Patrick Kennedy, retired from Congress after years battling addiction and mental illness, says that, as a nation, we’re still not comfortable with talking about and effectively treating those diseases.

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In May 2006, Patrick Kennedy, scion of an American political dynasty, a decade deep into a career in Congress, crashed his muscle car into a traffic barrier outside the U.S. Capitol. It was 2:45 a.m.

Addicted to painkillers, on a mix of prescription medications, he doesn’t remember the crash.

What he does remember is, five months later, telling The New York Times about his addiction and mental illness and how his father, the late Sen. Edward Kennedy, reacted.

“He called the article a ‘disaster’ — the word he always used to describe the most extreme situations,” Kennedy writes in his book, “A Common Struggle,” released last year. “How dare I talk about the family this way? How dare I discuss “these things” in public?”

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“I grew up among people,” Kennedy writes, “who were geniuses at not talking about things.”

Ten years later, the opioid epidemic is claiming thousands of lives a year and fighting it has become a priority of the Obama administration. But have attitudes really changed? Had his crash happened today, would Kennedy’s father have reacted differently?

“I’m not sure how much more comfortable he would have been with it,” Kennedy said in an interview, in Seattle to speak to the state Hospital Association. “I think intellectually, times are changing; he would have understood that these are illnesses.”

Kennedy paused.

He noted that his father fought much of his career for more funding for mental health and substance abuse.

“There’s a kind of disconnect,” he said. “We all can, on one level, talk about it, but it really hasn’t connected throughout ourselves that this is something we’re comfortable with. We’re not comfortable with it.”

Even with the best treatment, including a rehab stay at the Mayo Clinic, Kennedy had relapses for five years. He mentions Feb. 22, 2011, his sobriety day, casually in conversation. That was a month after he retired from Congress.

In Washington state, Gov. Jay Inslee recently announced executive actions aimed at reducing the overprescribing of opioid pain pills and increasing access to treatment for opioid addiction.

A big part of the push to increase treatment is to ease access to medications, like Suboxone and methadone, that researchshows — when combined with counseling and therapy — are more effective at battling addiction than 12-step programs alone.

Kennedy used two such medications, buprenorphine (usually sold as Suboxone) and naltrexone (often sold as Vivitrol), to battle addiction. But, just as his father wasn’t comfortable talking about it, not everybody is comfortable with using drugs to treat drug addiction.

There are adult drug court systems in 24 Washington counties whose purpose is to treat and rehabilitate nonviolent drug abusers, keeping them out of prison.

In five of those counties — Snohomish, Jefferson, Lewis, Skagit and Whitman — the local judges who run the drug courts won’t let defendants use medication as part of their treatment, said Janet Skreen, statewide drug court coordinator. Snohomish County is currently considering changing its policy.

“We’re hogtied because many of those influencing addiction policy in this country come from the 12-step culture, which says abstinence is the only true form of recovery,” Kennedy said. “We’re losing a lot of people on the altar of that type of rigid ideology.”

Despite the increased focus on fighting addiction and mental illness in recent years, Kennedy says we’re not there yet. Lawsthat he helped pass in Congress require insurance companies to pay for addiction and mental-illness treatment the same as they pay for any other illness. But they’re not being fully enforced, he says, and insurance companies will deny everything they can — part of the reason it’s so difficult to find affordable treatment.

Nationally, overdose deaths from pain pills have tripled since 2001. Deaths from heroin have increased at least sixfold.

“The proof is in the pudding: We’re not paying for these illnesses,” Kennedy said. “People are dying because of really bad public policy.”