President Trump is finally close to announcing his plan to address the opioid epidemic in the U.S., but there’s a serious problem. He appears to be channeling Rodrigo Duterte, the hated dictator of the Philippines, who made international headlines tackling his country’s drug epidemic with a heavy dose of law and order and relatively little emphasis on prevention and treatment.
Trump’s controversial plan is to make drug dealing a capital crime in many if not most cases. This will make previously petty crimes suddenly punishable by the death penalty, a move that will inevitably fill our already overcrowded prisons with drug dealers, according to a report by Politico.
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Trump, who has long demonstrated an affinity for authoritarian leaders like Duterte, seems to be favoring a similar get-tough approach. While increased law enforcement is the cornerstone of his plan, it is unlikely that American law enforcement will be urged to shoot suspected drug dealers on sight, as is the case in the Philippines, where over 12,000 have died in recent years largely due to Duterte’s influence – including a 17-year-old boy in January.
Still, Trump’s law enforcement-oriented crackdown idea goes against the advice of most medical and health professionals, which apparently is one reason his plan for the opioid crisis has taken months to develop.
According to Politico:
“The plan would ramp-up prosecution and punishment, underscoring the tension in how public health advocates and law enforcement officials approach the crisis.”
Trump talked a lot on the campaign trail in 2016 about dealing with the opioid epidemic, which was a major cause of over 65,000 drug-related deaths in the U.S. last year alone. After more than a year in office, however, he has not done anything of any significance to address the crisis.
Now, reports Politico, after months of behind-the-scenes discussions and a considerable amount of internal wrangling, Trump is poised to announce his response to the crisis as soon as Monday when he makes his first trip to New Hampshire since becoming president.
Public health advocates want opioid addiction treated as a disease, with massive boosts in treatment and prevention programs that are currently extremely underfunded. Law enforcement wants tougher punishment to deter users and especially drug dealers from illegally buying and selling opiods.
More from Politico:
“The two camps don’t always see eye-to-eye, at times pitting HHS (the Dept. of Health and Human Services) and DOJ (Department of Justice) officials against each other.”
“There is a lot of internal dissension between the health folks and the enforcement folks,” an official involved in the crafting of the plan told Politico.
Trump has been talking about using the death penalty to deter opioid dealing, but like so much of what he says, even politicians in his own party have not been sure how seriously to take his threats.
“I would have to strongly evaluate and look at any proposal like that,” said Sen. Dan Sullivan (R-Alaska). “I don’t know if the president was serious or just said it off the cuff. … It’s a big issue when you decide to bring a capital case or pass a law that allows for capital punishment.”
Sen. Shelley Moore Capito (R-WV), is against the death penalty in drug cases, even though her state has been among the hardest hit by the opioid plague.
“I mean, I get the message he’s delivering,” said Capito. “We’ve got to treat it seriously. I don’t see that that’s going to solve the problem.”
Trump’s plan would also provide for mandatory minimum sentencing for drug traffickers if they distribute illegal opioids like fentanyl that can be deadly.
Trump also wants Jeff Session’s DOJ to create the Prescription Interdiction and Litigation (PIL) task force to prosecute doctors, pharmacies and others who misuse opioids and provide them to drug dealers.
Healthcare advocates say that the lesson learned when President Reagan tried to get tough on drugs here at home – and after similar measure were undertaken by other countries – is that law enforcement crackdowns alone are ineffective and expensive because they only succeed in packing taxpayer funded prisons with more non-violent offenders.
The draft plan does include one aspect related to incarceration that health advocates have long sought: mandatory testing of every inmate upon arrival at a prison to see if they have an opioid addiction. This would help identify those who need treatment as well as those who are good candidates for rehabilitation through educational programs.
Trump’s proposal would also include changes to how the government pays for opioid prescriptions to help limit access to the painkillers, and it would change Medicaid rules to make it easier for patients with addictions to get treatment.
There would also be a task force to aggressively monitor online sales of opioids, and a national monitoring database so doctors and health care providers can identify patients who seek out multiple opioid prescriptions in a short period.
One thing everyone seems to agree on is the need to make naloxone, a medication that can reverse opioid overdoses, more readily available to first responders like ambulance drivers, firefighters, police, as well as others on the front lines of the epidemic who might be able to use it.
One big unknown is how the costs of these new programs – conservatively estimated to be in the billions of dollars annually – would be paid for.
For instance, the Trump proposal asks Congress to repeal a rule that bars Medicaid payments to residential treatment facilities that work with opioid addicts.
The rule is meant to discourage mass institutionalization of people with mental illness who then are kept in place with the use of lots of painkillers.
Now some states have complained it is a barrier to addiction treatment.
Like so much of what Trump does and says, the plans address real needs, but do so in a way that in part seems excessive and beyond what is reasonable considering the nature of the crisis.
To get the funding needed for both the programs and the law enforcement initiatives, Trump is going to have to convince Democrats as well as Republicans that his plan will be used by the professionals it is meant to mobilize and produce the impressive results he is predicting.
With Trump, it is always best to take whatever he promises, slice it in half, divide by ten, and then look for how many of his cronies will get a payoff from the added costs.
What we don’t want to see is police murdering people in the streets in the name of opioid addiction enforcement as happens in the Rodrigo Duterte’s Philippines.
It is one thing to have a wanna-be authoritarian who likes to talk tough, and another to have a murderer who bends the law to eliminate political enemies under the cover of solving a crisis.