Editor’s Note: Ford Vox is a physician specializing in rehabilitation medicine and a journalist. He is a medical analyst for National Public Radio station WABE-FM 90.1 in Atlanta. He writes frequently for CNN Opinion. Follow him on Twitter @FordVox. The opinions expressed in this commentary are his.
Vengeance is not a public health policy. But it’s implicit in a policy measure coming out of the White House, which would attempt to solve the opioid crisis with a plan that includes sentencing some high-intensity traffickers to death. It may feel good, and for some segment of the population, vengeance may even look good.
The death of those deemed to be problematic is how some strongmen leaders that President Donald Trump has embraced keep their hold on power – such as Philippine strongman Rodrigo Duterte, who is following through on his pledge to kill every drug dealer he can find. But adding to the number of lives lost at the hands of the opioid crisis is not what the United States needs.
The 1980s made Trump. During that era’s crack and cocaine epidemic, first lady Nancy Reagan led the “Just Say No” campaign in an effort to curb drug use. But that effort didn’t address the underlying economic, social and educational causes of the drug problem in communities, nor did it equip adolescents with skills to overcome the barriers they faced. Opioids may present a new problem, but our President is looking back to his ’80s heyday for an old solution. “Miami Vice,” meet the “Heroin Triangle.”
First lady Melania Trump started off the presentation at Manchester Community College, telling the audience about her observations of the opioid crisis. She spoke about her time spent with doctors in Cincinnati learning about the growing scourge of newborn infants experiencing opioid withdrawal and the heartbreak she witnessed in a mother who had lost a child to an overdose.
Like the nation saw in the ’80s, the new efforts will include an expensive ad campaign. Some ads, according to the President, will scare kids away “from ending up like the people in the commercials and we will make them very, very bad commercials.”
Plenty of research suggests abstinence messaging such as “Just Say No,” along with the scare tactics of the police-led DARE campaign, have not amounted to much in the past. But maybe Trump’s commercials will be better. Hey, with psychographic Facebook marketing, anything’s possible (even Trump’s presidency).
But it is the idea of a new drug war that occupied most of the President’s mind space in New Hampshire. A drug war is good business for some people: the military-industrial complex, the commercial prison industry, gun manufacturers and dealers. “If we don’t get tough on the drug dealers, we’re wasting our time,” the President said. “And that toughness includes the death penalty.”
I’ve treated numerous people who’ve overdosed and suffered grievous injury as a result. I’d like to see the traffickers and dealers who supplied them severely punished. So would their families. But injecting the death penalty into this problem is a level of pointless distraction we don’t need.
I remain astonished how anti-government conservatives reserve such reverence for one particular government function: the ability to find perfect justice and seal the matter forever via execution. We entrust our government to convene an ideally representative sample of clear-eyed citizens who will make errorless assessments of guilt, on the basis of government-gathered evidence, in a process overseen by a government-employed judge. But what about anything else we may need government to do, along the lines of improving life for the living, rather than exacting revenge? Suddenly the government is inept, we are told.
Not everything the President has proposed deserves disdain, however. Drug makers do deserve scrutiny (and sometimes state and federal lawsuits) over reckless marketing tactics. And, as Trump rightly pointed out, overprescribing is a factor worthy of more attention. The White House is even tackling the root causes of exorbitant drug prices so more people can actually access the few opioid alternatives that exist.
But far more needs to be done if we want to make a dent in the troubling statistics of opioid abuse. Research on nonaddictive painkillers deserves far more federal funding and should be the centerpiece of any effort to end this problem for good. Instead, the President gave this critical scientific endeavor a mere footnote. The limited array of non-opioid painkillers that medical providers can prescribe help far too few people. It’s wonderful when we find a non-opioid drug to be the perfect solution for a patient. But that’s far too rare an occurrence.
Policies that tinker with our health care system itself are all about the details. “Nobody knew health care could be so complicated,” Trump famously remarked last year. Even the deceptively simple matter of clamping down on opioid prescriptions has potentially deadly downstream harms, including people being driven to suicide after having their maintenance medications cut dramatically.
The President is telling us he’s deadly serious on opioids. Meanwhile, he has only recently named a second candidate to replace the Drug Enforcement Administration director who left his administration reportedly because he didn’t think the President had enough respect for the law. Tom Marino, the man he first wanted for the Office of National Drug Control Policy, had to drop out after a “60 Minutes” and Washington Post expose showed him kowtowing to opioid industry interests in his prior job as a congressman. In his place, Trump appointed Jim Carroll, who was Washington counsel for Ford Motor Co. and has held other federal government posts.
It’s true – one way to keep people off illicit drugs is making the nation as drug-free as possible. Let’s filter out the drugs at our borders, and track down and close down the domestic producers and dealers. It’s not just drug dealers who kill people; drugs kill people. (It’s curious that the Trump administration doesn’t use the same logic when it comes to America’s gun epidemic.)
Still, a drug war is serious business – even if it comes on the order of an unserious president.