Elizabeth Warren is widely known for her public battles with big banks and Wall Street. She’s gotten attention for her wealth tax proposal. She’s praised, even by some conservatives, for her book The Two-Income Trap.
One part of the 2020 presidential hopeful’s record doesn’t get as much attention: her efforts to fight America’s opioid crisis.
As a US senator for Massachusetts, Warren has built a formidable record on the opioid crisis, which now kills more Americans than gun violence or car crashes. She’s called for more research into alternative painkillers, including medical marijuana. She’s tried to hold President Donald Trump’s administration accountable for its weak response, even pushing a government watchdog agency to investigate the administration.
And Warren, along with Rep. Elijah Cummings (D-MD), in 2018 introduced what experts regularly cite as the best bill in Congress on the issue: the Comprehensive Addiction Resources Emergency (CARE) Act. The bill would authorize $100 billion over 10 years to combat drug addiction, funneling money to cities, counties, and states — particularly those hardest hit by drug overdoses — and other organizations to boost spending on addiction treatment, harm reduction services, and prevention programs.
“Our communities are on the front lines of the epidemic, and they’re working hard to fight back,” Warren told me in an interview. “But they can’t do it alone. They can’t keep nibbling around the edges.”
Warren is now running for president, and her record could set her apart on one of America’s worst public health crises. In 2017, there were a record 70,000 drug overdose deaths, about two-thirds of which were linked to opioids. The number of overdose deaths was so high that the Centers for Disease Control and Prevention linked it to a rare drop in US life expectancy that year. Preliminary data suggests 2018 was about the same, or perhaps a bit worse, nationwide.
There’s wide agreement, among activists and drug policy experts, that much more action is needed to reverse the opioid crisis. Congress has changed some regulations and rules to open up access to treatment, and it’s allocated some funds here and there, in the single-digit billions, to the crisis. But advocates and experts argue something far more comprehensive — tens of billions of dollars over the next few years — is needed. Republicans, however, have resisted such calls, voicing skepticism of running up government spending (outside tax cuts for the wealthy).
Yet so far, no presidential candidate but Warren has put forward a concrete plan to confront the opioid epidemic. Her Massachusetts Senate seat has likely influenced her actions: Like the rest of New England, Massachusetts has seen a disproportionate number of overdose deaths. Its rate of drug overdose deaths was 31.8 per 100,000 people in 2017, far above the national average of 21.7.
The CARE Act makes the kind of commitment that advocates and experts have called for. As I’ve traveled around North America and talked to people on the ground about the opioid epidemic, experts and activists have, without even being asked about federal legislation, pointed to the CARE Act as an example of a serious attempt to tackle the crisis.
The bill “is the only one that really grasps the nettle of how big the problem is,” Keith Humphreys, a drug policy expert at Stanford University, told me. “Whatever else people might say about it, this is the first thing that really recognizes that [the opioid crisis] is a massive public health problem, like AIDS, and is not going to be solved by a tweak here, a tweak there.”
This comparison to the HIV/AIDS epidemic is one that experts and activists — and Warren — frequently use, because it’s an example both of the death toll of government indifference and of the power of Congress to actually make change. (Relatedly, drug overdoses now kill more people in the US each year than HIV/AIDS did at its peak.)