Alexa Eggleston, JD, Senior Program Officer, Domestic Programs, Conrad N. Hilton Foundation
Tym Rourke, MA, Director of Substance Use Disorders Grantmaking, New Hampshire Charitable Foundation
2016 and 2012 Terrance Keenan Fellows
The country’s opiate epidemic grips national headlines. In 2016, more Americans died of an opiate overdose than from gun violence or traffic fatalities. More families have grieved the loss of a loved one due to overdose last year than in any year at the height of the AIDS epidemic in the 1980s. However, opiate overdose rates are only the tip of the iceberg. More Americans die annually from the overconsumption of alcohol than all illicit drugs combined; 4,300 of those deaths are people are under 18. The economic toll is staggering: more than $740 billion annually in costs related to crime, lost work productivity, and health care.
Philanthropy cannot solve this problem alone. But philanthropic organizations can help drive a national movement to address this epidemic. And it is essential that we do so.
It will not be easy. The roots of the epidemic are complex. Health care policy has routinely discriminated against those with substance use and mental health issues. Insurance companies have denied coverage, and state and federal policy has encouraged arrest and incarceration rather than access to prevention and treatment services. Those policies have disproportionally punished people and communities of color. Factors that can increase risk for a substance use disorder—adverse childhood experiences, toxic stress, family history, adolescent use, limited economic and social mobility—have been left unchecked, leading to a public health disaster that could have been avoided had we heeded the science earlier.
But here’s the thing: solutions are at-hand. Research, conducted over more than 30 years, shows that policies and programs already exist that are effective in preventing alcohol and drug misuse, reducing its negative effects, and helping people recover. But we have not had the will to support them.
The Affordable Care Act provided the most dramatic step forward in a generation. Under it, public and private insurance cover substance use services as an essential health benefit. Capacity to provide care has increased. The health care system has begun integrating prevention, treatment and recovery services within the medical home. And the recovery community has begun to build a national network to help people who have completed treatment to manage this chronic disorder. But these changes are imperiled.
Despite the great need—and the opportunity to conquer an epidemic—funders with a long-term commitment to this issue are rare. But philanthropy has responded to epidemics before, and with astonishing success. At the height of the AIDS epidemic, when the public sector was slow to respond, philanthropy stepped up. That response led to the health care innovations and policies that now give people with HIV the potential for a full life, albeit with a chronic, manageable condition. And that work paved the way for dramatic civil rights advances for people who are gay, lesbian, bisexual, and transgendered.
We can do the same with addiction—but philanthropy must lean in further. We are encouraged by interest from local foundations in tackling these issues, and hope these lead to more partnerships between local and national foundations. Our foundations—a statewide community foundation and a national family foundation—have combined efforts to implement a promising prevention system to screen young people for substance use. Flexible funding for the kind of innovation and change that were required was key. The next generation will need sustained, long-term investments to prevent and reduce the “addiction pipeline.” And the advocacy field needs expanded resources to continue to raise the voices of Americans who are wakening to the epidemic and saying “enough is enough.” And it is not only about funding: foundations must also raise our voices to help reduce the stigma and discrimination associated with substance use disorders.
No matter the issues your foundation focuses on—health equity, social determinants, or special populations—the insidiousness of the drug and alcohol epidemic is impeding progress on desired outcomes. It is time for philanthropy to come together in a coordinated effort to drive a robust, national movement that permanently transforms our health care system to better prevent and treat substance use disorders.
The New Hampshire Charitable Foundation and the Conrad N. Hilton Foundation are committed to bringing prevention, treatment and recovery to the millions of Americans who deserve it. Please join us. Philanthropy has an opportunity to play a key role in turning the tide on this epidemic. It is an opportunity to lead, listen, and inspire that we should not miss.