TRUMP’S WAR ON DRUG USERS
Obama made headway in ending failed policies, his successor is reversing progress
During the campaign, President Trump committed to addressing America’s drug crisis. He called it “a crippling problem” and “a total epidemic,” which it is. An average of 144 people a day die of drug overdoses. Trump promised increased funding and comprehensive Medicaid coverage for treatment. In March, he said, “We will show great compassion and resolve as we work together on this important issue.”
His rhetoric suggested a continuation of President Obama’s approach, which rejected the failed 45-year-old war on drugs.
The war treated drug use and addiction mainly as criminal problems. The Obama administration emphasized treatment-and-prevention programs based on scientific advances demonstrating that addiction is a brain disease with biological, psychological and environmental determinants. Obama championed landmark legislation that funded mental health and addiction treatment programs and research. He signed the 21st Century Cures Act and the Comprehensive Addiction and Recovery Act, which provides resources for state and community prevention and treatment efforts.
Obamacare mandated that insurance plans cover mental health, including addiction care, in parity with other diseases. WARTIME POLICIES Obama’s attorney general, Eric Holder, reversed wartime policies, including draconian mandatory minimum sentencing that filled prisons with people convicted of non-violent drug crimes.
His surgeon general, Vivek Murthy, released a historic report — as significant as the 1964 surgeon general’s report on smoking — on alcohol and drugs, which made science-based prevention and treatment a national priority.
In addition, Obama’s recent drug czar, Michael Botticelli, issued a budget that for the first time tipped in favor of prevention and treatment over interdiction and policing.
Last month, Trump abruptly fired Murthy and announced that the odd couple of his son-in-law, Jared Kushner, and New Jersey Gov. Chris Christie will lead an effort to create policies to combat the opioid epidemic.
Meanwhile, though Trump promised to fund treatment, he has proposed slashing $6 billion from agencies that, among other priorities, address drug use and addiction. He specifically targeted $100 million in block grants for the Substance Abuse and Mental Health Services Administration. Last week, the White House proposed a 95% cut in the Office of National Drug Control Policy.
Of immediate concern to the 20 million Americans who meet the diagnostic criteria for the disease of addiction — and the 40 million regularly misusing alcohol and other drugs — the president has said that he’ll end mandates included in the Affordable Care Act. Trump has said that he’d sign the bill the House passed Thursday that would allow states to apply for waivers of ACA-required benefits, including mental health and addiction care. DRUG WARRIOR SESSIONS Meanwhile, Trump’s team has begun a re-escalation of the drug war. Attorney General Jeff Sessions, an old-school drug warrior, criticized Holder’s policies and suggested that he’ll reverse them.
“You have to able to arrest people and then you’re intervening in their destructive habit,” Sessions said. “Many people never ever recover from addiction — except by the grave.”
It’s unsurprising that an administration that has vowed to be tough on crime plans to use battering rams rather than sciencebased health efforts — ignoring evidence that the former doesn’t work and that the latter does.
And how about killing them? Doubts about Trump’s compassion toward the addicted were confirmed last weekend when he cozied up to a dictator whose idea of treating drug users is murder
ing them. According to USA TODAY, his new friend, the Philippines’ Rodrigo Duterte, had at least 6,000 people killed for drug crimes in six months. Duterte doesn’t distinguish between users and dealers. He has exhorted Philippine citizens: “If you know any addicts, go ahead and kill them.”
It’s critical that the Trump administration reverse directions and focus on a public health approach. Science has demonstrated that addiction isn’t a choice made by people without willpower who only care about getting high, no matter the impact on society, their loved ones and themselves. It’s a brain disease.
We punish people who make bad choices. But people who are ill don’t need censure, stigmatization or jail time.
They need quality care for an illness that can, if it isn’t treated, kill them.
David Sheff is author of Beautiful Boy: A Father’s Journey Through His Son’s Addiction.