Lifting the Burden of Addiction: Philanthropic opportunities to address substance use disorders in the United States

Street crime is no longer the clearest barometer of our drug problem; corpses are.” – Sam Quinones, reporter

“We must bolster our current approach to addiction with more common sense. We must address it as a public health crisis, providing treatment and support, rather than simply doling out punishment, claiming victory, and moving on to our next conviction.”  – Peter Shumlin, Governor of Vermont

“Alcohol, prescription drugs, heroin, cocaine, they don’t ask you for your party registration card when the drug dealer is selling it to you.” – Chris Christie, Governor of New Jersey

“The thing people need to know is: Nobody wants to be like this.” –  Michelle Frigon, recovering opioid user

Substance use disorders cost lives and dollars. America spends over $400 billion a year on costs related to substance use, and each year over 150,000 people in the U.S. die preventable deaths related to drugs or alcohol.  And the numbers are getting worse over time: drug-related deaths increased by nearly 300% between 2001 and 2013. For impact-focused donors, the question in the face of these numbers and stories is: “How can I help?

Our latest guidance, Lifting the Burden of Addiction: Philanthropic Opportunities to Address Substance Use Disorders in the United States is our team’s answer to that question. In it, we include nine specific high impact opportunities to prevent death, improve lives, and save dollarsalong with over 20 organizations with a track record of success. Here’s some of what the guide can help funders achieve:

  • Prevent overdose deaths and the spread of HIV. The process of recovery can be long—or tragically short, for those who die from their disorder before they can overcome it. Overdose prevention kits help drug users stay alive long enough to get better, and clean syringe programs reduce the spread of HIV without increasing drug use.  In addition, clean syringe programs save three dollars for every dollar spent.   
  • Make the full range of effective treatment available. Most people know about 12-step treatment models based on self-help groups like AA. But many people, even health care providers, don’t know that other treatments like cognitive behavioral therapy, medication, and mindfulness training can be as or more effective
  • Reduce substance-related homelessness and instability.Compared to the general population, homeless individuals are four to six times more likely to have a substance use disorder. Stable, supportive housing for homeless people with substance use disorders can make an immediate positive impact in quality of life while also improving access to treatment and decreasing the use of emergency services. Such programs save public dollars while keeping recovery within reach. 
  • Innovate for more effective treatment and prevention. Effective prevention of substance use disorders would be a game-changer, and better treatment would save lives, dollars, and heartache for millions of Americans. We’re not there yet, but researchers from neuroscience, behavioral science and even economics are testing new approaches and learning more every day about what works
  • Increase access to care for everyone who needs itPhilanthropic support has already helped create policies with the potential to expand treatment access for thousands—or even millions—of individuals. To realize that potential requires smart implementation.

The full guide contains additional information about these opportunities along with resources and tips for identifying other promising efforts to support. We present these options as a menu for action. Not all will appeal to every donor, but all have potential for high impact, strong implementing organizations, and a clear role for philanthropy.  As always, we hope this work helps donors move from good intentions to action, and ultimately to lift the burden of addiction for everyone affected by the disorder.

Click here to read our full guidance on substance use disorders.