Does Trump's opioid plan lack consistency?

WASHINGTON, D.C. - As a candidate and now as president, Donald Trump has drawn attention to the opioid epidemic in America and the dramatic rise in lethal overdoses it has caused, but the new administration showed signs this week of struggling for a coordinated solution.

President Trump announced a Presidential Commission on Combating Drug Addiction and the Opioid Crisis on Wednesday and appointed Gov. Chris Christie of New Jersey, a rival for the 2016 Republican presidential nomination, to run it. But on the same day, Health and Human Services Secretary Tom Price was on Capitol Hill being questioned about administration proposals that would cut spending on substance abuse treatment.

While it is too early to judge the impact of his commission, critics are skeptical of Trump’s plan for several reasons.  Most important, the “repeal and replace” health insurance bill that he unsuccessfully supported would have increased the numbers of the uninsured, leaving an estimated 3 million Americans without access to addiction treatment.

That contradiction irks even some conservatives, such as columnist Jennifer Rubin. “When he meets with former opioid addicts and their families promising more resources days after failure of a health-care plan that would have slashed such resources, he has reached a new level of incoherence,” she wrote.

Further, the president’s proposed budget for next year contained no new spending targeting the opioid crisis. In fact, Trump’s proposed budget would cut the non-entitlement part of the Department of Health and Human Services budget by 16 percent and money for addiction treatment would likely come from that pot of federal dollars.  Specifically, the budget blueprint would cut $100 million from the Substance Abuse and Mental Health Services Administration's mental health block grant program, which can be used to help provide substance abuse treatment.

Sen. Jeanne Shaheen, D-N.J., another critic, said in a statement after Trump announced the commission and met with former addicts in a “listening session” at the White House, that “there is a massive gulf between President Trump's promises to tackle this crisis and the policies this administration has proposed during his first two months in office."

In fairness, the commission did receive praise from some unlikely sources.  “This executive order for an opioid commission seems to be an important step toward addressing the opioid epidemic at a national level,” Mary Bassett, director of the New York City Department of Health and Mental Hygiene, said in a statement. 

In his opening remarks during the “listening session,” the president said, “This is a total epidemic, and I think it's probably, almost un-talked about compared to the severity that we're witnessing."

The stunning statistics have become well known.  Nearly 30,000 Americans are now dying annually from opioid overdoses. Deaths by drug overdoes have quadrupled since 1999.

Lawmakers, especially Republicans, responded to prior drug abuse outbreaks — the heroin, amphetamines, and hallucinogens in the 1960s and crack cocaine in the 1980s as law and order issues. The opioid epidemic, which includes drugs from prescription painkillers to heroin and powerful synthetic opioids like fentanyl, has been treated mostly as a public health crisis.  Critics say that is because it affects white populations more than minorities. In any case, Trump has framed the opioid epidemic as a health and treatment issue more than as a law enforcement concern.

Finally, Trump has made boastful claims about the magic he will work to end the epidemic, as he has on many issues.  “If I win, I’m going to stop it,” Trump said on the campaign trail, referring to the opioid epidemic.

Trump has also said many times that his promised Mexican wall will cut off the supply of drugs, when in fact much of the problem is caused by prescription drugs distributed in the United States, fentanyl smuggled in from China and heroin from all over.

"We’re going to take all of these kids — and people, not just kids — that are totally addicted and they can’t break it," he said last summer. "We’re going to work with them, we’re going to spend the money, we're going to get that habit broken." 

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