The Opioid Overdose Epidemic Hypocrisy of Donald Trump
by Denise Oliver Velez –
Mother Jones has been on his case like white on rice. In “Remember When Trump Said He Cared About the Opioid Crisis? Fast Forward to Now” they point out:
The purpose of the commission, which will report to Trump’s son-in-law Jared Kushner, is to write a report by October of this year on the status of the epidemic and make recommendations for the future, after which it will cease to exist. The Surgeon General’s office under President Obama published a very similar report last November. Trump has yet to appoint a “drug czar”, or director of the Office of Drug Control Policy, which is charged with evaluating and overseeing federal anti-drug efforts.
Meanwhile, Trump has repeatedly proposed taking resources away from the programs that could stop the epidemic. For example:
- The president’s proposed 2017 budget would cut $100 million from the Substance Abuse and Mental Health Services Administration’s mental health block grants, which help provide substance abuse services across the country.
- His proposed 2018 budget would cut 16.2 percent of funding from the Department of Health and Human Services, the umbrella agency that funds things like SAMHSA and other mental health and substance abuse programs.
- The 2018 budget claims it would include a “$500 million increase above 2016 enacted levels to expand opioid misuse prevention efforts and to increase access to treatment and recovery services.” When pressed by Rep. Katherine Clark (D-Mass.), HHS Secretary Tom Price admitted that this $500 million is reference to funding from the 21st Century Cures Act, which Congress enacted under Obama signed into law late last year.
- Though it didn’t ultimately pass, Trump was hard-set on repealing the Affordable Care Act, which would have left nearly 3 million Americans without often life-saving addiction treatment.
As part of his public relations “tour de lies” he glommed onto previous actions by President Barack Obama.
The president’s budget blueprint touts “a $500 million increase above 2016 enacted levels to expand opioid misuse prevention efforts and to increase access to treatment and recovery services to help Americans who are misusing opioids get the help they need.” This caught the eye of Vox’s German Lopez, who noted that the 21st Century Cures Act — legislation signed into law by Barack Obama late last year — had already increased funding for opioid addiction treatment by $500 million over 2016’s baseline.
It wasn’t immediately clear whether Trump’s budget meant to propose an additional $500 million (as its presentation seemed to suggest). But at a congressional hearing Wednesday, Health Secretary Tom Price confirmed that “the $500 million is the $500 million from the Cures Act.”
In “Donald Trump believes the solution to the opioid crisis is talk” the author points out we already have federal agencies in place who are dealing with substance abuse issues.
“Opioid abuse has become a crippling problem throughout the United States,” Trump said today. “And I think it’s almost untalked [sic] about compared to the severity that we’re witnessing.”
But it’s actually not “untalked about.” There have been many, many reports about how to address the opioid problem. Most recently, the nonpartisan office of the Surgeon General came out with a report that included clear, evidence-based suggestions about what steps need to be taken.
The long and short of it is that America must double down on treatment options for addicts, and make sure insurers cover those benefits. As the Surgeon General’s report stated, “Substance use disorder treatment in the United States remains largely segregated from the rest of health care and serves only a fraction of those in need of treatment.” Only 10 percent of people with an addiction of any kind get treatment, and more than 40 percent also have a mental health condition, yet fewer than half get treatment. Others, including the American Medical Association Task Force to Reduce Opioid Abuse, have called for the urgent need to address this “treatment gap.”
So we already have reports. We already have opioid task forces. We already have reams of expert advice. We also have at least three government agencies that deal with drug problems — the White House Office for National Drug Control Policy (colloquially referred to as the nation’s “drug czar”), which coordinates America’s anti-drug spending; the Centers for Disease Control and Prevention; and Substance Abuse and Mental Health Services Administration, which administers the block grant for addiction treatment in the US.
I’ve worked on studies and interventions funded via NIDA and the CDC, as well as by state agencies. My husband currently works with clients who have both substance abuse and mental health issues. He said his clients are freaking out—wondering if the services they receive via Medicaid funding will be eliminated by the Republicans in control of the White House and Congress. Medicaid plays a key role in treatment services.
The mostly white voters attracted to Donald Trump’s claims to care about their addiction and overdose pain are often the same people who demand that the federal government get out of their lives, and deeply resent any monies extended to people of color, who Trump and Republicans portray as thugs, criminals and “bad hombres.”
Sadly, “white” people’s addiction is a disease that we are told we need to deal with as a medical issue. When it is in a community of color it is a “crime problem.”
Consider the opioid epidemic, which contributed to the record 52,000 drug overdose deaths reported in 2015. Because the crisis has disproportionately affected white Americans, white lawmakers — who make up a disproportionate amount of all levels of government — are more likely to come into contact with people afflicted by the opioid epidemic than, say, the disproportionately black drug users who suffered during the crack cocaine epidemic of the 1980s and ’90s. And that means a lawmaker is perhaps more likely to have the kind of interaction that Christie, Trump, Bush, and Fiorina described — one that might lead them to support more compassionate drug policies — in the current crisis than the ones of old.
Is it any wonder, then, that the crack epidemic led to a “tough on crime” crackdown focused on harsher prison sentences and police tactics, while the current opioid crisis has led more to calls for legislation, including a measure Congress passed last year, that boosted spending on drug treatment to get people with substance use disorders help?
Ithaca, New York, Mayor Svante Myrick, who’s black, told me this has led to resentment in much of the black community in his predominantly white town. “It’s very real,” he acknowledged. The typical response from his black constituents, he said, goes something like this: “Oh, when it was happening in my neighborhood it was ‘lock ’em up.’ Now that it’s happening in the [largely white, wealthy] Heights, the answer is to use my tax dollars to fund treatment centers. Well, my son could have used a treatment center in 1989, and he didn’t get one.”
Still, Myrick added, “I’m as angry about this as anybody. But just because these are now white kids dying doesn’t mean we shouldn’t care, because these are still kids dying.”
I agree with Myrick. I’ve lost many people in my life—of all colors—to death via drugs, and want to see every addict have access to treatment. That doesn’t mean I don’t see (and resent) the racial disparities. I’m also aware that the epidemic continues in communities of color.
Most of the media attention in the current nationwide heroin epidemic has focused on the uptick in overdose deaths among suburban, white, middle-class users — many of whom turned to the drug after experimenting with prescription painkillers.
And it’s among whites where the most dramatic effect has been seen — a rise of more than 260 percent in the last five years, according to the Centers for Disease Control.
But the epidemic has also been seeping into communities of color, where heroin overdose death rates have more than doubled among African-Americans, Latinos and Native Americans, but gone largely overlooked by the media.
Back in 2015, I wrote “Our drug overdose epidemic, and what you can do about it” and in it examined the success of Narcan (Naloxone) programs in saving the lives of people who have overdosed. This interactive map covers the state laws on its use. What we don’t need is Trump’s AG Jeff Sessions doubling down on the war on drugs.
The Kaiser Family Foundation polls frequently on public attitudes about health care, and addiction— and has been following the current addiction to the pills epidemic closely.
The new funding is sorely needed. To really be effective, the solutions to this epidemic, as with any drug epidemic, need to deal both with the suppliers and the users: in this case physicians who irresponsibly overprescribe painkillers and the people who get hooked on painkillers. A new survey of long-term opioid users by the Kaiser Foundation and the Washington Post underscores how challenging the problem is.
The users may not be who you think they are. You may know a 16-year-old skateboarder who ripped up his knee, has surgery, got some Vicodin from a physician or his parent’s medicine cabinet, and got hooked. But the typical long-term opioid user is not a kid getting high. The Kaiser-Washington Post survey found that six in 10 long-term opioid users were between 40 years old and 64 years old. Less than a quarter worked full time and 33% were on disability or retired (20%).
Seventy percent of long-term users said they have a debilitating disability or chronic disease. Long-term users are slightly more likely to live in rural areas; the problem of opioid overdoses is especially acute in rural America, where treatment is scarce and Emergency Rooms and jails can’t handle the problem.
Almost all long-term users of painkillers – 97% – received them from physicians, and both states and the federal government are taking steps to address overprescribing.