A fresh approach to fighting America’s opioids epidemic

Even as vaccination rates slowly climb, another deadly health crisis has been getting worse: The overdose epidemic. Last year, a record number of Americans died from drug overdoses: 93,000. That’s 254 people a day, or more than 10 every hour. Three-quarters of them died from opioids, often by unknowingly using drugs laced with fentanyl. 

The deaths are especially tragic because the victims are so often young. More than half of all overdose deaths occur among those 44 and under, based on the most recent data. They are in the prime of their lives, and then they are gone, devastating their families. 

We have all met too many Americans who are suffering from losing loved ones to this epidemic, which affects people of all backgrounds, in both urban and rural areas. And we are all deeply concerned about the damage this is doing to our country.   

Long before COVID arrived, U.S. life expectancy has been declining, largely because of overdoses. For decades, Americans could expect to live longer and healthier lives, thanks to advances in medicine, increases in living standards and cardiovascular improvement, as well as declining rates of smoking and violent crime. 

But now, we are moving in the opposite direction. And even after the pandemic subsides, life expectancy will likely continue to decline unless we urgently confront pressing public health emergencies like the overdose epidemic. 

The challenge we face is no longer just cracking down on doctors who over-prescribe pills and pharmaceutical companies that glutted the market, while outrageously downplaying the dangers of their drugs and failing to manage their supply chains to prevent abuse. Those problems created the epidemic and both groups should continue to be held accountable. 

But today, the leading cause of the overdose epidemic is not prescription pills, but street-level drugs that are cheap and easy to obtain. We need more federal support to fight this battle effectively, but we cannot wait for it to come. And so, we are joining forces to do more to turn the tide on this crisis — by acting boldly, following the science and data, and sharing lessons learned. And we know progress is possible.  

In 2018, Bloomberg Philanthropies began working with leaders in Pennsylvania to expand services and provide support to those struggling with addiction, while also focusing on prevention. The next year, those efforts expanded to another state hit hard by the pandemic, Michigan. In both states, overdose deaths fell before the pandemic — even as they increased nationwide.  

In fact, Pennsylvania had the largest decrease in overdose deaths of any state in the country from 2017 to 2019. During the pandemic, some of that progress has been reversed. But the increase in deaths has still been much lower in those two states compared to the national average. 

Through this work, a proven blueprint for confronting this epidemic has emerged. It centers on taking a public health approach to the issue, rather than relying on the criminal justice system so that people are not afraid to call for help.  

A public health approach includes increasing access to medications and treatment for people suffering from addiction, which must be done wherever those suffering from addiction interact with people who can help, including hospitals and prisons.  

It also means increasing the availability of harm reduction services including life-saving emergency medications like naloxone, which can prevent an overdose from becoming a death. And it means raising awareness and reducing stigma through public communication campaigns. 

Prior to the work in Pennsylvania and Michigan, there had been no major philanthropic support for fighting the overdose epidemic. With budgets stretched thin from the pandemic, and the overdose epidemic getting worse, states need more technical expertise and staff support to tackle this mammoth challenge. 

And so, working together, Bloomberg Philanthropies is expanding its work through a $120 million program that will support work in five more states — Kentucky, New Jersey, New Mexico, North Carolina, and Wisconsin — while deepening the work in Michigan and Pennsylvania.  

Our hope is that our shared commitment to this work inspires others, especially our elected officials in Washington, to confront this crisis with the urgency and boldness it requires. A nation as great as ours cannot tolerate losing so many of our people, so senselessly, every day. 

Michael R. Bloomberg, founder of Bloomberg LP and Bloomberg Philanthropies, is a former mayor of New York City and the WHO Global Ambassador for Noncommunicable Diseases and Injuries; Roy Cooper (D) is governor of North Carolina; Tony Evers (D) is governor of Wisconsin; Phil Murphy (D) is governor of New Jersey.