Congress should condemn Trump's shoddy drug strategy

Congress should condemn Trump's shoddy drug strategy
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House Democrats held a hearing this week to examine the Trump administration’s response to the overdose crisis and Trump’s new drug czar, Jim Carroll, was the administration’s witness. The Committee on Oversight and Reform hearing spotlighted the White House’s glaring failure to respond effectively to this crisis.

President TrumpDonald John TrumpTrump calls for Republicans to be 'united' on abortion Tlaib calls on Amash to join impeachment resolution Facebook temporarily suspended conservative commentator Candace Owens MORE has made many promises to end the overdose crisis, but two years in, his administration has failed to deliver. Trump has ignored most of the recommendations that his bipartisan commission came up with to tackle the overdose crisis. The president did act on one of his commission’s recommendations, and declared a public health emergency. But the Trump administration has failed to implement it

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As all of these events were unfolding and overdose deaths nationwide continued to climb, Trump proposed effectively shuttering the White House Office of National Drug Control Policy, the only federal office charged with coordinating drug policy across the executive branch.  Although this plan was thwarted by Congress, Trump downsized the agency’s budget and staffing levels. ONDCP became a stomping ground for Trump devotees who were given senior level jobs at the agency despite having no experience working with drug policy issues.

Given this backdrop, it’s hardly surprising that ONDCP released a plan in January for addressing the overdose crisis that is an absolute shambles.  The plan, which is President Trump’s first national drug strategy after more than two years in office, fails to lay out in any real detail how the administration will end the overdose crisis. The plan is introduced as a “strategy of action,” but the document reveals few details about how the Trump administration intends to actually act on its policy proposals. 

Trump’s plan reads more like a twenty page homework essay than a comprehensive White House strategy document. As an auditor with the Government Accountability Office noted in testimony during this week’s Oversight hearing, the plan fails to provide the most basic performance measures required by law to hold the agency accountable, rendering practically meaningless any effort to measure progress. 

This lack of accountability doesn’t end there, as Trump’s plan is largely mum on the status of the administration’s efforts to implement the president’s opioid commission recommendations. Likewise, the strategy makes no mention of any progress that the White House has made to address the overdose crisis following President Trump’s declaration of a national public health emergency.

While Trump’s drug czar testified that Trump’s opioid emergency declaration was intended to help the executive branch free up federal resources that could help scale up resources, Democratic members of the Oversight committee, including Democrat Rep. Alexandra Ocasio-Cortez, highlighted that Trump had not hesitated to use another emergency declaration to pull federal resources to build his wall. Curiously, Trump’s plan makes no mention of the president’s relentless push for a border wall. 

Trump’s first drug strategy is a far cry from President Obama’s last strategy, which detailed how ONDCP would work across the federal government and in communities to advance measurable goals to end the overdose crisis, delineating tasks necessary to complete stated goals, and publishing metrics specifying target goals for reducing overdose deaths and drug-related HIV and hepatitis C infections, among others. 

To the extent that Trump’s plan puts forward policy proposals, most are unimaginative, representing many outdated ideas and programs that have been demonstrated ineffective time and again.  For instance, the Trump administration proposes launching a media campaign to warn against using opioid drugs that is aimed at adolescents. The last time that ONDCP did this it failed so miserably that Congress pulled the plug on the program, but not before the bungled program cost taxpayers more than a billion dollars. 

Trump’s drug strategy also revives talk of a “drug-free society,” a tired slogan with no basis in reality that has done more to perpetuate zero tolerance policies that have undermined access to medication-assisted treatment and harm reduction programs than inspire positive change.

Although Trump’s strategy discusses how the Trump administration will work to reduce the stigmatization of people who struggle with addiction, President Trump’s extreme rhetoric calling for the execution of drug sellers undermines these efforts, since many drug sellers are people who struggle with addiction and sell drugs to subsist. 

Missing from Trump’s drug strategy are critical components to an effective strategy for preventing overdose and other drug-related harms. Trump fails to acknowledge the role that syringe services programs play in reducing overdose deaths, preventing blood-borne infections and providing critical health services.

There is also no mention of the price gouging of naloxone products by pharmaceutical companies, nor any plan to address this enormous problem for community-based harm reduction providers and first responders who cannot afford the exorbitant prices. Trump’s drug czar was prodded by House Oversight Chairman Rep. Elijah CummingsElijah Eugene Cummings5 things to watch as Trump, Dems clash over investigations Republicans defend drug company in spotlight over HIV medication prices Advocate praises Warren's opioid proposal: 'The scale of the plan is absolutely right' MORE to address the issue.   

Trump’s strategy emphasizes the need to expand treatment access. However, the Trump administration’s long sought goal of repealing the Affordable Care Act and rolling back Medicaid expansion would hurt millions of people who have received coverage for medication assisted treatment through these expansions in health care.

Moreover, President Trump’s budgets to Congress have proposed boosting funding for law enforcement at the expense of treatment. This was a reversal from President Obama’s last budget to Congress, which sought to focus more money on treatment than enforcement.

The overdose crisis our nation currently faces is the greatest public health emergency in a generation. Trump’s drug policy office claims that his administration “is matching the magnitude of today’s historic crisis with a historic level of focus and resources,” but Trump’s deficient plan to address this crisis and the lackluster actions of his administration prove otherwise.

Grant Smith is deputy director of national affairs with the Drug Policy Alliance.