rewrite this title RFK Jr. says he’ll fix the overdose crisis. Critics say his plan is risky

When Robert F. Kennedy Jr. talks about the journey that led to his growing focus on health and wellness — and ultimately to his confirmation hearings this week for U.S. secretary of health and human services — it begins not with medical training or a background in research, but with his own addiction to heroin and other drugs.

“I became a drug addict when I was 15 years old,” Kennedy said last year during an interview with podcaster Lex Fridman. “I was addicted for 14 years. During that time, when you’re an addict, you’re living against conscience … and you kind of push God to the peripheries of your life.”

Kennedy now credits his faith; 12-step Alcoholics Anonymous-style programs, which also have a spiritual foundation; and the influence of a book by philosopher Carl Jung for helping him beat his own opioid addiction.

If confirmed as head of the Department of Health and Human Services after Senate hearings scheduled for Wednesday and Thursday, Kennedy would hold broad sway over many of the biggest federal programs in the U.S. tackling addiction: the Centers for Disease Control and Prevention, the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration.

While campaigning for the White House last year, Kennedy, now 71 years old, laid out a plan to tackle the United States’ devastating fentanyl and overdose crisis, proposing a sprawling new system of camps or farms where people experiencing addiction would be sent to recover.

“I’m going to bring a new industry to [rural] America, where addicts can help each other recover from their addictions,” Kennedy promised, during a film on addiction released by his presidential campaign. “We’re going to build hundreds of healing farms where American kids can reconnect with America’s soil.”

Some addiction activists — especially those loyal to the 12-step faith- and values-based recovery model — have praised Kennedy’s approach and are actively campaigning for his confirmation.

“RFK Jr is in recovery. He wants to expand the therapeutic community model for recovering addicts,” Tom Wolf, a San Francisco-based activist who is in recovery from fentanyl and opioid addiction, wrote on the social media site X. “I support him for HHS secretary.”

A focus on 12-step and spirituality, not medication and science-based treatment

But Kennedy’s approach to addiction care is controversial, described by many drug policy experts as risky, in part because it focuses on the moral dimension of recovery rather than modern, science-based medication and health care.

“He clearly cares about addicted people,” said Keith Humphreys, a leading national drug policy researcher at Stanford University. “But in terms of the plans he’s articulated, I have real doubts about them.”

According to Humphreys, Kennedy’s plan to build a network of farms or camps doesn’t appear to include facilities that offer proper medical treatments for seriously ill people facing severe addiction.

“That’s a risk to the well-being of patients, and I don’t see any merit in doing that,” Humphreys said.

“I think [Kennedy’s plan] would be an enormous step backward,” said Maia Szalavitz, an author and activist who used heroin and other drugs before entering recovery.

“We have spent the last 15, 20 years trying to move away from treating addiction as a sin rather than a medical disorder,” she said. “We’ve spent many years trying to get people to take up these medications that we know cut your death risk in half, and he seems to want to go backwards on all that.”

The vast majority of researchers, doctors and front-line addiction treatment workers agree that scientific data shows medications like buprenorphine, methadone and naloxone are game changers when it comes to treating the deadliest street drugs, including fentanyl and heroin.

The Biden administration moved aggressively to make medical treatments far more affordable and widely available. Many experts believe those programs are factors in the dramatic national drop in overdose deaths that began in 2023.

Kennedy, who studied law and political science, not health care, before becoming an activist on subjects ranging from pharmaceuticals and vaccines to the American diet, has remained largely silent on the subject of science-based medical treatments for opioid addiction.

His campaign film included a scene that appeared to blame methadone — a prescription medication that has been used to treat opioid addiction since the 1970s — for some of the high-risk street-drug use visible on the streets of San Francisco.

In public statements, Kennedy has also repeated the inaccurate claim that the addiction and overdose crisis isn’t improving. In fact, fatal overdoses have dropped nationally by more than 20% since June 2023, according to the Centers for Disease Control and Prevention, falling below 90,000 deaths in a 12-month period for the first time in half a decade.

“What we have mostly heard from Kennedy is a skepticism broadly of medications and a focus on the 12-step and faith-based therapy,” said Vanda Felbab-Brown, an expert on drug policy at the Brookings Institution, a Washington, D.C., think tank.

“That appeals to a lot of crucial groups that have supported President Trump in the election. But we know what is fundamental for recovery and stabilization of people’s lives and reducing overdose is access to medications,” Felbab-Brown said. “Unfortunately, many of the 12-step programs reject medications.”

She’s worried that under Kennedy’s leadership, the Department of Health and Human Services could shrink or eliminate funding for science-based medical treatment and instead focus on spirituality-based approaches that appear to help a relatively small percentage of people who experience addiction.

Kennedy’s views on other science-based treatments, including vaccines, have sparked widespread opposition among medical researchers and physicians.

Kennedy boosts an Italian model for addiction recovery that has faced controversy

Another concern about Kennedy’s addiction proposals focuses on his interest in a program for drug treatment created in Italy in the 1970s.

“I’ve seen this beautiful model that they have in Italy called San Patrignano, where there are 2,000 kids who work on a large farm in a healing center … and that’s what we need to build here,” Kennedy said during a town hall-style appearance on the cable channel NewsNation last year.

According to Kennedy’s plan, outlined in interviews and social media posts, Americans experiencing addiction would go to San Patrignano-style camps voluntarily, or they could be pressured or coerced into accepting care, with a threat of incarceration for those who refuse care.

But the San Patrignano program has been controversial and was featured in a 2020 Netflix documentary that included images of people with addiction allegedly being held in shackles or confined in cages. The farm’s current leaders have described the documentary as biased and unfair.

Kennedy, meanwhile, has continued to use the program as a model for the camps he would like to build in the United States.

“I’m going to build these rehab centers all over the country, these healing camps where people can go, where our children can go and find themselves again,” he said.

Szalavitz, the author and activist who is herself in recovery, noted that the Italian program doesn’t include science-based medical care, including opioid treatment medications. She said Kennedy’s fascination with the model reflects a lack of medical and scientific expertise.

“It really is great to include people who have personal experience of something like, say, addiction in policymaking. But you don’t become an addiction expert simply because you’re someone who struggled with addiction,” Szalavitz said. “You have to engage with the research literature. You have to understand more beyond your own narrow anecdote. Otherwise you’re going to wind up doing harm to people.”