Responsible for the deaths of about 90 Americans a day, opioids are the cause of an increasingly dire health crisis finally being addressed by the Trump administration. The opioid epidemic had its beginnings in the early 1990s, when a combination of “aggressive marketing” and faulty science promoted by Purdue Pharma resulted in widespread use of OxyContin, a form of oxycodone, according to CNN. In 2007, Purdue Pharma and three of its top executives pleaded guilty to misleading and defrauding doctors and consumers about the safety of the drug. But since OxyContin was introduced in 1995, opioids have become a source of pain relief, addiction and subsequent devastation for a concerning number of Americans, especially in the Appalachian region.
On Oct. 26, President Donald J. Trump graced us all with a long overdue declaration of the opioid crisis as a public health emergency. Considering that some analysts attribute Trump’s electoral win in New Hampshire in part to his campaign promise to address the crisis by August 2017, Trump should have declared the opioid epidemic a national emergency months ago.
In the 1980s, opioids were considered a “safe treatment for chronic pain,” a conclusion based largely on a questionable letter to the editor published by the New England Journal of Medicine. The letter, titled “Addiction Rare in Patients Treated with Narcotics,” was not peer-reviewed nor supported by any verified, peer-reviewed evidence, yet was cited at least 608 times between its publication and June 2017 as proof that long-term narcotic use is not addictive. Many of these drugs are, in fact, highly addictive; the pharmaceutical industry was happy to supply individuals hooked on opioids with pills. Those pharmaceutical companies produced a seemingly endless supply of the drugs that addicts sought.
Before April 2016, the U.S. Drug Enforcement Administration (DEA) could investigate and fine shady pill distributors, and freeze possibly-illegal drug shipments from being moved around the country. Last year, however, Congress unanimously passed the Effective Drug Enforcement Act last year, divesting the DEA of its power to investigate pharmaceutical companies that may be responsible for the illegal distribution of narcotics. Joseph T. Rannazzisi, former DEA chief, was replaced in 2015 due to conflict over the bill; Rannazzisi spent his career investigating hundreds of cases involving illegal activity in the opioid industry and vehemently opposed the bill, claiming it would “protect defendants that [the DEA has] under investigation.” The pharmaceutical industry spent about $240 million dollars on lobbying in 2016, almost 60 times what the National Rifle Association has spent lobbying Congress on gun rights in the same year. Because of its political sway and money spent on lobbying, the pharmaceutical industry essentially wrote the law that crippled the DEA and insured the continuation of their cash cow.
Trump’s treatment of this urgent, concerning calamity reflects a bigger theme that has been present for the entirety of his term as well as his campaign — empty promises and so-called plans without actual substance or action to back them up.
At an Oct. 30 White House event attended by families devastated by the opioid crisis, Trump delivered a speech speckled with emotional adjectives to describe the “horrible, horrible situation that’s taken place with opioids.” Other choice phrases from the event include a promise that the government will produce “really tough, really big, really great” advertising intended to dissuade Americans from touching opioids in the first place. The reasoning behind this idea? “If we can teach young people not to take drugs, it’s really, really easy not to take them,” Trump said eloquently.
There’s a pressing logistical screw-up here: What Trump declared is completely different from what he enacted. Trump declared a “national health emergency,” which would allow the government to use Federal Emergency Management Agency (FEMA) funds allocated for such emergencies to combat the epidemic via the Stafford Disaster Relief and Emergency Assistance Act — as of September 2017, FEMA’s budget was approximately $3.3 billion. What Trump enacted is a “nationwide public health emergency” via the Public Health Services Act, which allows the government to access a measly $57,000 in funding from the Public Health Emergency Fund. The emergency will last 90 days, though it can be renewed.
Whether Trump, in his campaign promises, simply misspoke in calling the crisis a “national health emergency” or intentionally equivocated to mislead voters, his actions are clear. Our president’s policy decisions speak louder (and much more coherently) than his campaign promises. A mere $57,000 will barely even begin to cover any comprehensive plan for dealing with the opioid epidemic. According to analysis by Richard G. Frank, a economics professor who worked to implement the Affordable Care Act under the Obama administration, addressing the crisis would cost $14 billion this year and $183 billion over the coming decade.
Positive aspects of Trump’s plan include a requirement that prescribers that are federally employed are trained in safe opioid prescription protocols, a federal initiative to create nonaddictive painkillers and actions to restrict shipments of fentanyl, a cheap opioid, into the United States. Trump also intends to suspend a rule currently preventing Medicaid from funding some drug rehabilitation facilities.
But Trump’s failure to request adequate funding reflects his lack of concern for the crisis. Furthermore, Trump’s plan fails to consider the root cause of the opioid epidemic; it only addresses the issue for the already-affected generation. This is a start, but not enough. The underlying reasons people seek relief in opioids must be addressed by the Trump administration, and proper addiction treatment must be expanded, especially in rural regions of the U.S. A 2017 study of Neonatal Abstinence Syndrome (NAS), a condition found in newborns exposed to addictive opioids in utero, found that NAS disproportionately affects rural and Appalachian Kentucky counties and that “treatment options are disproportionately further away for these residents.” Until effective treatment is more widely and easily available, opioid overdose deaths will remain at dangerously high levels.
Maryah Amin is a College freshman from Syosset, N.Y.