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By Aaron J. Byzak, MBA, Chief Strategist & Lead Consultant for Galvanized Strategies, Healthcare and Non-Profit Leader
Nov. 17, 2025 (San Diego County) -- We like to tell ourselves we value prevention. It sounds responsible, forward-thinking, even noble. But the truth is far less flattering: we do not do prevention well in this country. Real prevention requires foresight, long-term investment, discipline, and the patience to stay the course when the payoff is years away. That is not how our political system is built.
Politicians — and human beings, in general — are profoundly reactive creatures. And in politics especially, there is a built-in incentive to look like you’re sprinting heroically toward a crisis. Respond to the fire, call a press conference, get the headline, collect the praise, and ride that momentum into the next reelection cycle.
And far too often, these same officials aren’t just failing to address root causes; they’re actively making problems worse.
Consider just one example: politicians championing policies that saturate their communities with psychotropic, high-potency drugs (think ultra-concentrated THC products) because the industry promises them tax revenue to fund their pet projects. Or because they’ve failed to make their city attractive to business and economic development and now rely on taxes from drug sales to install streetlights or fund youth programs.
Surely no elected leader would greenlight industries and systems that prey on addiction and disorder, then pat themselves on the back for the “economic development” generated by substances and policies that undermine public health and actually cause mental-health problems.
This isn’t hypothetical — the evidence is piling up. High-potency THC products are strongly linked to spikes in psychotic breaks, self-harm, and suicide risk. A 2025 systematic review found regular use of high-potency cannabis increased suicide risk by as much as 84%, and daily high-potency use tripled that risk. Stanford researchers found that in states with commercialized cannabis — especially those saturated with high-potency products — men under 40 experienced a 46% increase in self-harm injuries. And multiple studies show that daily use of high-potency THC can triple to quintuple the risk of psychosis.
But the policy failures don’t stop there. Politicians also pass laws that make it easier for people to use, sell, and traffic drugs. From open-border policies that allow the unfettered flow of fentanyl and other substances into the country, to the removal of drug sales (among a grab bag of other offenses) from the list of meaningful criminal acts, to social-service policies that don’t require people to get clean and sober as a condition of receiving taxpayer-funded support — the incentives all run in the wrong direction.
And while we’re on the topic, jeez — I wonder if essentially making it legal to steal up to $950 a day from stores, without meaningful consequences, might have contributed to the number of businesses closing in my area? Hard to say. Pure coincidence, I’m sure.
These aren’t small warning signs. They’re flashing lights — and the heartbreaking part is that these outcomes were highly predictable, and predicted, yet ignored. Preventionists, clinicians, and researchers warned for years that flooding communities with high-potency drugs and deregulating related criminal behavior would produce exactly the crises we are now experiencing. The political class simply looked the other way.
And you see the same dynamic across public safety and local governance. Responding to a fire is dramatic — lights, sirens, helicopters overhead. It’s cinematic. It’s the kind of thing elected officials love to stand in front of for the cameras. But the brush-clearance program that would have prevented the fire in the first place? Not sexy. No headlines. No viral clips. No chance to show up in an embroidered jacket that makes you look like part of the response crew rather than, potentially, one of the people whose decisions helped create the conditions for the disaster to begin with.
The same pattern shows up in the more mundane parts of public service. Hell, even fixing potholes and making “sexy streets,” as one local politician in our region likes to call them, is an implicit acknowledgment that someone failed to do basic preventive maintenance in the past. But again — repairing the damage is more visible, more photogenic, and far more politically rewarding than maintaining the infrastructure that would have prevented the problem to begin with.
Yet that quiet, unglamorous work — the brush clearance, the inspections, the planning, the road maintenance — is what actually keeps communities safe.
What Prevention Actually Is (And Why It Works When We Use It)
Before going any further, it’s worth defining what we’re talking about — because prevention isn’t one thing.
Primary prevention is the gold standard. It focuses on stopping problems before they ever begin by strengthening protective factors, reducing risk conditions, building skills, shaping environments, and creating norms that make harmful behaviors less likely. When primary prevention works, nothing happens — which is both its greatest strength and its greatest political weakness.
Secondary prevention steps in after a problem has emerged but before it becomes catastrophic. It focuses on early intervention, risk mitigation, screening, brief intervention, and targeted supports. It doesn’t prevent the first occurrence, but it tries to prevent things from getting worse.
Both forms of prevention matter. Both save lives, families, and money. But only one — primary prevention — actually shrinks the problem over time.
And unfortunately, primary prevention is exactly what we’ve abandoned.
The Drift From Prevention to Enabling
This same pattern is everywhere in public health. Harm reduction has a legitimate place in secondary prevention. Keeping someone alive today matters. But we’ve gone far beyond that. Today’s policies increasingly facilitate addiction: free needles, free pipes, “safe” injection sites, and de facto public drug-use zones. The goal is no longer to prevent addiction, but to manage its symptoms indefinitely.
Some call that compassionate.
I call it enabling.
And this enabling philosophy shows up well beyond substance-use policy. Consider SNAP, our nation’s largest nutrition-assistance program — which became a political flashpoint during the government shutdown in late 2025. That debate is partly why I’m mentioning SNAP here. But to be clear, it is just one of countless examples of how prevention has been sidelined across our systems.
SNAP allows benefits to be used heavily for ultra-processed food, sugary drinks, and products strongly linked to obesity and chronic disease. Research consistently shows:
- SNAP households purchase more sugary beverages and fewer fruits and vegetables than income-eligible non-participants;
- SNAP participants have lower overall diet-quality scores;
- Modeling suggests removing sugar-sweetened beverages from SNAP could reduce obesity and type 2 diabetes.
In other words, even well-intentioned programs often end up subsidizing behaviors that drive preventable disease.
We are quite literally paying to make the problem worse.
I’ve Seen What Real Prevention Looks Like — And It Works
Before the harm-reduction era swallowed the field, we actually knew how to prevent substance use, addiction, and overdose. And I’m not talking theory — I’m talking lived experience and documented outcomes.
During my years on the board and as president of the North Coastal Prevention Coalition (NCPC), our mission was simple: Reduce the harm of alcohol, tobacco, marijuana, and other drugs in (our region) through community action, education, support, and collaboration.
We used the phrase “reduce the harm,” but we weren’t doing harm reduction. We were doing primary prevention — the kind that stops problems before they begin.
And we were exceptionally effective at it.
Our coalition earned:
- 2008 Got Outcomes! Coalition of Excellence Award and National Coalition of the Year from CADCA (Community Anti-Drug Coalitions of America);
- Two National Exemplary Awards for innovative prevention programs and policies;
- SAMHSA’s Service to Science Award recognizing our evidence-based work;
- We also helped build a national best-practice Prescription Drug Abuse Task Force model;
- Documented, statistically significant reductions in substance-use indicators across the region.
These weren’t theoretical wins. They were real, measurable, community-level outcomes — the kind every politician claims to want and every family deserves.
We were invited to Congress to testify about our approaches. We helped shape local and state policy that measurably reduced overdoses and substance use.
And then, almost overnight, our society walked away from it.
Why Response-Only Strategies Fail: An EMS Reality Check
Let's step back for a moment and consider lessons learned from someone who started their career in EMS.
I spent years responding to shattered families, overdoses, suicides, violent incidents, and every imaginable form of human crisis. I’ve knelt on living-room floors and alleyways with people whose lives had already exploded long before anyone dialed 9-1-1. At that point, all you can do is pick up the pieces and try — sometimes desperately — to put the puzzle back together.
And EMS teaches you fast: It is always, ALWAYS less effective than preventing the crisis in the first place.
By the time the ambulance arrives, the horse isn’t just out of the barn — it’s halfway down the highway. Good luck getting it back.
The bottom line: responding to a crisis means the damage has already been done. Someone’s life — or an entire community — has already been profoundly impacted by the time you show up with resources, programs, or political urgency.
That is exactly what our public policy has become: a fleet of well-meaning ambulance crews racing from one preventable disaster to another. And just like in EMS, we’ve somehow convinced ourselves that reacting to the damage is evidence of success rather than confirmation of failure.
The Real Problem: The Funding Changed. Which Means the Politics Changed
Here's the reality: The prevention people didn’t change. The science didn’t change. The need didn’t change.
The funding changed. Which means the politics changed. Which means the priorities changed.
We replaced prevention with a harm-reduction model that promised to “meet people where they’re at” but often forgot the second half of the sentence: and help them move forward.
The results speak for themselves:
- Massive increases in illicit drug use;
- Massive increases in overdoses and overdose deaths;
- Massive increases in homelessness.;
- A society now so overwhelmingly impacted by addiction that Narcan — once reserved for paramedics — is in public vending machines.
If that’s not a sign of systemic failure, I don’t know what is.
We Can Fix This — But Only If We Reclaim Prevention
If we want healthier, stronger, more resilient communities, we need to return to the approach that works: evidence-based primary prevention. The kind of prevention that strengthens families, builds skills, sets boundaries, expands opportunity, and reduces early-stage risk long before addiction or crisis ever takes hold. The kind of prevention that teaches young people how to navigate life, manage stress, develop purpose, and build real connections — before their first exposure to substances or their first encounter with trauma.
But reclaiming prevention isn’t just about programs or data. It’s about expectations.
We need to set expectations for people — firm, fair, humane expectations — because expecting nothing produces exactly that. Societies become what they tolerate. Families become what they model. Individuals rise (or fall) to the standards placed in front of them. Prevention requires the courage to say: We expect better from you, and we will support you in becoming better — but we will not subsidize destructive behavior forever.
That means requiring sobriety as a condition of receiving services. It means holding people accountable for their choices while giving them the tools to make healthier ones. It means shifting from a culture of passive “harm minimization” to one of active human development. And it means funding the long-term work of building people up, not the short-term optics of cleaning up after their lives have collapsed.
Prevention is not soft. It is not permissive. It is the opposite. Prevention is the quiet insistence that people deserve the dignity of expectations — and the structure, support, and opportunity to meet them.
Because if we don’t reclaim that mindset, we will keep congratulating ourselves for managing the symptoms of problems we could have prevented — addiction, homelessness, violence, crime, chronic disease — and we’ll keep wondering why nothing ever gets better.
Prevention works. It always has. What’s missing is the will to demand it — and the leadership to invest in it.
Aaron J. Byzak, MBA, is a writer, speaker, and lifelong observer and developer of people and systems. He is the Chief Strategist and Lead Consultant for Galvanized Strategies, a strategic public affairs and leadership consulting firm that specializes in healthcare and non-profit clients, but excels across industries. His work draws on more than 30 years of experience in healthcare, leadership, public affairs, mentoring, and coaching — shaped by personal resilience, a deep sense of purpose, and a passion for driving meaningful change.
Read more insight from Aaron by following him on LinkedIn. He can be reached at aaron@galvanizedstrategies.com or at (760) 889-3609.
The views expressed in this editorial reflect the opinions of the author, and do not necessarily reflect the views of East County Magazine. To submit an editorial for consideration, contact editor@eastcountymagazine.org
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