The Trump administration’s latest proposal for tackling the opioid crisis is not devoid of good ideas. It’s certainly got more meat on its bones than the president’s declaration of the crisis as a public health emergency last fall.
There was talk, although still not enough specifics, of increasing treatment options for addicts, and of new limits on prescriptions of oxycodone, hydrocodone and other opioids.
But Trump spent the days leading up to his announcement touting the idea of the death penalty for opioid dealers, and his speech last week focused (as much as it focused on anything) on similar “tough on crime” policies.
The problem is, those policies don’t get good results. America — well, much of it — has learned from previous drug epidemics that such tough-talk tactics aren’t the solution. By all means, prosecute drug dealers and interrupt their trade routes.
But if too much emphasis is on chucking people in jail, let alone executing them, America will just raise another generation of damaged, hopeless families.
Many law enforcement officers and politicians in this area openly acknowledged this a few years ago — a welcome departure from the years when they were afraid of being painted as “weak on crime.” Now, at least at the federal level, that mindset has returned.
At least the plan released by the administration Monday merely referred to increased use of the death penalty under existing law, rather than increasing the situations where it might be used.
No word if the death penalty for opioid dealers would extend to the CEOs of companies that shipped millions of unnecessary painkillers to West Virginia, resulting in hundreds of deaths. No word if the doctors who overprescribed opioids, or the pharmacists who ran “pill mills,” would face execution.
Trump also claimed Monday that his beloved wall at the Mexican border would stop the flow of heroin into this country. Experts are extremely skeptical of that claim, to put it mildly.
Even the better parts of Trump’s plan have problems. Cutting prescriptions for painkillers sounds good, and West Virginia lawmakers have already taken steps in that direction. They passed a bill (SB 273) earlier this month that would limit many initial opioid prescriptions. Gov. Jim Justice asked for that bill, so even though he hadn’t signed it as of Tuesday afternoon, he almost certainly will.
That’s useful, but even though prescription painkillers kicked off this epidemic, heroin and fentanyl have eclipsed them in recent years, partially because those addicted to pills had to find other ways to feed their addiction once the pills became harder to get. And chronic pain sufferers who legitimately need opioids will likely find them harder to get under such limits.
The plan for increasing treatment for opioid addicts is still more undefined — as is how any treatment increase would be paid for.
A budget passed by Congress calls for $6 billion in spending on the opioid crisis over the next two years, but public health officials say that’s a drop in the bucket. Trump’s budget proposal calls for an additional $7 billion, which would be two or three drops in the bucket.
One specific goal from the Trump plan — to have Congress repeal a law that allows large treatment facilities to get Medicaid reimbursement — wouldn’t help West Virginia, because the state already has federal permission to waive that rule.
And speaking of Medicaid, many people in West Virginia who get treatment for their opioid addictions do so through the state’s Medicaid program, which was expanded under the Affordable Care Act, which Trump and his GOP cronies keep wanting to cut.
There are no easy answers for this huge and disastrous conundrum. But as long as the federal government focuses on punishment, rather than treatment and recovery, the problem will only get bigger.