The signals President Donald Trump has sent on what he has in mind for fighting the nation’s opioid addiction epidemic have been far from clear and consistent.
As he campaigned for the presidency last year, he talked tough, but never outlined serious solutions to one of the most critical problems of our time.
“But we’re going to have a real wall, and it’s going to be a great wall, and it’s going to work,” he said in March 2016 at a Portland campaign rally. “And we’re going to stop drugs from pouring into Maine and New Hampshire and all these places. It’s going to work. Believe me, it’s going to work. Walls work. Properly done, walls work.”
After Trump took office, his choice for attorney general, Jeff Sessions, revealed an approach to criminal prosecution more in line with the law enforcement-oriented War on Drugs than the public health-oriented approach to addiction of the Obama administration.
But Trump also chose New Jersey Gov. Chris Christie to lead a specially formed President’s Commission on Combating Drug Addiction and the Opioid Crisis. Over the summer, that commission called on Trump to declare a national emergency to direct more federal resources toward the addiction problem. The commission recommended attacking the addiction crisis as the public health problem that it is. It called for expanding the ability of Medicaid to cover addiction treatment. It called for expanding the use of medication-assisted treatment such as methadone and buprenorphine (known commercially as Suboxone). And it called on every local law enforcement officer in the nation to carry naloxone, to be able to quickly reverse an opioid overdose and save a life.
Trump later agreed with the commission’s assessment that the opioid crisis merited a national emergency declaration, just two days after his health and human services secretary, Tom Price, said it didn’t. But still, nearly a month after Trump said he would declare a national emergency, he has yet to follow through.
Sending another mixed message, Trump earlier this month formally nominated U.S. Rep. Tom Marino, a Pennsylvania Republican, to serve as director of the Office of National Drug Control Policy, a post that has historically set the tone for how the nation approaches drug policy. (Trump had previously proposed nearly gutting the office’s budget before changing course and proposing to preserve more of the office’s funding.)
Marino comes from the more law enforcement-oriented camp when it comes to drug policy. At a House committee hearing last year, he suggested a “hospital-slash prison” for non-violent drug users that would use criminal charges as a lure for people to enter addiction treatment.
“One treatment option I have advocated for years would be placing non-dealer, non-violent drug abusers in a secured hospital-type setting under the constant care of health professionals,” Marino said. “Once the person agrees to plead guilty to possession, he or she will be placed in an intensive treatment program until experts determine that they should be released under intense supervision. If this is accomplished, then the charges are dropped against that person. The charges are only filed to have an incentive for that person to enter the hospital-slash-prison, if you want to call it.”
The nation desperately needs to focus on the public health side of the addiction crisis, emphasizing treatment approaches backed by research. Instead, Marino’s hospital-slash-prison relies on criminalizing a disease, an approach that hasn’t worked to stem America’s drug problem.
Trump has sent mixed signals so far on how he views the addiction crisis. It’s time he backed and followed the public health-oriented approach of his special commission.