In my work fighting for equity and representation in the legal system, I’ve seen how transformative policy changes can be. As we confront our opioid epidemic, we stand at a similar crossroads – where thoughtful policy reform could prevent countless families from experiencing the struggle, scourge and life altering consequences of opioid addiction. As an attorney, I believe that policy reform targeting opioid addiction is a good option for turning the tide on this devastating epidemic that is hurting families across all spectrums and party lines. Their story, like so many across New York, points to a future we can reshape.
Though no one in my family has fallen into addiction, thankfully, I have witnessed firsthand the devastating effects addiction can have while working with the girls in our communities. Many of them face drug-related arrests, incarceration, and absenteeism from school due to the responsibilities thrust upon them—caregiving for younger siblings or even their parents who are struggling with addiction. When addiction strikes a family, it reshapes everything that follows. When I look at New York’s 10% increase in opioid overdose deaths between 2020 and 2021, I see more and more families who understand the trauma that accompanies addiction. These are our neighbors, friends, and our family members. These are people who never imagined addiction would become part of their story. Every preventable loss is a call to action for systemic change.
Many people don’t realize how a simple medical procedure can become a gateway to addiction. When 3.75 million patients—9.2%—become long-term opioid users after low-risk surgeries like knee arthroscopy, we’re not seeing individual failures. We’re witnessing a healthcare system that needs reimagining, one where safer alternatives become the default, not the exception.
This is where the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act offers a blueprint for change. By ensuring Medicare covers non-addictive pain medications at parity with opioids, we can create a new standard of care—one that prioritizes safety without sacrificing effectiveness. By eliminating the bureaucratic barriers to non-addictive prescriptions, we can make prevention the path of least resistance. These are common-sense solutions that could prevent countless families from experiencing the heartbreak of addiction.
At the state level, I was pleased to see that Governor Hochul recently added non-addictive pain medications to the state’s Medicaid formulary. This is a huge development that will go a long way to ensuring these game-changing medications are accessible to vulnerable New Yorkers. Similarly, at the state level, New York lawmakers have the opportunity to take critical action through the Rivera/Paulin Bill (S3185/A1921), which would provide outpatient insurance coverage for non-opioid treatment of chronic pain. Importantly, the bill stipulates that coverage shall not impose treatment limitations or financial requirements that are more restrictive than those applied to opioid-based treatments.
Through my experience as the founder of Girls Rule the Law, Inc., I’ve learned that visionary policy changes can cascade into widespread positive transformation. Consider this: New York spent $3,024 per capita on opioid use disorder and overdoses in 2017. Imagine being able to use those resources toward education or community programs. That’s the reality if we can prevent addiction before it gets to a costly cleanup point.
I often tell the young women in our program that systemic change requires both emotional investment and practical solutions. We can be outraged by the devastating impact of opioid addiction in our communities, but we must also direct that energy to take action. The Alternatives to PAIN Act represents a practical approach to a deeply personal problem, one that I am proud to champion today, having witnessed the struggle with addiction in the lives of people I work with.
Having built an organization with what I jokingly call “emotional crazy glue and financial duct tape,” I know that innovation often means working creatively with existing resources. Today, we have better tools than ever before: multiple FDA-approved non-addictive pain management options. The Alternatives to PAIN Act would ensure these safer choices are equally accessible to seniors on Medicare, marking a turning point in how we approach pain management.
The future of pain management in America stands at a crossroads. We can continue fighting a system that unnecessarily risks lives, or we can embrace a new approach that prioritizes safety and innovation. Having witnessed opioid dependency firsthand through my work, coupled with the sometimes-overwhelming challenges faced by young women in our communities, my hope is for a future where fewer families face this crisis. The Alternatives to PAIN Act and the Rivera/Paulin Bill aren’t just legislation—they are gateways to that better future. Our congressional representatives have the power to make this vision a reality.
Mirna Santiago, Esq. is the founder of Girls Rule The Law, Inc, a program and conference to introduce middle and high school girls to the law, legislature, and judiciary.
