During the pandemic and in its wake, alcoholism has soared. Alcohol use is up, too, and alcohol-related deaths jumped 26 percent between 2019 and 2020. As state governments locked down in 2020, they loosened alcohol regulations so restaurants could sell beer, wine and cocktails to go and delivery services could bring booze to your door. Many of those changes remained after lockdowns ended. Informed by his own struggle with addiction, former Rep. Patrick Kennedy (D-R.I.) wrote the 2008 Mental Health Parity and Addiction Equity Act, which requires insurers to reimburse for mental health care, including substance abuse treatment, as they would physical health care. Ruth talked to him about the state of addiction in the country, the connection between mental health and addiction and how public policy decisions can both hurt or help sufferers. The interview is edited for length and clarity. Is expanded alcohol delivery having an effect on alcohol abuse in the U.S.? We know not everybody becomes an alcoholic. But even if 10 to 15 percent of the population has that predisposition, that's 15 percent of a couple 100 million. That's what we're looking at. So we have to understand that the more that people gain access, the more people that are vulnerable are going to tip over. I was such a confirmed alcoholic and drug addict that I couldn't get my hands on enough. And I had to really scheme and manipulate and cajole and hide. Today, I wouldn't have to worry about all those things. I'm sure my life was spared to some degree because it was harder for me to get alcohol. What can policymakers do? You address it with data-driven solutions. We know that access correlates to much higher levels of usage. With tobacco, we did a lot of things to rein it in. So we've always got to be vigilant. We really need to have a public health approach, and the best way to do that is to go through public education and really strengthen the skills of our young people to understand how to self-modulate. In other words, have problem-solving skills and coping mechanisms. President Kennedy had a presidential physical fitness program, and we need to do mental fitness. What about social safety-net programs? If we don't pay for things like clubhouse models [that provide community-based services to aid] recovery that's both for mental illness and addiction, and if we don't get people trained to have purpose and socialization and places to stay like sober housing, you're just going into battle with a hand tied behind your back. We need to know what we are organizing ourselves to do. Say, reduce alcohol deaths by 20 percent. It's going to include raising taxes. It's going to include greater regulations. You're going to have to allow hospitals and Medicaid to sue alcohol distributors and manufacturers for the collective harm their product causes. Should law and regulation treat alcohol more like it does tobacco? Why not? I mean, alcohol has probably a worse public health impact than tobacco. We've totally lifted the ceiling off of the sales on alcohol. We used to have rules — you couldn't advertise hard liquor. And we haven't increased the taxes on alcohol and beer to the same degree.
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