(a lower dose opioid designed to help users taper off their dependence). Today, agencies have added Narcan (naloxone) and test kits to their arsenal. Narcan is a nasal mist that first responders use to block the actions of opioids, particularly during the overdose process. Opponents contest that it only perpetuates the addiction cycle, and encourages riskier abuse. But first responders in hard-hit areas like West Virginia, Maryland, and Massachusetts say that they couldn’t do their jobs without it. Also controversial are test kits, which some agencies hand out alongside clean needles, so that users can test to see if their heroin is laced with fentanyl. Any method that aids a user in his or her abuse is never popular, even when it prevents an overdose. And as the conversation about national funding heats up, the cost of the war on drugs— which has exceeded $1 trillion over a 40-year period, according to the Associated Press—may become a particularly hot topic. Recently, drug companies themselves have come under fire for over-promoting the use of painkillers. Fortune magazine reports that multi-state lawsuits against distributors and man- ufacturers of opioids—alleging negligence and aggressive marketing—are on the rise. Some of the controversy lies in the stigma sur- rounding users. Heroin and opiate addition has existed for thousands of years, but what’s different with this recent epidemic is that many begin their addictions innocently, sometimes not even know- ing the dangers of taking opioids. For the most part, this crisis did not begin in the social setting, launched by gateway drugs. The Fix podcast authors contend that for many years, health care professionals themselves didn’t really know what to do with addicts. In some communities, users are victims, and in other areas, they are first and foremost criminals. Yet the misuse of prescriptions is often seen as something that anyone can overcome, and chronic pain vic- tims themselves often think they can handle it. And heroin users are often viewed as beyond help. Because opi- oids train a person’s brain to crave a high, users can make irrational decisions in order to find the next high—committing other crimes to pay for a habit, lying, or stealing someone else’s prescriptions—and it can be difficult to see bad behavior as something beyond the individual’s control. Addiction and recovery professionals are hard pressed between making clients accountable for their actions, and creating an environment where they can reach beyond their physiological cravings and make better decisions. All in all, pointing fingers in this crisis has Ī 14 WWW.AGRM.ORG JANUARY/FEBRUARY 2018