Overdose crisis is a moral crisis for society

Opinion editor's note: Star Tribune Opinion publishes a mix of national and local commentaries online and in print each day. To contribute, click here.

•••

"To save one life it is as if you saved all of humanity." — Talmud and Quran.

As a health care chaplain, I have seen the tragic impact of the opioid epidemic for years ("Fentanyl death toll: more than one a day," Feb. 15). More than 1 million Americans have died since 1999 from a drug overdose. More than 75% of drug overdose deaths in 2021 involved an opioid. These deaths of despair are the leading cause of death for people 18-45. Life expectancy in the U.S. is actually trending downward.

For the past year our organization has been doing public health outreach along West Broadway in north Minneapolis. We completed 37 interventions and five lives were saved with Narcan and basic CPR. In September 2022, we learned that there had been 14 overdoses in one parking lot along West Broadway.

In our outreach, we feed folks at risk of an overdose and equip them with Narcan and fentanyl test strips. We teach them that they are protected from prosecution if they dial 911 to save someone's life.

When there is an overdose we only have six minutes before there is permanent brain damage. Some fentanyl overdoses can require multiple doses of Narcan to reverse. Minneapolis police officers carry four Narcan doses. There is significant variation among law enforcement agencies in the number of Narcan doses officers carry.

One night in north Minneapolis it took 20 minutes for first responders to arrive. We administered CPR and revived a young man well before then.

Another overdose intervention involved a young African American woman whose friend had overdosed the night before. After we treated her she told me, "I took the same pills my friend OD'd on last night." Some of these overdoses might actually be suicides.

Our American health care system is broken, with a severe shortage of access to psych beds. Only 10% of people with opioid substance abuse disorder can gain access to treatment. Our correctional facilities are our modern day asylums. Our emergency rooms are burdened with people struggling with mental illness and addiction waiting for a psych bed to open. There is a significant shortage of supportive transitional housing for people leaving treatment and re-entering society after being incarcerated.

One of the factors that contributes to these systemic barriers to treatment is insurance companies failing to abide by the late Sen. Paul Wellstone's legacy bill, the Mental Health Parity and Addiction Equity Act of 2008. Humana and Health Partners were recently fined with only the equivalent of a speeding ticket for violating federal law. The Legislature and the Attorney General's Office should increase penalties for such offenses, which could very well contribute to premature and preventable deaths.

Glaring health care disparities confront our African American and Native American residents, who do not receive treatment at the same levels as white patients. One specialist in African American addictions has stated: "Our epidemic was ignored for the most part ... our population was always treated as a moral, criminal problem."

We must do much more to prevent these deaths. In addition to addressing the racial/ethnic health care disparities, we need leaders at every level of government to help confront the stigma and shame surrounding mental health and addiction. The brain is a human organ; its diseases should be treated with the same level of concern and compassion as any other medical condition. This moral overhaul of our health care system's approach to mental health would be in the spirit of Wellstone's legacy bill.

No more stigma, no more shame, more love and compassion for these diseases of the brain.

Howard Dotson is a health care chaplain with the Twin Cities Crisis Response Team.