Can Employment Solve Drug Addiction?

The Centers for Disease Control and Prevention says that heroin use and overdose deaths have increased significantly in the United States. They attribute the rise in heroin use with addiction to prescribed painkillers and the low cost of heroin. This is so worrisome that the CDC is calling the trend an “epidemic.”

At the same time as heroin abuse is on the rise, the state of Illinois is proposing budget cuts that would decrease treatment. Governor Rauner’s budget proposal would reduce substance abuse treatment by 20 percent. If his budget is passed, about 7,800 fewer people will be able to access drug treatment. I’m grateful that I’m not responsible for balancing the state budget because these are difficult decisions to make. But cutting substance abuse treatment may cause an increase in costs for medical care and jails.

I’m interested in the substance abuse treatment proposals of US presidential candidates. Hilary Clinton has a plan to treat addiction as a public health issue, rather than a law enforcement issue. She is pledging more resources for drug treatment. She proposes wider access and distribution of naloxone, a drug that reverses the effects of an opiate overdose thereby saving lives. She wants to improve training for doctors who prescribe pain killers in order to limit prescriptions to addictive drugs. She also would devote money in federal and state partnerships to build state treatment programs with a match of $4 for every $1 that a state invests. As a drug counselor, I see that as a sound and comprehensive plan.

On the other hand, I saw a news article by Steve Benen on msnbc.com that reports that Rand Paul argued that the heroin epidemic in the US could be solved in part by putting people back to work. He is quoted as saying “If you work all day long, you don’t have time to do heroin.” Can employment solve drug addiction?

I asked a group of eight people who are in treatment for either pain killer or heroin addiction whether they would agree that employment is a deterrent to opiate addiction. All eight report that they abused opiates concurrently with being employed. It is not a deterrent. In fact, most people who suffer from an addiction are employed. Those who work have more money to spend on their habit.

That’s not to say that their work is not negatively affected by their addiction. As an opiate addiction spirals out of control, there are decreased productivity and increased absences. An opiate addict may miss work from either being sick from withdrawal or because they have to spend time accessing drugs in order to avoid withdrawal. This puts their job in jeopardy.

The National Center on Addiction and Substance Abuse (CASA) reports that 65 percent of people in jail have a substance abuse problems and only 11 percent get treatment during their incarceration. Mr. Rand’s would have difficulty securing jobs for people who abuse drugs if they have a felony drug charge.

Putting people to work does not address the complexity of the heroin addiction epidemic.