January 22nd, 2017

How alcohol and drug addiction issues will fare in the new Trump Administration is uncertain with one exception: the most sought-after Mexican drug lord has, after years of delay, been extradited to the United States to be tried on multiple criminal charges. Joaquin Guzman Loera, nicknamed “El Chapo” or “Shorty,” was flown out of Mexico to New York on January 19. Of the many questions surrounding this event, two stand out for me.

The first relates to the possible political implications of its timing. The extradition occurred on Obama’s last day in office and the day before Trump took over as President. Newspaper reports suggest that the date of the transfer took many by surprise. But how to deal with the Mexican gangs that have been supplying drugs to users and addicts in the US has been an area of collaboration and contention between the US and Mexico. If the transfer was a political message, the nature of that message is open to interpretation. Was it a farewell gift to Obama, or an ambiguous overture to Trump, or both? And how will it impact the US-Mexican relationship?

The second question involves how this event will influence the struggle to address drug addiction. I’m an ardent opponent of the “War on Drugs,” but was heartened by this event. Nevertheless, I wonder how much of a difference it will make to my patients. Historically, the removal of a “king pin” has created an opening for a new one who is sometimes even worse.  I have heard no reports that the flow of drugs from Mexico to the US has been reduced since the apprehension of Joaquin Guzman. Among the many criticisms of the “get tough on drugs” approach is that the law falls more often on addicts who sell drugs to support their habits than it does on people such as Joaquin Guzman, who have the resources to elude the system.

The issue of drug use and addiction was not a high priority during the presidential campaign, but associated issues such as crime and overdoses have historically forced attention on it.  The Obama administration was exceptional in shifting United States drug policy in the direction of treatment while diminishing the focus on criminal justice. I will continue to track the Trump administration’s approach to addiction and report what I find.


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