October 15, 2018 | ° F

WASSERMAN: Trump's opioid fight tactics may cause harm


Opinions Column: A Healthy Dose of Justice


JakeWasserman

With this Monday’s rollout of a new opioid plan from President Donald J. Trump's administration, I feel like it is necessary to talk about the advancements (or lack thereof) made on fighting the epidemic of opioid painkiller usage in the United States. Back in October, I wrote my first op-ed on this area called “Current response to opioid crisis is lacking,” which went into the ambivalent ways in which America racially divides who is worthy of medical rehabilitation and who deserves incarceration, as well as the lack of teeth to the Trump administration’s declaration of a public health emergency regarding opioids. From Trump’s announcement in New Hampshire, ambivalence has been declared a common theme across the months that the federal government has attempted to put an end to America’s epidemic of epidemics.

What stands out foremost in the new plan from the Trump administration is the inclusion of the death penalty for some drug dealers and distributors. To no surprise, backlash from the public health community has been vocal, aided by commentary from notable lawmakers like Sen. Shelley Moore Capito (R-W.Va.), who said, “I mean, I get the message he’s delivering: We’ve got to treat it seriously. I don’t see that that’s going to solve the problem.” The charging of drug distributors with serious carceral measures is not necessarily a new tactic for the justice system, with precedent in both Florida and New York in treating opioid distribution as homicide for longer prison sentences. But, there is a serious lack of evidence that increasing the severity of sentencing will have any significant impact in deterring crime, specifically regarding the distribution of opioid drugs. In response to Trump’s new plan, Sen. Ed Markey (D-Mass.) said, “We are still paying the costs for one failed 'war on drugs,' and now President Trump is drawing up battle plans for another. We will not incarcerate or execute our way out of the opioid epidemic."

The Trump administration is now more than one year into its tenure, and has still been unable to make permanent appointments and receive confirmations for key jobs that determine American drug policy. With three interim directors as of February 2018, the Office of National Drug Control Policy (ONDCP) still lacks a permanent director or “drug czar,” who is responsible for carrying out federal anti-drug efforts both internationally and domestically. In January 2018, The Washington Post published a bizarre story about a 24-year-old campaign worker that had ascended to high level leadership at ONDCP in the wake of high turnovers and vacancies, but has since stepped down, indicating the continued lack of organization at the nation’s highest drug policy office. The 2019 fiscal year budget transferred $254 million for the High Intensity Drug Trafficking Areas program from ONDCP to the Drug Enforcement Administration (DEA). The preservation of the program and move to the Department of Justice has been criticized for allowing for a wider federal coordination with local police departments to crack down on drug trafficking, rather than the necessary partnering with social and health services to treat overdoses and connect drug users with rehabilitation.

Cities and states have begun a wave of litigation against pharmaceutical companies that produce opioid painkillers, and recently acquired support from the Department of Justice in those cases. As a result, companies like Purdue Pharma, which invented the drug OxyContin, have stopped promoting opioid drugs to physicians, resulting in dramatic cutbacks of their sales staff. But even with legal action being pursued against the producers of opioid drugs, Trump’s new proposals miss the mark on who is responsible for the opioid crisis and what action ought to be taken. A 2017 study from the Department of Justice indicated that approximately one-third of drug offenders were committing the offense to be able to afford their addictions, meaning that charging distributors with the death penalty would be directly counterintuitive to the Trump administration’s goals of helping opioid crisis victims.

It would be unfair to make the claim that all of the Trump administration’s ideas toward combatting the opioid crisis are bad. The plan also includes calling on Congress to waive a rule that blocked Medicaid payments for inpatient treatment at large facilities, providing treatment for prisoners with opioid addictions and improving tracking systems to allocate resources to communities that are particularly struggling with opioid overdoses. Trump has also proposed a new Department of Justice task force to prosecute criminally negligent doctors and pharmacies, although this move remains one of the more controversial aspects of the plan. Despite the progress that is being made in policy reforms, the White House’s inconsistency between public health and criminal justice approaches to the opioid epidemic could result in either dangerous or ineffective outcomes, and more progressive strategies must be adopted as opioid deaths continue to rise.

Jake Wasserman is an Edward J. Bloustein School of Planning and Public Policy senior majoring in public health with a minor in cognitive science. His column, “A Healthy Dose of Justice,” runs on alternate Tuesdays.

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Jacob Wasserman

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