Why Democrats are wearing purple ribbons at the State of the Union

Democratic lawmakers donned purple ribbons at Tuesday’s State of the Union — in an effort to raise awareness about America’s opioid epidemic.

In 2016, there were nearly 64,000 drug overdose deaths in the US — an all-time high — and at least two-thirds were linked to opioids. The rise in drug overdose deaths was a big reason that life expectancy fell for the second year in a row in the US, which had not happened since the early 1960s.

The early data suggests that 2017 was worse: According to preliminary figures from the Centers for Disease Control and Prevention, there were nearly 67,000 drug overdose deaths in the 12-month period through June 2017, up from more than 57,000 in the 12-month period through June 2016.

Democrats tweeted about the purple ribbons shortly before President Donald Trump’s State of the Union speech, calling on the president to do more to combat the opioid epidemic. Sen. Jeanne Shaheen’s office led the effort, her office said, handing out the ribbons to other lawmakers. Her state of New Hampshire has been one of the hardest hit by the opioid epidemic.

The opioid epidemic goes back to the 1990s, with the release of OxyContin and mass marketing of prescription painkillers, as well as campaigns like “Pain as the Fifth Vital Sign” that pushed doctors to treat pain as a serious medical problem.

Doctors subsequently prescribed opioids in droves, leading to a proliferation of pills that eventually ended up with not just patients but also teens rummaging through their parents’ medicine cabinets, other family and friends of patients, and the black market.

This contributed to the spread of opioid painkiller misuse and addiction, which over time also led to greater misuse of illicitly produced opioids like heroin and fentanyl. Drug overdose deaths have climbed every year since the late ’90s as a result.

The issue has really turned into two simultaneous crises — which Keith Humphreys, a Stanford University drug policy expert, has described as the dual problems of “stock” and “flow.”

On one hand, you have the current stock of opioid users who are addicted; the people in this population need treatment or they will simply find other, potentially deadlier opioids to use if they lose access to prescribed painkillers. On the other hand, you have to stop new generations of potential drug users from accessing and misusing opioids, including painkillers.

Addressing these crises will, experts say, require tens of billions of dollars.

As I previously explained, we have a pretty good idea of what those resources should go to: They could be used to boost access to treatment (particularly highly effective medications for opioid addiction), pull back lax access to opioid painkillers while keeping them accessible to patients who truly need them, and adopt harm reduction policies that mitigate the damage caused by opioids and other drugs.

Democrats have put out proposals to this end, aiming to add tens of billions to deal with the crisis over the next several years. But the proposals have failed to move through Congress.

Trump, meanwhile, has taken no significant action on the opioid epidemic. There has been no move by Trump’s administration to actually spend more money on the crisis. Key positions in the administration remain unfilled, even without nominees in the case of the White House’s drug czar office and the Drug Enforcement Administration (DEA). And although the Trump administration renewed a public health emergency declaration about opioids this month, it has led to essentially no action since it was first signed — no significant new resources, no major new initiatives.

Chuck Ingoglia, a senior vice president at the National Council for Behavioral Health, which advocates on addiction issues, summarized the general consensus among experts and activists: “A lot of talk, little action. It’s great that the president says this is a priority. It’s great that he convened a task force so we have another paper that says the opioid crisis in America needs attention. But too little has happened to actually do anything about it.”

For more on the opioid epidemic, read Vox’s explainer.

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