New War on Drugs Won’t Solve Substance Abuse Treatment Crisis


Anti-drug poster from the Office of National Drug Control Policy circa 2000. (Wikimedia commons)

The War on Drugs may be about to heat up again. Despite last year’s US Surgeon General’s report and the predominant finding by doctors and addiction specialists in general that addiction is not a moral failing, some in Washington DC still want to prosecute and law-enforce our way out of the opioid epidemic.

On Tuesday President Donald Trump received the report of his Commission on Combating Drug Addiction and the Opioid Crisis, and rejected many of its recommendations, including that it should be declared a “National Emergency.”

I’m not sure I disagree with that. While it would reinforce what the President said during the campaign that he took the opioid addiction, overdose and death epidemic seriously, it’s mostly just words. What you do is more important, and the priorities expressed by Trump and his representatives – Attorney General Jeff Sessions, Health and Human Services Secretary Tom Price and Counselor to the President Kellyanne Conway – suggest they aren’t going to follow many of the commission’s recommendations. They don’t even see much of a difference between marijuana and heroin.

Those other recommendations, as enumerated in an interim report, focus largely on improving and expanding treatment, sharing information, eliminating barriers, education and increasing access to naloxone – a drug that Trump specifically mentioned on the campaign trail that can reverse an overdose – and medication-assisted treatment (MAT) — buprenorphine (Suboxone), methadone, Vivitrol — for heroin addiction treatment

Of particular interest to the substance abuse treatment industry is it calls on the US government to “enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) … to ensure health plans cannot impose less favorable benefits for mental health and substance use diagnoses verses physical health diagnoses.” If not enforced, or if made optional as the recent House and Senate healthcare bills would have done, millions of people who have received substance abuse treatment under the Affordable Care Act could lose it.

So far the administration hasn’t mentioned the MHPAEA. Instead the President said, “Opioid overdose deaths have nearly quadrupled since 1999. … Meanwhile, federal drug prosecutions have gone down in recent years.” Apparently never hearing that correlation doesn’t necessarily equal causation, he promised, “We’re going to be bringing them up and bringing them up rapidly,” as if that will solve the problem.

Then, reasoning that the “best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place,” he suggested one way of accomplishing this is “maybe by talking to youth and telling them: ‘No good, really bad for you in every way.’ ”

So, locking up more people and teaching kids to “Just Say No.” Who said insanity was doing the same thing over and over again and expecting a different result?

UPDATE: Hours after this was posted, President Donald Trump announced, that the opioid epidemic “is a national emergency and we are drawing documents now to so attest.” On Aug. 8, his Health and Human Services director Tom Price said this was not necessary because although it is an emergency,  “national emergency”  is usually used for  “a time-limited problem,” such as a hurricane.