Five years after writing about addiction, and sharing my own experience, I’m revisiting the same question. why hasn’t anything improved? Addiction is often a response to instability, stress, and lack of support. Until we address those root causes, enforcement alone will continue to fail, no matter how long we pretend otherwise.
About five years ago, I wrote about addiction for the Valley Review, when it was still publishing. I wrote about policy, about enforcement, and about the idea that we were losing the war on drugs. I also wrote about my own experience, what addiction actually felt like from the inside, and how it doesn’t fit neatly into the narratives we tend to use to explain it.
I’m revisiting that now because not much has changed, except the outcomes have become harder to ignore.
Two people go in for the same surgery. They’re given the same prescription, an opioid like Oxycodone or Hydromorphone, and sent home with the same instructions. One uses the medication for a few days, maybe a couple of weeks, and then stops. The other doesn’t.
That difference is where most conversations about addiction begin, and where they usually go wrong.
If the substance itself were the cause, both outcomes would be the same. If it were simply a matter of willpower, the explanation would be easy. But neither holds up. The reality is more uncomfortable, the difference between those two people is not just what they were prescribed. It’s what they went back to.
One returns to stability, support, and a life that feels manageable. The other may return to stress, isolation, instability, or unresolved pain. In that context, the medication doesn’t just treat physical pain. It begins to relieve something broader. Something harder to name, and harder to escape.
That is where addiction takes hold.
Looking back now, it’s difficult to argue that anything has meaningfully improved. Despite decades of escalation, the underlying conditions that drive addiction have not been addressed. In many cases, they have worsened. Housing is less stable. Economic pressure is higher. Social isolation is more common. Mental health systems remain strained and often inaccessible. And the outcomes reflect that reality.
Addiction is still rising. Overdoses are still happening. The “war” never ended, it just stopped working. There is a reason for that.
Addiction is often treated as a problem of substances. In reality, it is more accurately understood as a problem of conditions. Chronic stress, instability, trauma, and lack of control over one’s life are not side factors, they are central drivers. When those pressures build without relief, people look for ways to manage them. Substances can provide that relief, at least temporarily. Not just from physical pain, but from everything else.
In that sense, addiction is not irrational. It is functional. It is an attempt, often a desperate one, to cope.
That doesn’t make it harmless. It doesn’t make it acceptable. But it does make it understandable. And if we misunderstand it, we will continue to fail at addressing it.
I know this not just from research, but from experience. I was addicted to fentanyl. I have now been clean for over 15 years. The difference between those two states was not simply a decision to stop. It was a change in the conditions around me, stability, support, and a life that no longer required escape in the same way.
That is the part that is often left out of public discussion. Recovery is framed as an act of individual will, but sustained recovery almost always coincides with a change in environment, access to support, a reduction in chaos, a sense that life is, if not easy, at least livable.
Without that, the expectation that someone will simply stop is not just unrealistic. It is disconnected from reality. This is where policy consistently breaks down.
We continue to invest heavily in enforcement, despite decades of evidence that it does not reduce addiction rates. Criminalization increases instability, reinforces stigma, and creates additional barriers to treatment. It addresses the visible symptoms while leaving the underlying causes untouched.
At the same time, support systems, treatment access, housing stability, mental health care, remain inconsistent, underfunded, or difficult to navigate. Programs that do work, including approaches like Housing First are often treated as secondary or controversial, rather than foundational.
The result is predictable. We are trying to solve a conditions-driven problem without changing the conditions.
A more functional approach would start from a different premise, that support is the primary response to addiction, not a secondary one. That means making stability, housing, access to care, social support, the baseline, not the reward for recovery.
At the same time, any system still needs boundaries. There are actors who profit from harm, and there are situations where behaviour poses clear risks to others. Enforcement has a role in those cases, not as a substitute for care, and not as a response to people struggling with addiction, but as a targeted response to exploitation and public safety concerns.
Those are not contradictory ideas. They are a recognition that addiction is complex, and that a single approach will not address every part of it.
What has failed is the assumption that enforcement can solve what is fundamentally a quality-of-life issue. It cannot. It never has.
We already know this. We have known it for years.
The question is not whether the current approach works. The outcomes answer that clearly. The question is whether we are willing to act on what those outcomes are telling us, and shift toward a model that addresses the conditions people are trying to escape from in the first place.
Until we do, the pattern will continue. Different substances, different headlines, same result.
And we will keep pretending we don’t know why.
