ECLECTIC RANT: Opioid epidemic likely to continue unabated

Ralph E. Stone
Friday July 21, 2017 - 02:35:00 PM

Let's stop calling it a "war on drugs." Over the past four decades, federal and state governments have spent over $1 trillion into drug war spending and some would say much of this money was wasted. Drug abuse is a public health issue, not a war. By treating it as a war, our commitment to drug prevention has been too heavily weighted on the supply side. This is a short-sighted view.  

What is desperately needed is increased funding for treatment, prevention, education, and recovery support services, as well as research to identify and promote strategies to reduce demand. President Obama changed the long-standing policy on combatting the growing opioid painkiller and heroine epidemic through public health, not criminal justice, programs. The Trump administration has reversed this policy. 

Consider that the U.S. has the highest use of both legal and illegal drug use. It is this high demand for illicit drugs, which largely fuels the drug trade.  

The Centers for Disease Control and Prevention recently estimated that prescription opioid abuse, dependence and overdoses cost the public sector $23 billion a year, with a third of that attributable to crime. An additional $55 billion per year reflects private-sector costs attributable to productivity losses and health care expenses. 

About 80,000 Americans are incarcerated for drug-related crimes alone. Harsher drug policies are costly and bring a low rate of return. 

What is Trump going to do about the opioid epidemic? So far it is underwhelming. On the campaign trail Trump promised about the opioid epidemic, “We’re going to work with them, we’re going to spend the money, we’re gonna get that habit broken.” Instead on March 2017, by executive order, he established the President's Commission on Combating Drug Addiction and Opioid Crisis headed by Gov. Chris Christie of New Jersey as chairman. The Commission will work closely with the White House Office of American Innovation led by Jared Kushner. The Commission is supposed to compile a report on the state of the opioid epidemic—along with recommendations for responding to it by October. If Trump was really serious, there would be a budget and an action plan for getting "the habit broken." 

Republican Senators are trying to repeal the Affordable Care Act but there is a split among Senate Republicans over federal spending on Medicaid and the opioid epidemic. Republican senators from states that have been hit hard by the opioid drug crisis have tried to cushion the Medicaid blow with a separate funding stream of $45 billion over 10 years for substance abuse treatment and prevention costs, now covered by the expansion of Medicaid under the Affordable Care Act. This is opposed by conservatives. Now that the Republicans do not have the votes for repeal, will there be a $45 billion stream or any substantial dollar stream at all? I am not optimistic. 

Unfortunately, under Trump, the U.S. will revert back to an emphasis on treating the opioid-related epidemic as largely a supply-side problem -- a continued war on drugs if you will -- rather than a public health issue. As a result, I fear the opioid-crisis will continue unabated.