June 19th, 2017

The Opioid Epidemic And The Trump Administration

If you can tolerate the pain of reading it, Margaret Talbot’s New Yorker article of June 5 provides a heartbreaking account of the devastating human toll the opioid addiction is taking in rural West Virginia. Nationally, the overdose rate continues to climb. The misery of these people overshadows the positive news that significant resources are being directed toward addressing the opioid problem. Progress has been made, and many lives are being saved through treatment. The New Yorker article profiles a photographer, Lori Swadley, who is using her skills to increase the visibility of people in recovery and to counter the shame-driven tendency to hide the overdose deaths.

Clearly, more help and perseverance are needed. 2016 ended hopefully as the public health interventions of the Obama-Biden administration began to take effect. The fruits of these interventions are reflected in funds for opioid treatment being distributed to states. The big question is what can be expected from the new administration. Early indications are not encouraging.

First, President Trump named a commission to study the opioid problem, even though many studies have already been done, and recommendations have been made. The first meeting of the commission, made up primarily of politicians rather than addiction experts, was held last week. Given the urgency of the opioid situation, I think the better option would be to continue and extend the efforts already underway.

The administration then dismissed Surgeon General Vivek Murthy, a vocal advocate for addiction treatment who issued the first Surgeon General’s Report on Addictions last year. Making matters worse, Attorney General Sessions is reviving the misguided notion that marijuana is responsible for the opioid problem. The limited evidence supports the opposite possibility. Marijuana has some advantages over opioids in the management of pain and states that have legalized its medical use have seen a reduction in the use of opioid medications.

Proposals to increase law enforcement focused on marijuana threaten to reverse these developments and divert valuable resources from dealing with the illicit use of opioids. The recent upsurge in the availability of synthetic opioids over the internet is already straining these resources.

The good news is that effective steps are being taken on a state government level. Maryland, for example, passed a number of productive laws on a bipartisan basis. Given the regressive ideas of the current administration, the best that we can hope for currently is continued progress on a state level, accompanied by Federal inaction.

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