programs which support recovery. The new federal approach is about working smarter, not harder. We are spending more than comparable nations on health and getting less. For example, substance abuse costs us close to 200 billion dollars a year. We have been using that money to advance ineffective approaches. Let's use less of those resources and achieve a better outcome. We can do that with a recovery focus.

Our states and local governments also need to redirect their efforts. Kerlikowske pointed out that our states and local governments have enacted over thirty eight hundred laws which impede access to recovery. One law, for example, is the proposed Los Angeles Community Care Facilities Ordinance, which may be enacted this year. The ordinance is not designed to help those in our community suffering from substance abuse -- it is aimed at preventing them from living and recovering together in residential homes, despite federal endorsement of these homes and established law prohibiting this type of housing discrimination. Although Kerlikowske has committed to litigate against all state and local laws which impede recovery, is that really going to be necessary? States and local governments, like Los Angeles, should be policy leaders, not adversaries, in combatting this disease. Our community members and children are being lost. We have the most at stake in winning the substance abuse battle by redirecting our efforts toward recovery.

We can do better than an “F” -- we have to look at what is killing us and destroying our health and implement effective health strategies. We all benefit from that. Kerlikowske’s statements signal that President Obama may be the first president, in the 41 years since “The War On Drugs” began, to fundamentally change ineffective substance abuse policy by supporting recovery as a pillar of the government’s attack on this epidemic. The shift in national policy is not necessarily about legalizing illicit drugs - - it is about winning the substance abuse battle by enabling the sufferer to achieve long term recovery from the disease itself. This is a recovery effort which is worthy of our attention and support.

Lisa M. Jacobsen, Harvest House