The Trump Administration’s Opioid “Policy” Is a Bad Joke

Trump Maladministration

Well, strictly speaking, Trump doesn’t seem to have an opioid policy. He made big promises to address the opioid crisis on the campaign trail. But as president the drug problem has slipped his mind. Last October he directed the Department of Health and Human Services to declare the opioid crisis a public health emergency, which seemed to indicate he was about to do something

“No part of our society — not young or old, rich or poor, urban or rural — has been spared this plague of drug addiction and this horrible, horrible situation that’s taken place with opioids,” Mr. Trump said during an elaborate and emotional ceremony in the East Room of the White House, attended by families affected by opioid abuse, members of Congress and administration officials. “This epidemic is a national health emergency.”

To combat the epidemic, the president said the government would produce “really tough, really big, really great advertising” aimed at persuading Americans not to start using opioids in the first place, seeming to hark back to the “Just Say No” antidrug campaign led by Nancy Reagan in the 1980s.

“This was an idea that I had, where if we can teach young people not to take drugs,” Mr. Trump said, “it’s really, really easy not to take them.” He shared the story of his brother Fred, who he said had struggled with alcohol addiction throughout his life and implored Mr. Trump never to take a drink — advice the president said he had heeded.

“We are going to overcome addiction in America,” the president said.

That’s about as much of a drug policy as we’ve seen so far. There was no follow up even to that much. Brianna Ehley wrote for Politico in last month,

President Donald Trump in October promised to “liberate” Americans from the “scourge of addiction,” officially declaring a 90-day public health emergency that would urgently mobilize the federal government to tackle the opioid epidemic.

That declaration runs out on Jan. 23, and beyond drawing more attention to the crisis, virtually nothing of consequence has been done.

Today we read that Kellyanne Conway is sabotaging what little was being done to address the crisis. Brianna Ehley and Sarah Karlin-Smith write,

President Donald Trump’s war on opioids is beginning to look more like a war on his drug policy office.

White House counselor Kellyanne Conway has taken control of the opioids agenda, quietly freezing out drug policy professionals and relying instead on political staff to address a lethal crisis claiming about 175 lives a day. The main response so far has been to call for a border wall and to promise a “just say no” campaign.

Trump is expected to propose massive cuts this month to the “drug czar” office, just as he attempted in last year’s budget before backing off. He hasn’t named a permanent director for the office, and the chief of staff was sacked in December. For months, the office’s top political appointee was a 24-year-old Trump campaign staffer with no relevant qualifications. Its senior leadership consists of a skeleton crew of three political appointees, down from nine a year ago.

“It’s fair to say the ONDCP has pretty much been systematically excluded from key decisions about opioids and the strategy moving forward,” said a former Trump administration staffer, using shorthand for the Office of National Drug Control Policy, which has steered federal drug policy since the Reagan years.

The office’s acting director, Rich Baum, who had served in the office for decades before Trump tapped him as the temporary leader, has not been invited to Conway’s opioid cabinet meetings, according to his close associates.

See also  Eric Levitz at New York magazine, “Trump Has Given Victims of the Opioid Crisis Nothing But Contempt“; Jeremy Binckes, “Trump administration gives up on being serious about the opioid crisis“; Denis Slattery and Christopher Brennan, “Kellyanne Conway opts for Trump cabinet members over drug policy experts for opioid epidemic meetings: report.

Levitz writes,

The year Donald Trump was elected president, drug overdoses killed 63,600 Americans. That was 21 percent more drug deaths than America had seen in 2015, which had been the worst year for such fatalities in our nation’s history. It was also more unnatural deaths than gun violence, HIV/AIDS, or car accidents had ever caused in the United States in a single year. The scale of devastation wrought by the opioid epidemic was so vast, life expectancy in the United States fell for the second consecutive year — the first time that had happened since the early 1960s.

The epidemic’s body count was almost certainly higher in 2017, according to preliminary data from the Centers for Disease Control and Prevention. If the use of synthetic opioids like fentanyl continues to grow at its current rate, Stat News forecasts that more than 650,000 Americans will die from drug overdoses over the next decade — which is to say, slightly more than one would expect to perish if a foreign military power incinerated the entire city of Baltimore.

And yet, in his first State of the Union address, Trump did not offer a single concrete policy proposal for combating this “public health emergency.” Instead, he promised to get “much tougher on drug dealers and pushers”; “get treatment for those in need”; and pass restrictive immigration reforms — asserting, without evidence, that building a border wall and ending “chain migration” would “support our response to the terrible crisis of opioid and drug addiction.”

So, about addressing the opioid crisis … never mind.

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9 Comments

9 Comments

  1. Bonnie  •  Feb 6, 2018 @8:33 pm

    The bottom line is that trump is a joke.

  2. c u n d gulag  •  Feb 6, 2018 @9:35 pm

    Hmm…

    You know, I shouldn't say this, but I'd LOL if there was even an atom's worth of humor in this, my comparison of two very different drug epidemics:

    Well, dear fellow white folks, now the rest of you might have at least an idea of how black people and their families felt as crack spread like an inner-city 'Black Plague' during the tail-end of Reagan's, and throughout "Papa Doc" Bush's, terms. 

    I know how bad it was, because I was living in NYC at that time, and lost a more than a few black friends because if their addiction.  I know how addictive crack is, because I smoked  some with them a few times.  Luckily, I realized how alluring crack's siren song was, and stopped doing it.  It was like when I snorted heroin:  I knew that anything that great should never be tried – but if you did try it, NEVER EVER DO IT AGAIN!!!  The ruinous steep cliff would come at you faster than you could apply the brakes – if you didn't brake immediately.  I was lucky, and walked away.  I wasn't smarter, by any means.  I was luckier.  I walked away, and never looked back.  And I never looked back, because I remembered how great – and potentially lethal – that wondrous high was.     

    But hey, fellow white folks, you can console yourselves in that at least this POTUS has talked about an opioid epidemic.  The crack epidemic was, like the AIDS epidemic, almost completely ignored by the Republicans in power.     

    And conservatives back then, could chuckle at the fact that crack cocaine was almost as effective as Jim Crow – in that potential Democratic black voters either died, or were charged and sentenced as felons, and could be erased from the voter rolls.  I'm actually surprised now, because a lot of the white opioid victims are from either traditional Republican districts, or from new tRUMPian ones.

    And that, is the best proof of how inept and dangerous this mal/mis-administration is.

  3. freetofu  •  Feb 7, 2018 @12:03 am

    I've read a fair amount about chronic pain over the years because of my own problems, and I've gone back and forth on the issue of opioids for chronic pain. It's just recently that I've realized that I'd been indirectly manipulated by drug company propaganda.

     

    The first relevant book I read was, "The Truth About Drug Companies," by Marcia Angell, former editor for the New England Journal of Medicine, which had a chapter about how Purdue was pushing Oxycontin, so this initially had me very anti-opioids.

    However, one of the next books I read was "The Pain Chronicles," written by a NY Times journalists who is a chronic pain sufferer, and which had been favorably reviewed on the generally excellent website Science-Based Medicine. The final chapter was based around an interview with a doctor who was a big proponent of opioids for chronic pain, based on the idea that there was no "ceiling dosage," and one could "titrate upward" indefinitely as long as the patient was careful to stay with the increased dosage. It made a clear distinction between "tolerance" and "addiction," which it said was characterized by destructive behavior, and gave examples of well-meaning doctors who had been victimized by what it portrayed as a legal witch-hunt. In conjunction with a few other books and articles I read, as well as some blog commenters who claimed to be using opioids responsibly for their own chronic pain, I found this persuasive.

    However, I recently googled this doctor and learned that he had received payment to promote opioid use and had recently admitted his error and come out against it.

    Suffice to say that this promotion was very effective and I was taken in by it for a while. It's also consistent with a lot of other sleazy behavior by drug companies that were described in that Angell book, as well as things like the tobacco companies' propaganda campaign against the link with cancer, or the oil companies' climate change denial campaign.

    So Purdue clearly ought to be punished. As far as how to end the epidemic they've created, though… well, I'm not sure what to do.

  4. freetofu  •  Feb 7, 2018 @12:16 am

    "Moderation" in all things, apparently…

  5. Swami  •  Feb 7, 2018 @2:02 am

    Why doesn't he get Mick Mulvaney to be the permanent director of the drug policy office? I'm sure Mick ( the man of many hats) could fit it into his schedule of directorships

  6. Lynne  •  Feb 7, 2018 @6:48 am

    After a year of this, I've decided that 45's speeches are simply campaign speeches and have little meaning outside his desire to be popular. I don't think he has an actual plan for anything much.

  7. Swami  •  Feb 7, 2018 @1:18 pm

      I don't think he has an actual plan for anything much.

      You''re wrong about that, Lynne. I hear we've got a big military parade coming up. I'm really looking forward to it. I love parades. I'm hoping there are lots of mobile missile launchers ( the ones with all the wheels) in the parade. They'e like way cool.

     I bet little rocket man is going to be so envious of us with all our great power.

  8. Doug  •  Feb 7, 2018 @1:33 pm

    Stay with me on this. In NC the legislature passed the controversial law which required you use your birth gender in determining what public toilet you could access. Huge outcry, but it wasn't a meaningful law -nor was it ever intended to be in any was effective in regulating where people poop.Were NC state troopers dispatched to highway rest stops with instructions to check the birth certificates of every traveler?

    Here's the thing. It was purely a gesture, a legislative insult directed at a small minority in NC which the evangelicals despise. By comparison, so much of what this president says is not backed up by any action. The danger of this presidency is the secretive, evil and malicious effective damage done by some of his competent advisors and appointees – most of which Trump is oblivious to in his Fox News bubble. 

  9. grannyeagle  •  Feb 7, 2018 @3:57 pm

    I certainly don't want to minimize the opioid crisis which it is reported caused over 63,000 deaths last year.  However, according to the American Lung Association and the American Cancer Society, tobacco use is responsible for over 400,000 deaths per year.  And it is legal.  Just sayin'