Five Issues to Follow in Addiction in 2022


The coming year will be defined by the ongoing pandemic, the scourge of fentanyl, weed legislation and more

By Jason Langendorf

Given the swirling complexities just below the surface of addiction and mental health disorders, including the sheer number of factors that influence each, singling out the most important topics in this space might seem like an impossible task.

So we won’t try.

There are countless subjects to consider, and each is potentially significant in such a fast-moving space. What seems less “important” today may become mission-critical tomorrow.

Instead, as we look ahead to 2022, is highlighting a few of the topics in the fields of addiction and mental health that we expect to receive the most attention. We anticipate developments, research and big decisions to be made in these areas over the next 12 months (and often beyond) that will have great potential to create change and shape debate. With that, here are five issues to follow in addiction and mental health in 2022:

1. The Pandemic Fallout

The pandemic—and everything that comes with it—will continue to hang around in ’22.

In the two years since COVID-19 arrived in the U.S., the virus has claimed 825,000 lives, led to 56 million reported positive cases and pushed many of our systems to (and sometimes past) the brink. The attendant stress and anxiety have been enormous triggers for many people with substance use disorder (SUD) and have led to a higher rate of substance use overall among the country’s population—all at a time when many treatment facilities are struggling to remain viable, let alone fully staffed and open for in-person services. Some experts are concerned that funding won in litigation or earmarked by legislation may be repurposed to address COVID-related shortfalls. With variants and the unvaccinated threatening to drag the pandemic well into 2022, America’s No. 1 public health crisis also poses an existential threat to anyone who is experiencing or at risk for addiction and mental health disorders.

2. Telehealth

In March 2020, emergency federal legislation relaxed telehealth restrictions and improved access to remote addiction treatment in response to the challenges presented by the pandemic. In April 2021, Arkansas policymakers made it permanent state law, and today many experts and other representatives are pushing for similar telemedicine legislation that will help connect more people with the treatment they need, even in a post-pandemic environment. There are still many hurdles to clear, however, including a variety of stakeholders with regulatory and profitability agendas that don’t necessarily jibe. Many patients still prefer face-to-face care, but telehealth fills a gaping hole in treatment access for populations ranging from rural residents and people in underserved metro areas to the disabled.

3. Fentanyl

In November 2021, opioid overdose deaths topped 100,000 for the first time over a 12-month period since the CDC began tracking such numbers—the latest sign that the national opioid epidemic has become fully entrenched. Specifically, fentanyl and other synthetic opioids—powerful and cheaply manufactured—are driving the crisis to ever more alarming heights. Small amounts can be lethal. Furthermore, mixing fentanyl with other substances can have an amplifying effect, and many distributors and users aren’t even aware that their drugs have been adulterated. Policymakers and law enforcement officials have few answers as 2022 begins, but in the meantime, access to naloxone (the overdose reversal medication) can save lives.

Look for a lot of developments on the marijuana front this year, including new legislation.

4. Marijuana Legislation

A jumble of issues with ties to marijuana legislation appear to be on the verge of being untangled—or snarling into even nastier knots. In 2021 alone, six states either legalized or decriminalized a form of marijuana (recreational or medicinal), Illinois made landmark marijuana reparations, and Congress introduced the Cannabis Administration and Opportunity Act, intended to decriminalize weed at the federal level. But despite Americans’ overwhelming shift in attitudes toward marijuana and the increasingly glaring injustices of the War on Drugs, too much of the progress being made is bypassing the populations and communities that have suffered the greatest harm from antiquated (and racially inequitable) laws. Additionally, although many policy and public health experts agree that marijuana criminalization and stigmatization have done more harm than good, the lack of research and regulation within an exploding cannabis market is a continuing cause for concern, and an area in which policymakers and advocates alike should focus their attention.

5. Psychedelics Research

Long regarded as taboo in mainstream circles, hallucinogens—also known as psychedelics—are increasingly being examined for their potential medicinal properties. Psilocybin and mescaline already have shown some promise in the treatment of depression, anxiety and even addiction, and although widespread acceptance of therapeutic psychedelics still seems a long way off, a growing body of research suggests they may be safer than other drugs currently prescribed to treat certain disorders.

Keep an eye on these five important topics as 2022 progresses.

Middle photo: Tim Mossholder; bottom photo: Elsa Olofsson