President Donald Trump has plans stop the opioid epidemic, but surprisingly, it does not involve the only solution: Cannabis. Trump released an executive order months ago laying out a plan to create a commission dedicated to addressing the country’s opioid crisis. He cracked down on October 26, ordering the Department of Health and Human Services to declare the crisis a public health emergency.
However, despite this national emergency, which is exactly what it is, Trump did not allocate any new monies toward the fight. He did not even acknowledge the role that medical marijuana could play in reducing opioid addiction and overdose rates, nor even that it could provide a safer alternative to prescription opioids for pain and other common health problems.
More people consume opioids in the United States than they do anywhere else in the world. According to recent data released by the Centers for Disease Control and Prevention, 142 people die every day from opioid overdoses in the country, and heroin is not to blame. The vast majority of these deaths are due to abusing prescription painkillers, such as Percocet and OxyContin.
America’s obsession with taking pain pills has reached such unimaginable proportions that the president declared it a national emergency in a statement made in the White House. He spoke about his intention to tackle the crisis. Back in March, he wrote an executive action for a task force to create a report he could recommend to enforcement agencies for this very purpose.
According to a currently unnamed “top administration official,” Melania Trump is pivotal to the president’s plan. Just last month, Melania held a roundtable at the White House on opioid abuse. The president will also propose changes to health care policy, as well as embark on massive public relations and advertising campaigns nationwide.
The executive-ordered opioid commission released its first interim report back in July. Its publication noted that in 2015, the sheer quantity of opioids that doctors were prescribing in the United States would medicate every single American for three solid weeks without respite. Published in July, the report itself had this to say:
“The average American would likely be shocked to know that drug overdoses now kill more people than gun homicides and car crashes combined. In fact, between 1999 and 2015, more than 560,000 people in this country died due to drug overdoses. This is a death toll larger than the entire population of Atlanta.” The report advised declaring a national emergency, changing health policies, and raising awareness.
Trump’s decision to classify addiction to opioids a national emergency is in itself highly unusual. In fact, it is a first for any drug crisis worldwide. That frightening categorization is typically for extreme natural disasters, such as floods, hurricanes, tornadoes, and yes, even terrorist attacks. However, it remains unclear how declaring it an emergency will work to stop it.
In theory, officially making the opioid crisis a national emergency would allow the administration to use funds set aside specifically for disasters to address the issue. Beyond that, it does little else, and Trump’s rhetoric suggests either confusion about the drug crisis or insincerity. Despite research indicating that marijuana can curb opioid use and dependency, Trump has yet to distinguish between addictive drugs like prescription painkillers and heroin, and milder substances, like cannabis.
Furthermore, Trump is insisting on repealing national healthcare, and despite the nation being in the middle of a severe health crisis, such action severely undermines any claim Trump makes about caring for all the addicted Americans in urgent need of drug treatment. The president displays little support for marijuana overall, which is a powerful alternative to opioid painkillers.
Trump was quiet about state marijuana laws right up until May. Only then did he indicate, albeit obliquely through a rider in an omnibus spending bill, that he would not be sending the federal government after marijuana consumers and businesses in states that legalize its use. Trump noted the following in a statement made on the bill:
“Division B, Section 537 provides that the Department of Justice may not use any funds to prevent implementation of medical marijuana laws by various States and territories. I will treat this provision consistently with my constitutional responsibility to take care that the laws be faithfully executed.” This falls very short of the echoing cry issued by other politicians at state and federal level to make research into medical marijuana’s efficacy as an alternative to opioids more accessible to scientists.
Medical cannabis may well be the non-narcotic alternative to the nation’s current reliance on prescription painkillers. However, research in the United States is both limited and unreliable because the federal government prohibits study of the drug. In September, conservative Senator Orrin Hatch introduced a bill to prioritize pot research for this very reason, but there is no indication that Trump will.
Additionally, Trump’s choice of Jeff Sessions as United States Attorney General does not inspire any confidence in his ability to make research-supported decisions around drug policy. Sessions is a vehement and outspoken opponent of marijuana legalization, and back in June, the Washington Post reported that Sessions wrote a letter to Congress in May.
In the letter, Sessions blatantly opposed the abovementioned restrictions on federal funding. He believes wholeheartedly that the Department of Justice should have full access to federal monies to fund actions that would prevent states from implementing their own marijuana laws, “particularly in the midst of a historic drug epidemic,” as Sessions wrote.
In plain speak, Sessions actually cited the opioid epidemic as sufficient reason to stop states from making medical marijuana legal to patients, even while some of his conservative colleagues were sponsoring and introducing legislation petitioning for deeper research into using medical marijuana to curb that exact same crisis.
According to data released by the National Institute on Drug Abuse, preliminary research shows that opioid prescriptions, use, abuse, addiction, and overdoses are significantly lower in states that allow the use of medical marijuana. The statements that Sessions keeps making deliberately conflate and obfuscate issues, which, as a reputable national attorney, he should be able to distinguish easily.
Another potential problem is Trump’s tight relationship with Big Pharma. Back in September, the President nominated Tom Marino, a Republican representative from Pennsylvania, to tackle the opioid crisis. Marino withdrew his consideration for the job in October, after reports emerged claiming him instrumental in limiting the ability of the Drug Enforcement Administration to crack down on pharmaceutical giants fueling the epidemic to begin with.
On October 16, after Marino’s withdrawal from the position, Trump said this of drug companies at a press conference, “They contribute massive amounts of money to political people.” However, he failed to mention that he also accepted funding from Big Pharma, leading attendees of the news conference to point out the hypocrisy, “When it comes to pharma donations, Trump was with the elephant in the room.”
Despite Trump himself only accepting a $6,500 donation from Pfizer in 2016 for his presidential campaign, the same pharmaceutical giant gave his inaugural committee $1 million this year for the inauguration. Aside from Big Pharma’s money, philosophically, choosing Marino initially indicates that Trump either does not understand the drug problem or has no plan to resolve it, as Marino famously suggested in the past that drug addicts receive treatment in “prison-slash-hospitals.”
Throwing addicts into jail is not an option, particularly as they are everywhere in society. It is also impossible to hospitalize all of them, especially since the President intends repealing the Affordable Care Act, an action that would deprive many Americans of health insurance, and therefore, the coverage they would need to treat addiction to opioids.
In fact, Trump is actively taking steps to limit the ability of Americans to pay for addiction treatment. His distaste for national health care and his desire to revoke “Obamacare” will certainly hinder the ability of anyone to resolve a crisis with its basis in addiction. Trump’s efforts to get rid of the ACA could leave addicts with no choices and inadvertently exacerbate the national opioid epidemic.
In 2015, the Substance Abuse and Mental Health Services Administration reported that only 10 percent of drug addicts receive treatment. Only one in 10 get help, and nearly a third of those needing treatment but not receiving it cite either the high cost of insurance or a lack of coverage as reason for not getting the help they so desperately need.
Based on these statistics, there is a very strong likelihood that making insurance even less accessible will discourage addicts from seeking treatment even further, which would worsen the problem instead of solving it. In an editorial that Plos Medicine published in August, physician and health commissioner of Baltimore, Maryland, Leana Wen argued against repealing the Affordable Care Act.
She said that repealing and replacing the ACA would “weaken or even eliminate the requirement that marketplace plans cover ‘essential health benefits,’” which include the treatment of opioid use disorders. It would leave even those with insurance without treatment options. Wen writes that, “The plans would also allow states to waive the requirement to cover pre-existing conditions, immediately pricing people with opioid use disorders out of the individual market.”
The National Institutes of Health reported in 2012 that every dollar invested in treating addicts saves taxpayers $12 in costs later. Wen believes that Trump’s proposed policies for health care, such as minimizing insurance options and reversing recent Medicaid expansions, would prove exorbitantly expensive for most Americans.
In conclusion, Wen said, “No matter what, the American people will bear the cost of this epidemic, either by paying for treatment now or by paying for the medical, economic, and social consequences of denying it later. The choice should be clear.” For most, it is. However, Trump’s approach seems woefully lacking, so what do experts think he should do about the opioid crisis?
Resolving a national crisis of opioid addiction requires much more than declaring it a national emergency. The problem is widespread, complex, and has been gaining traction for decades. The only way to slow and get it back under control is to legalize marijuana. As legalization spreads across states, more and more people within them are replacing their prescription painkillers with cannabis.
More are using marijuana to treat pain than ever before, and all of these people are now taking fewer prescription pills, some none at all anymore. Doctors in marijuana-friendly states are prescribing less opioids, and science is revealing how marijuana can become a therapeutic target for the treatment of addictions, including dependence on harsh drugs, such as opioids.
Solving the problem of opioid reliance will require a regulatory overhaul. There needs to be stricter oversight of pharmaceutical companies who are pushing the pills and doctors who are prescribing them. People need more access to treatment, not less, which will require more insurance, not less. Furthermore, the nation will need to approach the problem compassionately.
Treating opioid addiction requires persistence, patience, and the cooperation of many domains. It also requires lots and lots of money. Many argue that funds designated for national emergencies should not be funding the opioid crisis. Rafael Lemaitre, who served in the Federal Emergency Management Agency and in the White House Drug Policy Office under the Obama administration, is one of them.
As an individual with a professional interest in both drugs and disasters, Lemaitre tweeted his suggested advice for resolving the crisis recently, writing, “The answer to opioids is dedicated, long-term funding from Congress it deserves, not raiding the rainy day fund for disasters.” Until the federal government legalizes marijuana and gives people options, the opioid epidemic will continue unabated.
