When it comes to supporting accessible and effective addiction treatment and other vital healthcare to address addiction and other health epidemics, the nation’s public health systems, policies, and philosophies matter to everyday people.
“Public health in America is being actively dismantled—not just in funding or leadership, but in spirit,” wrote MeiLan Han, MD, the chief of pulmonary and critical care at the University of Michigan recently in an opinion piece for STAT. “Institutions that once anchored our national response, like the Centers for Disease Control and Prevention and National Institutes of Health, are being stripped of authority and resources. Grants to study vaccine hesitancy are vanishing. Routine flu vaccine ads have disappeared. The infrastructure is weakening.”
Dr. Han feels that something deeper is unraveling, too: “the idea that we owe anything to one another at all. We are living through a responsibility recession—not of personal responsibility, but of shared commitment to one another’s well-being. We’re witnessing a collective pullback from the values and systems that make public health possible.”
Public health involves “a collective social effort to enhance health and prevent communicable and non-communicable diseases,” explains a website providing medical and life science news. “Public health fulfills its mission through organized, interdisciplinary efforts that address the physical, mental, and environmental health concerns of communities and populations at risk for disease and injury.”
That means public health isn’t the sum of individual choices, warns Dr. Han. “It’s our collective agreement to protect the most vulnerable among us: the elderly, the immunocompromised, the uninsured, the people who can’t isolate or work remotely. When we treat public health as a menu of optional precautions, we stop being a society and start being a collection of disconnected risk profiles.”
REASONS FOR PUBLIC HEALTH BEING COMPROMISED
According to Dr. Han, change didn’t come overnight. “It crept in gradually, in part due to how pandemic messaging evolved. As guidance shifted and fatigue set in, people were told to assess their own risk,” she wrote. “But now the consequences are visible everywhere. When someone chooses not to vaccinate, they’re not just deciding for themselves. They’re deciding for the newborn at the grocery store, the transplant patient in the next row of the plane, the teacher with asthma.”
“The idea that all health decisions are personal is a myth born of privilege,” says Dr. Han. “Many of my patients don’t have choices. They live with chronic illness, limited access to care, or jobs that expose them to daily risk.”
She feels that personal choice in the area of public health has been weaponized to undermine shared responsibility. “Opting out of vaccination is seen as empowerment, and doing nothing is framed as virtue. The social contract has been quietly torn up and tossed aside.”
The dilemma is that when people stop trusting institutions, it doesn’t mean they are no longer needed. “People don’t stop looking for answers, wrote Dr. Han. “They just look elsewhere—often to misinformation, charismatic grifters, or dangerous conspiracy narratives.”
BETTER COMMUNICATION
For Dr. Han, the solution isn’t to burn everything down—it’s to rebuild better. “Invest in infrastructure that works. Communicate clearly, consistently, and transparently. Because when the NIH disappears, there’s no private-sector replacement waiting to fund basic science. When the CDC is reduced to a shell of its former self, there’s no crowdsourced version of public health ready to step in.”
Rugged individualism is not enough to save us. “Health and Human Services Secretary Robert F. Kennedy Jr. recently downplayed the measles outbreak, suggesting that good nutrition and vitamin A are sufficient defenses, Han wrote. It’s not true.”
IMPACT ON ADDICTION TREATMENT
Another long-lasting public health crisis in the United States has been addiction and overdose deaths. One of the targets of Secretary Kennedy’s transformation of public health is the $8 billion Substance Abuse and Mental Health Services Administration. According to coverage by the Associated Press, SAMHSA would be “absorbed into a new office, where its more than 700 staffers would co-exist with employees from other agencies responsible for chemical exposures and work-related injuries. In all, five agencies are to be swallowed up under what will be called the Administration for a Healthy America, or AHA, echoing Kennedy’s Make America Healthy Again slogan.”
“Millions of Americans who get mental health and substance use services depend on SAMHSA even if they have never heard the name of the agency,” Brendan Saloner, an addiction researcher at Johns Hopkins Bloomberg School of Public Health told the AP.
Experts fear that crippling SAMSHA could stall progress on overdose deaths. The agency regulates methadone clinics and pays for addiction prevention efforts in all 50 states.
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Isolation and lack of community are at odds with effective addiction treatment. At Foundry Front Range, we believe that every patient deserves the best medical care. When it comes to behavioral healthcare, the quality of your treatment provider and their ability to understand your needs, provide effective therapies, and identify the specific resources that will help you maintain health and recovery after treatment are vital to your success. Foundry Front Range aims to be the gold standard for comprehensive, coordinated, and accessible treatment for substance use and co-occurring mental health disorders.
But we also believe that home environments, workplaces, family systems, and community culture play important roles in helping people stay healthy and maintain recovery from substance use and co-occurring mental health disorders.
“We must continue to advocate for ongoing education, understanding, and policies that have begun to have real-world impacts. We are seeing young adults choosing to reduce or forego alcohol consumption. More sober events are springing up in Colorado and nationwide. Initiatives led by SAMHSA and greater awareness generally of the health impacts of substance use and the ability to promote healthier lifestyles are working, in large part due to science-based government policy and spending that leads to grassroots action and a belief in individual responsibility for personal and public health,” suggests Foundry Front Range CEO Tom Walker. “We need to help keep public health awareness moving in the right direction so that we can continue to see more movement toward healthy behaviors. The dismantling of SAMHSA and other steps to reduce access to recovery-oriented public education and programs may threaten the progress being made.”
