Ugly emails reveal 'conviction without facts' regarding substance use disorder

The Committee on Oversight and Government Reform holds a hearing at The Johns Hopkins Hospital to examine the opioid epidemic and the recommendations of President Trump's Commission on Combating Drug Addiction and the Opioid Crisis. (Algerina Perna, Baltimore Sun video)

I’ve been speaking out about the escalating overdose death toll and the impediments to needed reform, enough to have accumulated numerous email responses from people I don’t know. Because my perspective is that of a mother whose son struggled with a substance use disorder and died of a mixed drug overdose, many of these messages have been written out of kindness. But there are some startling exceptions.

Recently, after lamenting the pointless restrictions that blocked access to the life-saving medical treatment my son desperately wanted and failed to get, I received an email that simply said: “Let the addicts die.” I would no sooner reply to this than I would go toe-to-toe with someone in the fits of road rage. While I resisted the urge to fight back, I am troubled by the mindset and realize it is shared by a larger portion of the population than I’d like to think.


Not only is this attitude mean-spirited, but also it represents what I see as “conviction without facts,” a frightening combination no matter the topic — and downright dangerous in regard to the opioid epidemic where pervasive stigma compromises life-saving treatment.

Here’s what people don’t get: A substance use disorder stems from childhood trauma, addiction is a brain disorder rather than a character flaw, and families including children are suffering mightily as they struggle to cope with secondary but devastating consequences.

If you are not moved by the humanity, then consider the economic reality: Substance use disorders cost the nation over $150 billion annually in lost productivity alone and at least three times that if all associated societal costs are bundled together. This battle is all of ours.

Disseminating factual information is important. It can be powerful. I’ve seen it transform perspectives and even ignite a passion for making a difference. But, sadly, there are too many for whom the facts don’t seem to matter, too many whose propensity to dehumanize or even vilify those who are different trumps an interest in learning. Curiosity is non-existent, human suffering irrelevant.

Until we can break free from these cultural ills that seem to be on the upswing, I do not know how we move forward. In a fractured society, where both truth and compassion are under attack, effective problem solving is frustratingly out of reach. Yes, recent legislation addresses some important aspects of needed reform, but the overdose death toll continues to climb. We pat ourselves on the back for our efforts, and when the numbers speak the grim reality we cast blame elsewhere. But the fact is, our values are not aligned and our legislative initiatives lack focus and coordination.

On one hand, we have a surgeon general fighting to combat the stigma, declaring addiction a brain disease, calling for increased availability of effective health care, and supporting harm reduction strategies to reduce the risks of substance use. On the other hand, there is our justice department where the emphasis is on punishment rather than treatment, and where a continued belief in the “war on drugs” and incarceration as a solution supports the notion that those who suffer from addiction are bad or dangerous or have made the choice to be “addicts.” On the health insurance front, we have legislators fighting for expanded coverage and others fighting to undermine the gains made and thus devastate any hope for overcoming this deadly calamity.

How does our citizenry achieve enlightenment when our leaders send mixed messages and often perpetuate the assault on facts?

If we turn our backs on those who need help today, and sustain a society in which inequality and poverty are on the rise, despair will flourish. Given that childhood despair promotes addiction, we unwittingly create a new generation of young people whose insurmountable sorrows will lead them to substance use disorders.

I very much hope to be wrong in this bleak outlook. But in the foreseeable future, the rising overdose count — making the drug epidemic more deadly than gun violence and car accidents combined and claiming on average 200 lives per day in the U.S. — is not showing signs of reversal. And it won’t until legislation focuses on evidence-based health care rather than scanning postal packages, denying needed medication to chronic pain sufferers, and loading our jails with those who need medical help.

This is undoubtedly the biggest public health crisis of our time and is worthy of coordinated effort. For the 2 million currently suffering with a substance use disorder, I say, “Let them live.”

Jessie Dunleavy ( is a writer and retired school administrator.