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24 25 Nelson believes that the AATA has adopted a more urgent posture, recently, in response to the current opioid crisis that has engulfed the country. “The opioid crisis is terrifying,”he declares.“It’s the worst publichealth crisisAmerica has faced in decades. The death rate is climbing at a scarypace.It’smaking overdoses the leading cause of death for people under 50–worse than guns,worse than car accidents. “The problem is that the easy response is to crack down on doctors and pharmacies and limit access to prescriptions for opioids,which has created a great opportunity for criminal organizations and cartels to import fentanyl and carfentanil coming in from China and across the border and filling the void. It’s very easy to have a reopening of the War on Drugs, but that doesn’t really solve the problem.What we really need is to get to providing evidence-based resources and access to care that gets people away from opioids, but still addresses the underlying pain that’s driving them towards illegal sources.” “The longer term challenge is how do we address the underlying pain crises?”Nelson adds.“Part of it is a crisis of lost social connection in American life.We see the problem is worse in places where unemployment is higher,where social networks have decayed, and we have work to do to rebuild. We started the organization focused on addiction treatment, but the opioid crisis is deeply imbedded in the problem and the solution.” While there are few positives to be seen in the opioid dilemma,Nelson concedes that it has created a similar sense of urgency in the general popula- tion.“Opioids have become a ‘soccer mom’ issue,”he maintains.“The death toll has gotten everybody’s attention and has put the issue front and center. When the attempt in 2017 to repeal the Medicaid expansion under the Affordable Care Act failed, it was specifically because nine Republican governors THE AMERICAN ADDICTION TREATMENT ASSOCIATION who had expanded Medicaid were concerned about the opioid crisis. So, I think that the opioid crisis has been ‘useful’ by generating awareness of the problem. I also think, for addiction treatment, this is creating pressure to end the separation of addiction treatment from the rest of healthcare, as well as the stigmatization of addiction. I don’t know anyone who hasn’t been touched by it in some way at this point, and I think that’s going to continue.” It’s a lot of work for the AATA’s staff of four. Luck- ily, they are abetted by a five-person Board, and an advisory committee made up of 20 individuals who are very active in leading clinical and treatment organizations around the county.“We try to build a broad network of people who are committed to the same values that we are in terms of supporting and helping the industry get stronger,” says Nelson. “Addiction treatment is changing radically and we’re helping to spread effective information about how you treat people with all kinds of problems–alco- hol is still a massive problem; we have the opioid problem; we have all these other drugs out there. So, there’s a critical need to develop evidence-based standards and share that information so that people are getting the care they need and programs are adapting.” We want to get more people aware of our re- sources so that they take advantage of them,”Nel- son says, in summation. “We’re putting information out there to get people what they need: for patients –safety and protection in the process of recovery; and for providers–to be able to do the right thing and survive in the crazy environment in which we find ourselves.”