The Trump administration, finally yielding to a screaming chorus of pleas to fulfil a promise made two months ago to tackle America’s opioid crisis, last week declared it a “national public health emergency”. Between pledge and action, 10,000 more have died of an overdose.
The declaration, his officials explained, would increase access to emergency federal funding… eventually.
At 175 deaths per day, and with overdoses now the leading cause of accidental death in the US, we finally all agree that the opiate epidemic is a crisis.
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President Trump described it accurately when he said: “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.”
But the rest of his plan seemed to forget that, and all the lessons of failed anti-drug campaigns between 1970 and 2017. Like many Trump policies, this one appears to be a mishmash of defunct policies freshly extracted from a time capsule with an overlay of grandiose promises directly contradicted by the administration itself.
War on Drugs
In other parts of his announcement, he relaunched Richard Nixon’s 1971 “War on Drugs”, a series of aggressive law enforcement strategies comprising a mixture of crackdowns and prohibitions that were long since deemed to be a in 2011.
He also relaunched Nancy Reagan’s “Just Say No” campaign from the 1980s, peddling the very concept of teaching abstinence to students as his own original contribution to the cause, despite common knowledge that drug use soared in that decade. Especially cocaine abuse.
He even promised a “really tough, really big, really great” advertising campaign to drive home the impact of drug use, reminiscent of the “” commercial that became a US pop culture sensation, circa 1987.
And although this was ranked one of the best commercials of all time by TV Guide and Entertainment Weekly, nevertheless – inexplicably perhaps to a president who puts much store in television ratings – drug use continued to rise.
Then there are the promises for the future directly contradicted by recent actions of the Trump administration.
Most of those with opiate dependence and addiction end up there not as a result of peer pressure or recreational use or experimentation, but from legal but liberal prescription of painkillers from a physician community that was taught pain could be safely treated through opiates.
So the Trump administration promises Medicaid access to large rehab facilities, that it will be “pushing the concept of non-addictive painkillers very, very hard”, developing expensive partnerships for research for , and using addiction specialists via telemedicine to expand treatment access into rural areas.
Only, it’s hard to square these initiatives with healthcare and budget proposals that all seem determined to cut Medicaid, the public healthcare vehicle . The budget of the US National Institutes of Health agency that focuses on drug abuse (NIDA) is being cut by $210 million, yet Trump calls on the NIH to develop urgent solutions.
What’s more, telemedicine only works when there are enough specialists to staff it and the internet connectivity to deliver it, which often does not exist in rural zones. Then there is the whole overriding question of the non-existent funding that is necessary to implement any of these initiatives.
We now have to count on Congress to approve this additional funding in a budget they’re working hard to reduce, but only after Trump requests it, which has not yet occurred.
While the administration congratulates itself on rebranding obsolete strategies from yesteryear and promises a brighter future, the rest of us know it is missing the point. Our family members are dying. One hundred and seventy-five per day.
Sad.
Samantha Murphy is a science writer based in Pennsylvania
Read more: Just say maybe: Is the world ready to abandon the war on drugs?
