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Nelson Knight

Political Science 1100

Professor Gutaj

February 16, 2018

Drug Addiction and the Opioid Crisis in America

“The best way to prevent drug addiction and overdose is to prevent people from abusing

drugs in the first place. If they don’t, they won’t have a problem anyway, (President Donald J.

Trump, 2017).” Drug addiction and opioid use are ravaging America, from coast to coast, with

hundreds of thousands of Americans dying from a crisis that spiraled out of control for reasons we

now know could have been preventable. Research data suggests the problem is only getting worse

with numbers of use and overdose growing (HHS.GOV).

While running for President in 2016, Donald Trump campaigned on many important

topics, along with promises of how he would implement or reform what is broken. It wasn’t that

long ago that we witnessed a wild Trump rally on television with thousands of his supporters

chanting, “build the wall, build the wall.” According to Trump, building a border wall is

absolutely dyer in solving many of our country’s biggest problems, from illegal migration to drug

smuggling along the southern border (whitehouse.gov). Trump’s passion surrounding the border

wall runs deep. During the presidential campaign, Trump shared a very personal experience of

addiction and loss, which gives credence to his passion toward drug addiction, a border wall, and

the current out of control opioid epidemic. The President’s beloved brother, Fred Trump, battled

his own addiction for many years, and ultimately died from alcoholism. This family tragedy

shaped President Trump’s life from that day forward, and is the reason for his own life long

commitment to remain alcohol and drug free (politico.com).


Due to the urgency of the opioid crisis, On March 29, 2017, President Trump signed an

Executive Order establishing the President’s Commission on Combating Drug Addiction and the

Opioid Crisis, with the following mission statement: To study the scope and effectiveness of the

Federal response to drug addiction and the opioid crisis and to make recommendations to the

President for improving that response. During this ceremony, President Trump expressed, “I made

a promise to the American people to take action to keep drugs from pouring into our country and

to help those who have been so badly affected by them… This is an epidemic that knows no

boundaries and shows no mercy, and we will show great compassion and resolve as we work

together on this important issue.”

Before the committee gave final recommendations in November 2017, they expressed that

its first and most urgent recommendation was for President Trump to declare a national

emergency, to free up emergency funds for the crisis and “awaken every American to this simple

fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon

will” (hhs.gov).

To help get a better understanding of what the opioid epidemic looks like, we can look at a

study entitled, 2016 National Survey on Drug Use and Health (hhs.gov). Here is what we know…

 In 2016, more than two million people had an addiction to prescription or illicit opioids.

 In 2016, drug overdoses are now the leading cause of injury death in the United States,

outnumbering both traffic crashes and gun-related deaths

 In 2016, over 46,000 people died from an opioid related death.

o This represents a rate of 175 deaths a day.

o This exceeds the number of Americans killed daily in the Vietnam War.

o The rise in overdose deaths is largely due to the proliferation of illicitly made

fentanyl, a highly potent synthetic opioid, and fentanyl analogs.


 In 2016, more than 11.5 million Americans ages 12 and older reported misuse of

prescriptions opioids in the past year, and nearly 950,000 Americans reported heroin use in

the past year.

 In 2016, the cost of the opioid epidemic was over 504 Billion dollars (HHS.GOV).

How did we get here? What led up to this crisis? Who is at fault? What if it doesn’t affect me?

Should everyone care? Who are the stakeholders? What will be the cost to reform the crisis? With

so many questions, it’s vital that all American citizens be informed and engaged in the emergency

efforts that are taking place. Awareness is always the first step. Furthermore, awareness leads to

education of how the epidemic started, and what caused it to spin so out of control to the point of

an emergency crisis,

In the late 1990’s, pharmaceutical companies reassured the medical providers that patients

would not become addicted to opioid pain relievers. With this false knowledge, healthcare

providers began to prescribe opioids. The increase of prescription opioid medication led to

widespread misuse around the country of both prescription and non-prescription opioids before it

became very clear that these medications were high risk and very addictive. Not only has the

prescription of opioids increased, doctors began treating pain with opioids at higher doses and for

longer durations of time, which has been highly associated with abuse, addiction, and overdose

(NIH.GOV).

Among the demographics of those misusing opioid drugs, there is an alarming increase of

opioid misuse during pregnancy, which results in a drug withdrawal syndrome in newborn babies

called neonatal abstinence syndrome (NAS). In 2014 the number of babies born drug-dependent

had increased by 500 percent since 2000, and children place in foster care due in part to NAS is

going up – now it is almost a third of all child removals (HHS.GOV).


The opioid epidemic is a two-tiered problem. Along with the misuse of opioid prescriptions

and illegal use of opioid related drugs, the lack of treatment and recovery has been ineffective.

Basically, the second issue is a lack of a health system and healthcare provider’s capability to

identify and engage patients at risk, and provide them with high-quality, evidence based opioid

addiction treatment. Or in other words, healthcare providers were not trained, and thus failed, to

provide a full spectrum of medication-assisted treatment (MAT). Research from the 2016 opioid

epidemic study, it is well documented that the majority of people with opioid addiction in the U.S.

do not receive treatment, and even among those who do, many do not receive evidence based

MAT, and fail to recover. Sadly, the 2016 study makes one thing clear… “too many of our

citizens are being robbed of their God-given potential in the prime of their life” (DHH.GOV).

Since President Trump declared the opioid crisis as a Nationwide Health Public Emergency in

October 2017, and renewed for another 90 days in January 2018, his entire administration is

collaborating together in combatting the crisis. Each of the President’s cabinet is determining their

role in this multi-faceted and multi-dimensional epidemic. Due to this collaboration, crucial

changes have been made in the following ways…

 More than $1 Billion in funding has been allocated or spent directly for prevention,

treatment, first responders, prescription drug monitoring programs, recovery and other care

in communities, inpatient settings, and correctional systems.

 The CDC has launched the Prescription Awareness Campaign; a multimedia awareness

campaign featuring the real-life stories of people who have lost loved ones to prescription

opioid overdose and people in recovery.

 The Food and Drug Administration is imposing new requirements on the manufacturers of

prescription opioids to help reverse the overprescribing that has fueled the crisis.
 The Department of Justice’s Opioid Fraud and Abuse Detection Unit is targeting

individuals that are contributing to the prescription opioid epidemic, has netted the largest-

ever health care fraud takedown, secured the first-ever indictments against Chinese

fentanyl manufacturers, and seized AlphaBay, the largest criminal marketplace on the

Internet and a major source of fentanyl and heroin.

 The State Department has secured a binding UN agreement making it harder for criminals

to access fentanyl precursors ANPP and NPP.

 The National Institutes of Health has initiated discussions with the pharmaceutical industry

to establish a partnership to investigate non-addictive pain relievers and new addictions

and overdose treatments, as well as a potential vaccine for addiction.

 The Department of Defense, Department of Veterans Affairs, National Institutes of Health,

and Department of Health and Human Services are collaborating on a six-year, $81 million

joint research partnership focusing on nondrug approaches to managing pain in order to

address the needs of service members and veterans (thewhitehouse.gov).

The final report from The President’s Commission on Combatting Addiction and the Opioid

Crisis is a document of 183 pages with more than 58 recommendations (whitehouse.gov). In

finalizing his plan, President Trump considered the Commission’s Recommendations, as well as

recommendations from other world leaders in his final initiative plan. On March 18, 2018, in the

state of New Hampshire, President Trump unveiled his Administration’s Initiative to Stop Opioid

Abuse. The plan includes three main elements: reducing the demand and over prescription of

opioids, cutting off the supply of illegal drugs and increasing treatment and recovery services.

First, the new initiative aims to cut opioid prescriptions by one-third within three years by

implementing a “Safer Prescription Plan,” incentivizing states to use a national database

monitoring opioid prescriptions to help flag people requesting prescriptions of opioid pain killers
by several different physicians. Second, the Initiative includes an increase of law enforcement

measures, allowing the Department of Justice to seek the death penalty for some drug dealers

where appropriate under the current law. There is much controversy and debate regarding Trump’s

passion for using the death penalty already in law for several limited drug related offenses… for

example, through violations of the ‘drug kingpin’ provisions in 18 USC 3591(b) and 21 USC 848

(e). Also, Trump is calling on Congress to pass legislation to invoke maximum punishment for

drug dealers who knowingly distribute certain illicit opioids in trace amounts. The House Energy

and Commerce Committee are hammering out legislation and plan to submit a package to the

House floor by Memorial Day weekend. Lastly, the plan includes a mix of efforts from advocates

to expand access for the gold standard of treatment for addiction, and make it mandatory for first

responders to be equipped with an opioid overdose reversal drug (Roubein, 2018).

In conclusion, the opioid epidemic has grown exponentially over the past two decades, and is

now killing over 175 lives per day… a number higher than people killed in unintentional deaths

altogether. Time will tell if The Administration’s Initiative will be successful. Obviously, it will

not occur overnight, but with patience and hard work, this plan seeks to restore hope in the lives of

those suffering the hell of drug addiction, along with the family and friends in their support

system. For those personally involved in the crisis, one Surgeon General of the U.S. gives his

encouragement, when he expressed, “we need to stop seeing addiction as a moral failing and start

treating it as the chronic illness it is, one that demands our skill, urgency and compassion. Once

we stop judging, we can start helping (Murthy, 2017).


Works Cited

The Department of Health and Human Services. 2017. About the U.S. Opioid Epidemic. Retrieved

on March 1, 2018 from https://www.hhs.gov/opioids/about-the-epidemic/

McCaskill, Nolan D. 2017. Trump shares cautionary tale of his alcoholic brother Fred. Retrieved

on March 1, 2018 from https://www.politico.com/story/2017/10/26/trump-brother-fred-

alcoholic-244213http://thehill.com/homenews/politics-101/376508-what-caused-the-

opioid-crisis

Murthy, V. 2018. We know what strategies work. Retrieved on March 1, 2018 from

https://www.usatoday.com/story/news/nation-now/2018/01/29/175-americans-dying-day-

what-solutions-opioid-epidemic/1074336001/

Office of National Drug Control Policy: Presidents Commission. 2017. Retrieved on March 1,

2018 from https://www.whitehouse.gov/ondcp/presidents-commission/

Roubein, R. 2018. Trump to release opioid plan Monday that includes death penalty. Retrieved on

March 20, 2018 from

http://thehill.com/homenews/administration/378618-trump-opioid-plan-will-include-death-

penalty-for-drug-dealers-reportg-action-drug-addiction-opioid-crisis/

Schallhorn, K. 2018. How the White House is tackling the opioid epidemic. Retrieved on March

15, 2018 from http://www.foxnews.com/politics/2018/03/21/how-white-house-is-tackling-

opioid-epidemic.html

White House. 2018. The President’s Commission on Combatting Drug Addiction and the

Opioid Crisis. Retrieved on March 1, 2018 from

https://www.whitehouse.gov/sites/whitehouse.gov/files/images/Final_Report_Draft_11-1-

2017.pdf

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