UPDATED March 20, 2018 // In a wide-ranging speech outlining his latest plan of attack on the opioid crisis, President Donald J. Trump emphasized the need for stricter law enforcement and the interruption of the drug supply. He also vowed to seek the death penalty for dealers.
"Unless you have really, really powerful penalties, led by the death penalty, for the really bad pushers and abusers, we're going to get nowhere," said Trump during a speech at Manchester Community College, New Hampshire, in which he announced the latest proposals.
That state has been on the leading edge of the opioid problem, although the rate of drug overdose deaths appears to be slowing, according to the Centers for Disease Control and Prevention.
In his proposal, the president also recommended the following:
Making overdose-reversing drugs more widely available, especially to first responders;
Lifting a 1970s-era Medicaid rule that prohibits reimbursement for addiction treatment, especially medication-assisted treatment, in facilities with more than 16 beds;
Increasing access to medication-assisted treatment;
Increasing access to treatment for the incarcerated and offering treatment as an alternative to incarceration.
The American Society of Addiction Medicine (ASAM) commended most aspects of the plan, including increasing access to evidence-based addiction treatment and recovery support services, and enhancing prevention efforts. But, said Corey Waller, MD, FACEP, DFASAM, chair of the ASAM's Legislative Advocacy Committee, in a statement, "We cannot arrest and prosecute our way out of this crisis, and an overemphasis on law enforcement approaches at the expense of prevention, treatment, and recovery support services will not serve our nation well."
Chuck Ingoglia, senior vice president for public policy and practice improvement at the National Council for Behavioral Health, said the group "welcomes this call to action from the White House," especially if it widens access to medication-assisted treatment. "However, these are just first steps. More needs to be done to increase community treatment capacity and recovery supports," said Ingoglia, in a statement.
Jack Ende, MD, MACP, president of the American College of Physicians, said in a statement that the organization supports the proposals to expand treatment and therapy options and to lift the Medicaid prohibition on residential treatment.
The American College of Physicians also applauded Trump's announcement that the government will try to find therapies to prevent addiction and to ensure that first responders have access to naloxone.
Healthcare Providers on Notice
Trump put healthcare providers and drug manufacturers on notice that they, too, would be subject to legal action.
"Whether you are a dealer, or doctor, or trafficker, or a manufacturer, if you break the law and illegally peddle these deadly poisons, we will find you, we will arrest you, and we will hold you accountable," he said.
He noted that in 2017, the Department of Justice (DOJ) prosecuted 3000 defendants, including a pharmacist, a physician's assistant, and an opioid trafficker, for opioid-related "serious drug crimes."
The president spent much of the 40-plus-minute speech discussing law enforcement strategies that he said would help stop the opioid crisis, including building a wall on the border with Mexico to keep drugs from entering the United States, denying funding to so-called sanctuary cities that shield undocumented immigrants from federal action, and beefing up criminal penalties for those involved in selling opioids.
The US government is also weighing a federal case against opioid manufacturers, he said. In early March, the DOJ asked a federal judge overseeing hundreds of lawsuits against opioid makers and distributors to take 30 days to decide whether to join in the class action. The move came just days after the department said it had formed the Prescription Interdiction and Litigation Task Force to coordinate litigation efforts and oversee enforcement against opioid manufacturers and distributors.
"This isn't about 'nice' anymore," he said. "This isn't about committees, this isn't about, 'let's get everybody and have dinners,' or 'let's have everybody go do a blue ribbon committee where everybody gets a medal,' " said Trump. He then noted that his own President's Commission on Combatting Drug Addiction and the Opioid Crisis had made 65 recommendations that he said his administration had "worked aggressively to put into action."
Cut Opioid Prescribing by One Third
The Trump plan also calls for reducing all opioid prescriptions by a third during the next 3 years. Also, the administration is seeking within 3 years to have 75% of the opioid prescriptions that are reimbursed by federal health programs to be written using best practices. Within 5 years, the goal is 95%.
Best practices should be followed by at least 50% of federal healthcare providers within 2 years, and by 100% of those clinicians within 5 years.
"We'll ensure that opioid addiction is not subsidized by the American taxpayer," said Trump.
Ads to "Scare" Kids Away From Drugs
The president said his plan would also focus on prevention, in part by creating commercials to scare children away from ever taking up drugs. "The best way to beat the drug crisis is to keep people from getting hooked," said Trump.
"That's the least expensive thing we can do — where you scare them from ending up like the people in the commercials," he said. He noted that the tactic had been effective in persuading children not to smoke.
The administration also debuted a new website, www.crisisnextdoor.gov, in which individuals and families can share their stories about opioid addiction.
In addition, the government plans to support more research and development on a vaccine to prevent opioid addiction and on non-addictive pain management options.
"We have to come up with a solution, where we come up with a painkiller that's not so addictive, and we can do it — we're not that far off," said Trump.
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Cite this: Trump Vows to Seek Death Penalty for Opioid Dealers - Medscape - Mar 19, 2018.