Robert F. Kennedy Jr. and I share the experience of recovering from heroin addiction. Like me, he started the process at a residential rehabilitation facility in the 1980s and participated in a 12-step program based on Alcoholics Anonymous, which promotes abstinence from substances. Unlike me, however, he seems to have remained wedded to this treatment model, despite evidence that it fails many people with drug addictions. This could do enormous harm if he is confirmed as secretary of health and human services.
H.H.S. oversees the National Institutes of Health, the world’s largest source of funding for addiction research, and the Substance Abuse and Mental Health Services Administration, which provides billions in funding to states for drug treatment. It also leads the Food and Drug Administration, which regulates medications, and the Centers for Disease Control and Prevention, which tracks overdoses.
Addiction care has made agonizingly slow but meaningful progress since the 1980s, shifting from a one-size-fits-all model of total abstinence toward a data-backed approach that can include addiction medications and is tailored to people’s needs and preferences. This could be reversed if such therapies are no longer prioritized by the government.
bca77 slotMr. Kennedy has said very little about highly effective addiction medications, like methadone and buprenorphine, despite the fact that these are the gold standard for opioid addiction treatment. And he has repeatedly expressed opposition to other psychiatric medications, a view that could be particularly harmful.
Mr. Kennedy’s vision for the future looks like the past. He has proposed building a network of organic farms where people with addictions would labor in the fields and be “reparented” (potentially referring to an approach where the therapist and other patients serve as a surrogate family). Presumably they would also attend 12-step groups — as Mr. Kennedy still does and has repeatedly supported. Psychiatric drugs would almost certainly not be used: The farms would also be places for people to go to get off of antidepressants or A.D.H.D. medications, which may mean no anti-addiction medication, either. People would stay for as long as three or four years, eating healthy diets. Phones and other screens would be banned.
Mr. Kennedy also favors involuntary treatment. At the premiere of a documentary he made as a presidential candidate, he said that the government must use “tough love” and incarcerate people with addiction if they refuse treatment more than two or three times.
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She is spending far more money than he is — nearly three times more in August.
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