-- $269.7 billion --

Costs of addiction-related healthcare in the U.S. from the second half of 2013 through June 2019.*

In Rhode Island, much of that work falls to BHDDH, which oversees “a comprehensive statewide system of mental health and substance abuse prevention intervention, treatment activities and recovery supports,” according to the department website.

“This department is so recovery-oriented,” said Lori Dorsey, senior public health promotion specialist at BHDDH and a recovering addict who lost a son in 2017 to an overdose. “Everything we do is recovery-oriented.”

That is the direction set by department head Rebecca Boss, who in a recent conversation about the considerable costs of addiction emphasized what might be called the flip side: the value of recovery, which can bring employment, stability, and a payback to society in the form of wisdom and support from people like Dorsey.

“We're working on the prevention end,” Boss said, on endeavoring to “get kids not to misuse substances to start with and not have this problem 10, 20 years down the road, regardless of what the drug du jour is, whatever the drug of the time is.”

That, she said, involves providing children and adolescents “the skills and resiliency to be able to cope with life and its stressors, and some of the despairs that have been talked about without substance use. And giving them opportunities to live a meaningful and purposeful life and not become involved in substances.”

She calls recovery “the other end.” Naloxone, also called Narcan, can save lives, she said, and medically assisted treatment, 12-step programs and other interventions can help maintain sobriety -- but housing, community and employment, among other factors, are critical, too.

“If there's no opportunity for somebody, then it's really easy to think about 'Why am I doing this if I don't have a place to live, I don't have a job to go, I don't have any meaning or connection,'” Boss said. “'Why am I going to bother to be in recovery when life was better when I was using?'

“You've got to make life in recovery equal to or better than a life of substance use.”