While on the campaign trail in 2016, then-candidate Donald Trump promised a three-fold approach to addressing America's opioid crisis: tougher law enforcement and criminal justice responses, tougher border security, and wider access to mental healthcare and addiction facilities.
But President Donald Trump is more focused on the first two prongs of that approach than the third, and the administration has taken few meaningful action steps after more than a year in office.
The Trump administration quietly renewed the [public health emergency] declaration recently. But it has given no signs it's developing a comprehensive strategy to address an epidemic that claims more than 115 lives every day. The president now says that to combat opioids, he's focused on enforcement, not treatment.
Trump spent just over a minute of his 80-minute State of the Union address talking about opioids. In a speech this week in Cincinnati, he had a few more comments. The opioid epidemic, he said, "has never been worse. People form blue ribbon committees. They do everything they can. And frankly, I have a different take on it. My take is you have to get really, really tough, really mean with the drug pushers and the drug dealers."
The President's Commission on Combating Drug Addiction and the Opioid Crisis handed the administration more than 50 recommendations in combating the drug crisis, but Trump has followed through with only a few.
And while Trump donated his third-quarter salary to the Department of Health and Human Services' efforts to fight the opioid problem, the president has not requested funding from Congress.
In fact, Trump's budget proposals have reduced funding to the very agencies and programs slated to lead the fight.
In the 2018 budget, the president recommended cutting the Office of National Drug Control Policy budget by 95 percent, and may do so again this year.
"It's very hard to make sense of," says Keith Humphreys, a professor of psychiatry at Stanford and former policy adviser to the drug czar's office in the Obama administration. "I mean, it's like closing a fire station in the middle of a wildfire."
"The 2018 budget had a $400 million cut to the Substance Abuse and Mental Health Services Administration, which is the lead agency that funds treatment in the United States," Humphreys says. "So, the administration's impulse seems to be not to spend more — in fact to spend less."
Trump has yet to nominate someone to head the Drug Enforcement Agency, and there is still no head for the Office of National Drug Control Policy.
So what has the Trump administration done to combat the opioid crisis? NPR notes the few actions taken so far:
- Trump declared a public health emergency in October to deal with the opioid epidemic. The declaration brought no new money to fund the federal response.
- The Centers for Medicare and Medicaid Services announced a policy change in November that allows states to apply for waivers allowing them to use Medicaid to pay for residential drug treatment at facilities that have more than 16 beds. Some states are already taking advantage of that policy change.
- President Trump signed the Interdict Act in January giving federal agents additional tools for detecting fentanyl and other synthetic opioids at the border.
- Attorney General Jeff Sessions announced an operation using medical data to crack down on pharmacies and doctors that dispense suspicious amounts of opioids.
- The administration launch a campaign to educate the public, especially young people, on the dangers of opioids. The campaign is being developed not by the Office of National Drug Control Policy, but by a team in the White House led by Kellyanne Conway.