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The End of the Beginning

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Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” Winston Churchill, November 10, 1942

As the calendar turned January 1, 2021, many Americans breathed a small sigh of relief in the hope that the new year would prove far better than the last. Indeed, it can be better, much better, but of course turning the calendar page did not spontaneously and measurably improve our circumstances. The pandemic of COVID-19 wreaked devastation on the world, our country, and, for so many of us, on the addiction treatment field and the patients and families we serve.

The year that began with the existing national healthcare emergency of addiction, made worse by the lethality of the opioid epidemic, now gave us a second federally declared healthcare emergency in the form of a pandemic, the likes of which we have never seen in our lifetimes. We know that isolation feeds addiction, recovery occurs in community, and COVID all but destroyed sufferers’ access to that community as evidenced by an overdose increase of 42% per month from 2019. As demand for treatment increased, capacity to treat simultaneously decreased as providers scrambled to keep current patients safe while admitting far fewer patients due to lack of testing and PPE and the need to limit treatment populations for social distancing. NAATP members surveyed reported widespread layoffs, furloughs, reduced programming, and revenue losses as high as 50% from the prior year. A great toll was taken on our resilient staff members, with 86% of staff showing an increased rate of burnout.

It was a terrible year. Now, in 2021, it is necessary that we take accurate stock of our current environment – seeing it for what it is and what it is not – so that we may move forward effectively, toward a day when the virus is contained. This will take much time, but we are now seeing some victories and promise. We showed remarkable resilience as a field. Many centers climbed back to 80% capacity or better, and we see rises in emerging programming, including telehealth now offered by 80% of our surveyed members. 2020 PPP money helped many and it seems 2021 PPP relief is on its way with a promise of considerable additional behavioral health funding in the Biden Administration’s new bill. The new Administration has signaled a renewed emphasis on treatment and welcomed NAATP’s input on behalf of our members. Likewise, we are encouraged by the new appointments to the federal agencies with whom we work and on which we rely for strong SUD public policy.  

Most of all, the COVID-19 vaccines are now within reach. Nothing is more significant in terms of turning the tide. All the vaccines are safe, highly effective and essential for our treatment staffs. It is the victory we needed to move us forward. As Churchill said following the first real victory of WWII, with still much left to do, “we have a new experience. We have a victory – a remarkable and definite victory” that signals “the end of the beginning” and illuminates our path forward.


Marvin Ventrell, JD