March 5th, 2018

White House Opioid Summit: Searching For The Positive

Looking for good news in the Trump administration’s approach to the opioid problem can sometimes seem like searching for a needle in a haystack. I was therefore pleased to actually find such a “needle” when the new HHS Secretary Alex Azar said at the White House opioid summit on March 1st that “…we need to treat addiction as a medical challenge, not as a moral failing.” He went on more specifically to make positive comments about the use of medication-assisted treatment (MAT), which echoed statements made repeatedly over the past several months by the FDA Commissioner Scott Gottleib.

Having administration officials say the right things – rather than take productive action – is, unfortunately, the most that we can expect in help with the opioid crisis in the foreseeable future from the Federal government. A previous example of positive words – the admirable recommendations of the President’s Opioid Commission – is unlikely to see any significant implementation. I hope that I am wrong in disagreeing with one of its chief authors, Bertha Madras, who saw reason for optimism in what she heard as substantial “resolve” on the part of administration officials at the opioid summit.

This may be a low bar to set for positive news, but things have been and could get worse. For example, last year, then HHS Secretary Tom Price stunningly made negative public statements about MAT, echoing ideological positions contradicted by a preponderance of evidence. Even worse, Attorney General Sessions is attempting to revive the Drug War despite decades of experience with how counterproductive this strategy has been in addressing problems relating to drug use. The good news is that the broad political support necessary to implement such a misguided strategy appears to be lacking.

I was surprised to find myself pleased both to have a sense that the opioid crisis is no longer a top priority for the Trump administration and to find no coverage of the opioid summit in the New York Times. While hoping for Federal inaction, I am more optimistic about productive action on state and local government levels, as well as by professional addiction and other medical associations.

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