Donald TrumpDonald TrumpMcCabe wins back full FBI pension after being fired under Trump Biden's Supreme Court reform study panel notes 'considerable' risks to court expansion Bennie Thompson not ruling out subpoenaing Trump MORE did especially well in regions of the country hit hard by the prescription opioid and heroin crisis. The devastating impact of opioid addiction on their families and Obama’s tepid response to the problem gave voters in these areas a good reason to believe the federal government had failed them.
It was not until Obama’s last year in office that he sought significant funding for addiction treatment and started speaking about the crisis— a full five years after Centers for Disease Control and Prevention (CDC) labeled it “the worst drug epidemic in United States history.”
Trump’s promise to “drain the swamp” and take on Big Pharma resonated well with people who understand that the crisis is fueled by opioid overprescribing.
Many advocates on the front-line of the epidemic, whose efforts to promote more cautious prescribing have been thwarted by a powerful industry, believed Trump would be an ally. Opioid manufacturers, distributors and retailers spent more than $880 million over the past decade blocking state and federal policies to reduce opioid prescribing, according to an investigation by the Associated Press and Center for Public Integrity.
Many Trump supporters now feel betrayed. Trump’s pick of Dr. Scott Gottlieb for FDA Commissioner and Representative Tom Marino for Director of the White House Office of National Drug Control Policy are exactly the individuals the opioid lobby would want for these jobs. Both Gottlieb and Marino have been active in efforts to weaken DEA regulation of opioid distributors like Cardinal Health, Mckesson and AmerisourceBergen and both have financial ties to the opioid industry.
In 2012, after DEA took action against Cardinal Health for shipping millions of oxycodone tablets to two Florida pharmacies, Gottlieb penned a Wall Street Journal op-ed defending Cardinal Health. In the piece, he called for a statutory change that would limit DEA’s enforcement authority to illegal narcotics. Marino went even further. He successfully pushed through legislation to make it harder for DEA to suspend the registration of manufacturers, distributors and pill mills that violate federal laws.
From the very beginning of the opioid crisis, when reports of overdose deaths involving OxyContin first began surfacing from Appalachia and New England, the opioid lobby urged policymakers not to overreact. It claimed the problem was limited to so-called drug abusers and that millions of pain patients were benefitting from more liberal prescribing. The issue was framed as if there were two distinct groups and that all of the harms were limited to drug abusers looking for a high. This is not true. Millions of patients have become addicted to opioids taking them as prescribed and thousands have lost their lives to opioid overdoses.
In their efforts to block DEA from cracking down on legal narcotics suppliers, Gottlieb and Marino have read from the opioid lobby’s script. They argued that efforts to stop drug abusers should not penalize patients with chronic pain. While opioids are essential medicines for end-of-life care and short-term use, they are not safe or effective for the vast majority of chronic pain sufferers. Compassionate care for patients with chronic pain is not jeopardized by more cautious prescribing- it demands it.
It would not be hard for Trump to improve upon Obama’s response to the opioid addiction epidemic. But he is off to a very bad start.
Andrew Kolodny MD Andrew Kolodny MD is Executive Director, Physicians for Responsible Opioid Prescribing.
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