President Trump Declared the Opioid Crisis a Public Health Emergency. Now What?

By Christopher Smith 11/07/17

Our president is unwilling to develop new solutions to a crisis deeply ingrained in a poisoned society--instead falling back on methods of attack that have shown minimal success or outright failed.

Donald Trump at a podium.
Evan El-Amin /

On Thursday the 26th of October, 2017, President Trump declared the opioid crisis a designated Public Health Emergency. In the East Room, surrounded by Americans who have been directly impacted by the opioid epidemic in some of the most tragic ways imaginable--through the death of loved ones--Trump tried to contain his usual boisterous and flamboyant speech, giving the subject matter the solemnity it deserves. He laid out the framework for a new plan that will use “sound metrics...guided by evidence and guided by results.”

As emotionally impactful as it was to those who have been hit hardest by the epidemic, the speech lacked real substance. It shows that our president is unwilling to develop new and novel solutions to a crisis deeply ingrained in a poisoned society--instead falling back on methods of attack that have shown minimal success or outright failed. Sadly, much of the speech was fluff trying to camouflage that the administration has developed no new approaches for dealing with the opioid epidemic.

The speech follows announcements he made in a memo to Attorney General Jeff Sessions in May, which rescinded a 2013 Obama-era address that limited the prosecution of low-level drug dealers. His announcement in May instructed prosecutors to do a complete 180, charging even low-level offenders with the “most serious, readily provable offense," sentencing many people to lengthy prison terms with overbearing mandatory minimums.

As of yet, no monies have been allocated for either medication-assisted treatment programs or traditional rehabilitation programs. Since the opioid crisis has been designated a public health crisis, the funds must specifically be requested by the president. Trump did mention he was in favor of drug court, which has dismal success rates.

The parallels with the Reagan era’s tactics in the War on Drugs are obvious. Like Reagan, Trump’s approach of prosecuting even minor offenders to the fullest extent of the law will cause the prison population to skyrocket. Under the Reagan administration's approach to the drug war, those incarcerated for nonviolent drug offenses jumped from around 50,000 in 1980 to 400,000 by 1997.

The president’s advertising approach mirrors Nancy Reagan’s failed “Just Say No” campaign, which ushered in the zero-tolerance policies of the 80’s. Not long after, the D.A.R.E. program was introduced by Los Angeles police chief Darryl Gates, who once said that casual drug users "ought to be taken out and shot.” The program rapidly spread nationwide although its effectiveness was never proven, and now it’s been shown that it may have had the reverse effect, influencing children to try drugs.

It looks like we’re heading back toward the 80’s.

Being a recovering addict, I have a unique perspective on the political environment regarding drug use. I can say firsthand that for many people who struggle with addiction, this new political climate is terrifying. Trump’s policies, well-meaning though they may be, will only be detrimental to all of us trying to recover. They show that he knows nothing about addiction. It’s like a doctor trying to treat cancer with just willpower.

Increased prosecution and punitive laws do nothing to deter a drug user from using drugs. When we’re in the midst of the cloud of active addiction, getting caught is generally the last thing on our minds. We’re impervious to the nebulous concept of consequence. Being numb, rational fear of anything--whether it be the imminent fear of the looming specter of death from accidental overdose, or the comparatively moderate danger of incarceration--goes straight out the window. A man or woman hell-bent on self-destruction or desperately chasing a high is hard to reason with. Possible consequences aren’t on the radar.

Policy makers would do well to listen to some in the rooms of 12-step programs. After all, no one understands us like we understand ourselves. Open ears at a particularly graphic meeting will quickly show an outsider that we don’t think anywhere near rationally when in active addiction. One could also learn that we’re never going to stop using until we want to, and even then, we have to have the help and means available to stop.

For some, that simply means having the support of an understanding group and a lot of willpower. But many times, that just isn’t the case. We will see many people, believing themselves cured, go out and decide to use again, only to come back with tail between legs. Some will spend time behind bars, only to come out and immediately use again. And some don’t make it back.

For me personally, it took relapse after relapse and finally some solid treatment to begin to recover. Though the desire to recover was there, I simply didn’t know the way out of the mess I was in. I needed to be led by the hand.

The current administration is creating an atmosphere that will make that helping hand exceedingly hard to hold. Fear of punishment will drive many of us into hiding, ashamed of our disease. The administration is telling us that we are bad people who need to be punished, not sick people who need treatment.

As lawmakers sit isolated behind locked doors, the TV is going to show horrible, graphic, anti-drug commercials, driving home the demonization of the sick even further. Ads will target those who have never touched a drug before, hoping to plant a seed that will keep them from ever trying one. But it will fail, just as it did in the 80’s and every decade since. People aren’t stupid--we know bullshit when we smell it. The advertisements will bias people who are unfamiliar with addiction, representing it as a moral issue and further isolating those who need the most help.

Even if against all odds someone drums up the desire to change, in the current environment it doesn’t look like he will have options to do so. If the G.O.P. does away with the Affordable Care Act and millions end up losing health insurance--as they have speculated in the media--the person seeking help for addiction will have no way to receive the proper treatment he needs.

Trump’s $100 million in proposed cuts to the Substance Abuse and Mental Health Services Administration will limit funding available for many nonprofits. HHS secretary Tom Price argued that medication-assisted treatment, the gold standard in opioid addiction treatment, is “simply replacing one opioid with another.” The hardline stance that abstinence is the only measure of successful treatment is an outdated way of looking at recovery, and leads to more unnecessary deaths and incarcerations in a society that just can’t handle any more.

The War on Drugs has been a rigid, unchanging failure of institutionalized racism and classism since it was first initiated during the Nixon administration. Millions of lives have been ruined--not only by the substances themselves, but by unsympathetic officials unwilling to listen, change, or educate themselves about the situation they are trying to control. History has proven that we don’t need more of the same. This atmosphere of tough, punitive action where people only have reasonable access to treatment after sitting behind bars for untold years is sacrificing many lives that don’t need to be lost along the way.

People in recovery are diligent, creative, compassionate, and intelligent. They need to be given a legitimate chance to safely enter recovery without fear of retribution or other negative consequences. We reap what we sow. If seeds of fear are planted, we will raise an environment of shame and hate for our next generation. But if seeds of hope and love are planted, we may yet raise a garden.

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Chris is a survivor of the opiate epidemic and tries to be a advocate for those still suffering from addiction. From the dark hollows of Appalachia and based in Lexington KY, he writes full-time and is thankful to have the opportunity to do so. He can be reached at [email protected]