Trump’s bluster on opioids fails to give crisis gravity it merits

President Donald Trump has declared that his administration is getting serious about the opioid epidemic several times since taking office. But he has repeatedly failed to offer a substantive plan — and he has floated at least a few truly absurd ideas. He did it again last week.

Trump gave a rambling speech on opioids in which he offered few details about how he would increase access to substance abuse treatment and prevention to help the millions of Americans suffering from this disease. Some 64,000 people in the United States died of drug overdoses in 2016, including 481 in New Hampshire, one of the hardest hit states in the country, where Trump gave his speech.

The president went on at length about his preposterous proposal to fight the scourge of drugs by executing drug dealers — an idea that many experts say would not stand up in court and would do little to end this epidemic. He also reprised his cockamamie idea to build a wall along the nation’s southern border, arguing that it would “keep the damn drugs out,” and accused sanctuary cities of releasing “illegal immigrants and drug dealers, traffickers and gang members back into our communities.”

It was Trump playing his greatest “law and order” hits — as usual, full of sound and fury but signifying nothing.

Trump seems so enamored with autocrats and strongmen that he wants the United States to imitate governments like China and the Philippines by executing drug dealers, claiming such countries “don’t have a drug problem” because of their brutality. This is patently absurd. While it is hard to analyze the experience of many of these countries because they do not collect and publish reliable data about substance use, experts say it is clear that they have not eliminated drug abuse or the crime that often accompanies it. More broadly speaking, many scholars have concluded that there is no good evidence that capital punishment deters crime.

Trump seems so enamored with autocrats and strongmen that he wants the United States to imitate governments like China and the Philippines by executing drug dealers, claiming such countries “don’t have a drug problem” because of their brutality.

But we do have convincing evidence that ratcheting up the war on drugs, as Trump and his attorney general, Jeff Sessions, want to do, would not work. Since the early 1980s, the federal government and states have imposed increasingly harsh criminal penalties on drug dealers and users. Not only did they fail to stem drug use or the availability of illicit substances, but they may have contributed to their spread by taking resources away from treatment and prevention efforts. It is no wonder, then, that the per-gram retail price of heroin fell by about 85 percent between 1981 and 2012, according to a report published in 2016 by the White House Office of National Drug Control Policy.

Further, legal experts say it is unlikely that a law authorizing capital punishment for drug dealers would be considered constitutional, because the Supreme Court has previously struck down laws that allowed the use of the death penalty for crimes other than murder.

Trump’s other get-tough policies are also unlikely to help. The wall would not stop drugs — most imported illicit substances like heroin and methamphetamines already come in through legal border crossings. And his plans to penalize sanctuary cities, which choose not to participate in federal deportation crackdowns, would be counterproductive. That’s because law-abiding immigrants are less likely to identify and testify against drug dealers and gang members if they fear that helping law enforcement agencies could put them or their relatives at risk of being detained or deported.

Trump’s New Hampshire speech did contain a few good ideas — but only a few. He said the administration would seek to reduce opioid prescriptions and expand access to medication-assisted treatment for those suffering from addiction. Experts, including a commission appointed by Trump last year, identified these and other solutions months ago, but the administration has taken little action and provided few details about how it would carry out these ideas.

There are a number of other good ideas that Trump and his team have done little to advance, like getting health insurance companies to cover mental health and substance abuse treatments as well as they cover other medical treatments, something required by federal law. He could also encourage 18 states that have not expanded Medicaid under the Affordable Care Act to do so. This would make addiction treatment available to millions of additional people. Not only has he not sought to expand that program, but Trump and Republicans in Congress have proposed deep cuts to Medicaid, which covers about 38 percent of people with an opioid addiction, according to the Kaiser Family Foundation.

Trump might be sincere in his concern for people suffering from this epidemic. But more than a year into his presidency, he is miserably failing them.