President Trump recently announced his plan for combating the epidemic of opioid abuse and deaths in America. Once again, he has displayed his ability to ignore sound advice from experts, and advance his political agenda as a “solution” to the crisis.
Over the past year, Trump has reassured the public of his intellect, calling himself “really smart” and “a very stable genius.” While such intelligence apparently made a contribution to these policies, experts have been underwhelmed. This plan will not create sustainable change, according to researchers and treatment providers who work with individuals addicted to these dangerous drugs.
Sobering Statistic on Overdose Deaths
From 2015 to 2016, opioid deaths have kept increasing. According to the Centers for Disease Control (CDC), there has been more public education related to opioid abuse, doctors have become more aware of their choices when prescribing painkillers, and there are more public programs to treat opioid abuse, yet the mortality rate continues to rise.
There were over 42,000 deaths from opioid overdoses in 2016, accounting for two-thirds of drug overdose deaths in the U.S. Mortalities from opioid use increased 27.9 percent between 2015 and 2016, which some law enforcement personnel think may be due to fentanyl being added to cocaine. These officials suggest drug dealers combine 2 two so the cocaine becomes more addictive, resulting in a deadly drug cocktail.
The increase in opioid deaths started in the 1990s, with prescription opioids. Deaths from heroin and other illegal opioids began to rise in 2010. Now there are many more deaths from these synthetic opioids than in years past, as they account for about 46% of all overdose fatalities.
Reducing Overdose Deaths: Trump vs. Medical Professionals
To combat this epidemic, Trump’s plan suggests taking away restrictions on how Medicaid can be used to pay for treating individuals. The proposal also involves commercials to explain the dangers of drugs to children. More alarmingly, Trump focuses on illegal immigration as a cause of the epidemic, and advocates the death penalty for drug dealers.
Many researchers and treatment providers have been less than complimentary of this plan, and its lack of adequate funding. Among them is Dr. Richard Saitz of Boston University. Dr. Saitz is a School of Public Health professor, and a professor in the Boston University School of Medicine.
Saitz argues that Trump’s plan needs to focus more on preventing and treating addiction, including lowering the cost of medications. Saitz notes that drug companies may charge $3,000 for a dose of naloxone, which does not cost much to produce, but can save the lives of people who have overdosed.
He is not hopeful about price reductions, though, given that Trump’s Health and Human Services secretary Alex Azar used to head a drug company. But Saitz also notes that even when prescriptions used to treat addiction are cheap, if the government does not compensate drug abuse programs for those medications, it does little good.
Saitz also criticizes parts of Trump’s plan as ineffective, such as the commercials targeted at kids, which can encourage behaviors they were meant to discourage. Trump has also recast his Mexican border wall as a way to keep out immigrants allegedly selling drugs. Saitz dismisses this idea, saying immigrants are not coming to the United States to unload their opioids.
He further argues that having drug dealers face the death penalty is a horrible idea, since targeting sellers has not been helpful in reducing addiction. Saitz points out that those who sell drugs are often addicted themselves: “The death penalty for people with addiction is beyond nonsensical. It is just wrong, plain and simple.” To combat the number of deaths, Saitz suggests we instead focus on changing the demand for drugs, and how we treat those who suffer from addiction.
Prescription for Better Health Care
Saitz notes that treatment for drug abuse has been reduced under Trump because of changes to the Affordable Care Act (ACA). Under the ACA, part of the general care regimen was help with addiction and substance abuse. Saitz emphasizes that we need health care that incorporates addiction treatment, and that people with addictions should be treated in places “that help break down the barriers between general healthcare settings and addiction treatment settings.”
If people who need treatment for addiction do not feel like they will be stigmatized, they will be more likely to seek help. Saitz also argues that problems with addiction in America go far beyond opioids to alcohol and other drugs. To combat opioids, we must also face the social problems that have made addiction rates so high.
Seeking Social Solutions
Researchers have been asking important questions about what causes opioid abuse, and whether depression can lead to abusive behaviors. Studies have found a connection between the increase of opioid use and social factors that cause depression, including fewer marriages, and the difficulty finding well-paying jobs.
Depression would be prevalent without opioids, but people who feel hopeless can get addicted to drugs more easily. To combat addiction we must also combat depression, which means instituting social programs that give people a better standard of living and sense of security.
If individuals have better access to education, quality food, safe housing, and good health care, they are less likely to feel unsafe, become depressed, and abuse drugs. Indeed, part of recovering from addiction is feeling a sense of hope, and finding a community that can provide an emotional safety net.
Building a (Social) Wall
Trump’s plan to reduce opioid addiction builds more social stigmas than safety nets. His “solutions” stigmatize people who are addicted to opioids, when these individuals need help and compassion.
Trump wants to suggest walls will solve problems, but our real social problems run much deeper and require longer-term solutions. Further, Trump is only committing $6 Billion in his proposal, while experts like Saitz think the cost of curbing addiction will be far higher.
We cannot put such a tiny band-aid on a gaping social wound.
Clearly this plan is the work of a “very stable genius.”