On average, 115 Americans die every day from an opioid overdose, according to the Centers for Disease Control. In 2016, around 42,000 people lost their lives to overdose deaths related to heroin, prescription painkillers and illegally manufactured fentanyl—a five-fold increase since 1999. The opioid crisis isn’t slowing down, and preliminary reports show that overdose deaths for 2017 are on track to be around 30 percent higher than in 2016.
Opioid abuse has been on the increase for nearly two decades. In March of 2017, President Trump formed the Commission on Combating Drug Addiction and the Opioid Crisis, expressing his dedication to combating the opioid epidemic.
The Findings of the Opioid Commission
In November of 2017, the opioid commission released 56 recommendations, including:
- Increasing federal funding and issuing grants to states to combat the epidemic
- Increasing access to treatment, particularly medication-assisted treatment
- Creating a nationwide media campaign to encourage treatment and de-stigmatize addiction
- Enhance the Prescription Drug Monitoring Program
- Mandating physician education about opioids
- Increase pain management and addiction research
But despite the opioid commission’s call for urgency, the federal government neglected to act on its recommendations for several months.
The President’s Plan to Address the Crisis
On March 19, 2018, the president unveiled his plan to combat the opioid crisis, which includes:
- Stiffer penalties—including the death penalty—for drug dealers
- Cracking down on illegal immigration, including building the border wall
- A large-scale media prevention and education campaign
- Improving the ability of the federal government to fund treatment
Although the president offered very few specifics during his speech, the ultimate goals of the plan are to reduce the supply of illegal drugs through tougher penalties, reduce the number of prescriptions and the overall demand for opioids and expand access to treatment and the overdose-reversing drug naloxone.
In his speech, the president didn’t mention the serious issues of opioid over-prescribing by physicians or the aggressive—and sometimes illegal—marketing done by pharmaceutical companies. His plan also didn’t address issues like fraudulent addiction treatment programs that have overrun Florida and California, nor did it address the tragic practice of body brokering, where disreputable treatment centers and sober living homes pay recruiters to send them addicted individuals with insurance—and then offer very little in the way of successful, research-based treatment.
Criticisms of the Federal Government’s Plan
Many experts are unsure how the president’s plan will be funded. While President Trump’s recent budget plan included $10 billion to combat the opioid epidemic over the next two years, Congress allotted just $6 billion, which public health experts say isn’t nearly enough.
Dr. Andrew Kolodny, co-director of Opioid Policy Research at Brandeis University, estimates that it will cost $60 billion over the next ten years just to create enough treatment facilities in the country to help those who are addicted.
The current administration appears to be focusing on law enforcement and harsher penalties to combat the epidemic, but critics cite a large body of research conducted since the 1980s showing that stiffer penalties for drug dealers not only does very little to reduce the availability of drugs, but it also leads to lower prices for illegal drugs.
Additionally, legal experts point out that authorizing the death penalty for drug dealers is unconstitutional, and the Supreme Court has repeatedly struck down laws calling for capital punishment in drug cases that don’t involve murder. Former New Hampshire Governor and current Senator Jeanne Shaheen commented to The New York Times, “Frankly, whether a drug dealer, after exhausting all of their legal appeals, gets the death penalty 20 years from now has no impact on our immediate crisis.”(3)
Critics are also dubious about the president’s claim that building the border wall will curb the supply of opioids. They point out that, according to the U.S. Customs and Border Protection, more than 80 percent of the illegal drugs that come into the U.S. from Mexico come through legal ports of entry, not the wilderness between ports that the wall would protect.
In its report, the opioid commission stressed that increasing access to treatment is central to successfully curbing the opioid crisis. While the president cited a goal to expand access to evidence-based addiction treatment in every state, he didn’t offer any details on how this would be done.
Critics note that he didn’t call on the 18 states that failed to expand Medicaid under the Affordable Care Act to do so, although this would provide millions more Americans with access to treatment.
In fact, the president called for the repeal of the Affordable Care Act, and Congress is expected to make deep cuts to Medicare and Medicaid later this year to help fund the recent tax cut.
It remains to be seen how the federal government’s opioid crisis plan will work and what it will entail. Meanwhile, state and local governments and countless organizations are doing everything they can to address opioid addiction in their jurisdictions, even though resources are stretched thin as the problem continues to grow.