White House Addresses Opioid Crisis
Officials in Washington, including Counselor to President Trump Kellyanne Conway and Secretary of Health and Human Services Tom Price, made an address Tuesday afternoon to discuss the current opioid crisis. The address, which came after the president met with health officials and members of his administration was an attempt to inform the public that the White House and Federal officials were aware of the severity of the problem and were working on specific actions to improve the situation.
Perhaps the largest information which was revealed was the fact that President Trump is currently refusing to declare the current opioid crisis a national health emergency. Price told reporters during the address that “the focus that we need to bring to bear to the opioid crisis at this point can be addressed without the declaration of an emergency.”
This refusal to declare a national health emergency means Trump is acting against the advice of the special commission on the national opioid crisis which he formed in May. That commission, which includes New Jersey Governor Chris Christie (R) was initially charged with finding “ways to combat and treat the scourge of drug abuse, addiction and the opioid crisis.” While members of this commission have spoken publicly about more modern and innovative ways to combat the current issue of opioid addiction and overdose, the president’s own comments and actions have seemed to take a more dated approach.
While the recent dialogue in Washington has shown that officials are taking the problem of the opioid crisis seriously, they seem to be falling into the rut of decades old talking points and politicized solutions for drug abuse which have bared little to no fruit in the past. Instead of focusing on things like more widely accessible drug treatment, Trump and the rest of Washington seem resigned to focus more on politically expedient issues like stopping the flow of heroin and other opioids from foreign countries as well as stricter punishment for drug dealers. Unfortunately, these ideas are not new and have been tried before with underwhelming results.
The scope of the opioid crisis
One thing which cannot be disputed is the scope and severity of the opioid crisis our country is currently facing. The number of fatal drug overdoses has risen by almost 400% since 1999. According to the American Society of Addiction Medicine there were 52,404 lethal drug overdoses in 2015 and those numbers are expected to continue to grow in coming years. During his address Price stated, “When you have the capacity of Yankee stadium or Dodger Stadium dying every single year in this nation, that’s a crisis that has to be given incredible attention, and the president is giving it that attention.”
The number of fatalities is quickly reaching unprecedented levels and has recently passed the number of deaths from other issues in the past including the peak levels of fatal car accidents, HIV deaths and fatal shootings. All of these other issues were met with significant legislative action at both the national and state levels, leading to significant decreases in the levels of fatalities. The same actions are going to be necessary in the case of the opioid crisis if we as a country expect to reduce the number of deaths from drug overdoses.
While the statistics on drug overdoses are garnering most of the national attention, what is just as alarming are the less reported statistics on the number of people who are addicted to opioid drugs across the country. The American Society of Addiction Medicine estimated in 2016 that there are over 2.5 million opioid addicts in America. This is a staggering number which highlights the fact that preventing fatal overdoses is only part of a potential solution to the issue. While saving lives is obviously important, the number of un-treated or undertreated opioid addicts means that these overdoses will continue to occur unless the people who are struggling with the disease of addiction are properly treated and able to recover from their drug abuse issues.
Old ideas, old outcomes
It is clear that the White House and President Trump have an understanding of the severity of the opioid crisis, but the current consensus on how to tackle to problem seems to be a bit less well understood. Going back two years, when the president began to campaign for the election his main talking points in regards to the opiate crisis tended to focus mostly on issues such as building a wall along the entire U.S. – Mexico border to stop illegal immigration as well as the flow of illegal drugs such as heroin into the country. While this may have been effective as a form of campaign rhetoric, it’s a point of view which has not only been held for decades but has also proven itself to be tone-deaf to the root of the actual issue of drug abuse and addiction.
Yesterday President Trump spoke to reporters and stated, “If they don’t start, they won’t have a problem. If they do start, it’s awfully tough to get off. So, if we can keep them from going on – and maybe by talking to youth and telling them ‘no good, really bad for you in every way.’ But if they don’t start, it will never be a problem.” While on the surface this may seem like a perfectly acceptable stance on how to stem the rise of the current opioid crisis, it harkens back to the “just say no” campaigns of Nancy Regan in the 1980s during the height of crack cocaine use in the country.
The problem with this is that Nancy Reagan’s “just say no” campaign didn’t work then and it won’t work this time either. The issue stems from the simple misinterpretation of the disease of addiction and the nature of drug use in general, especially among teens and young adults. For those who have already experimented with or are consistently using drugs, the idea of simply saying no is certainly possible for a large section of the population. A majority of the people who try drugs like alcohol and marijuana do not become addicted, however there is a significant minority within the population that is susceptible to the disease of addiction for genetic, social or emotional reasons. For these people, just saying no is something that they cannot do because they are afflicted with a brain disease which prevents them from doing so. For these individuals the solution is a bit more intensive than teaching them to say a two letter word. Successful treatment for addiction typically requires in depth care provided by licensed and trained professionals for lengths of time which can be as long as a year or more.
Telling children to say no to drugs and alcohol has proven to be just as problematic. Scientific research into the DARE program of the 80s and 90s which involved law enforcement officers going into classrooms in order to educate children about the dangers of using drugs and alcohol proved to be ineffective. Those kids who were involved in those programs were just as likely to use drugs as those who were not. This again stems from an oversimplification of what is a complex social, psychological and medical issue. Children and young adults have brains which are still developing, which is why they are notorious for making questionable choices and succumbing to things like peer pressure. Expecting that a short lecture from a police officer once a week is going to override the basic biological reality of their brains is an exercise in magical thinking.
A new solution to the opioid crisis
Thankfully, there are some officials in Washington who seem to understand that a new way of thinking about the opioid crisis, and drug addiction in general, is desperately needed. Many of the members of President Trump’s special commission on the national opioid crisis including Governor Christie are making it clear that this problem is going to be solved on the medical, social and psychiatric front and not with law enforcement. Instead of continuing to play a game of whack a mole, which our country has seemingly been involved in since the early 1970s, focusing our efforts on improved and more easily accessible substance abuse treatment options for those addicted to opioids and other drugs is the solution we have yet to truly attempt.
The fact of the matter is that the past few decades in which the United States has used the war on drugs as its policy towards treatment of drug use and addiction has slowly led us to the situation we are in now, with little focus on treatment and a massive focus on punishment for drug use. Policies like locking away drug users in jail and massive attempts to eradicate those who produce and sell drugs have clearly proven themselves to be ineffective. As long as there are drug addicts there will be a demand for illegal drugs and as long as there is a demand, the black market will find a way to fill it. As soon as lawmakers and enforcement officials close one floodgate, another one will open. This is why cutting off the demand by treating drug addicts is the only logical answer at this point. If there are far fewer people who are buying drugs like heroin then the economic incentive for criminals to produce and sell them will no longer be there.
The preliminary report by the special commission described the severity of the opioid crisis as a “September 11th every three weeks,” referring to the fact that an average of 142 Americans die every single day from drug overdoses. Because of this the report called for the removal of regulations and barriers which are making it more difficult for people to receive substance abuse treatment. Things like strict regulations on what treatment centers can accept state and federally funded forms of health insurance mean that a large part of the population has only a few perpetually crowded and underfunded treatment programs to choose from. This sometimes makes it nearly impossible for the large number of those who are struggling with substance abuse and have Medicare or Medicaid to find effective treatment for their disease.
Thankfully, yesterday’s address by the White House provides ample evidence that the highest levels of the federal government are aware of the opiate crisis and are looking for real solutions, however it’s up to President Trump to take the advice of those around him who are truly aware of the specifics of the situation and put those suggestions into action. There are those around him who do have good ideas and could offer real help to the problem, but only if their words do not fall on deaf ears. The last thing we need as a country is to double down on the same policies which we have clearly not worked for decades.