Highlights:
- During Donald Trump’s presidency, opioid deaths set record highs in 2017, 2019, and 2020. Donald Trump took credit for a 2018 drop in overdose deaths, only for new records to be set the final two years of his administration.
- Trump doubled down on the ineffective “War on Drugs” approach, falsely claiming that his “big, beautiful wall” would prevent drugs from entering the United States and encouraging the death penalty and mandatory minimum jail sentences for drug traffickers.
- While claiming that his administration prioritized addressing the opioid crisis, Donald Trump sought significant funding cuts of up to 95% to the Office of National Drug Control Policy (ONDCP), the Executive office responsible for the country’s drug control agenda, and Medicaid, the top provider of coverage for addiction treatment.
- Trump appointed an unqualified former Trump 2016 campaign staffer to second-in-command at the ONDCP.
- Donald Trump’s National Opioid Task Force was panned by critics as redundant and a waste of time.
- When the commission established a series of actions Trump should take, he chose to ignore them.
- Donald Trump broke a promise he made in August 2017 to declare the opioid epidemic a “National Emergency.”
- In October 2017, Trump labeled it a “Public Health Emergency,” a declaration that provided no additional funding to combat the crisis.
- Health experts noted that Trump Administration initiatives have not led to any substantial improvements in the opioid crisis, a problem only exacerbated by the coronavirus pandemic.
¶ Opioid Deaths Set Yearly Record Highs Three Times While Trump Was In Office
¶ 2017 And 2018 Were At The Time The Two Worst Years For Drug Overdose Deaths
¶ 2017: Opioid Overdoses Passed Car Crashes As A More Likely Death
2017: The Likelihood Of Dying In A Car Crash Was Surpassed By The Possibility Of Dying Due To An Overdose. According to the New York Times, “The opioid crisis in the United States has become so grim that Americans are now likelier to die of an overdose than in a vehicle crash. That’s according to a new report by the National Safety Council that analyzed the causes of preventable deaths in the country in 2017. The probability of dying from an opioid overdose, according to the report, is one in 96. The chances of dying in a vehicle crash? One in 103.” [New York Times, 1/14/19]
¶ 2018: While There Was A Decrease In Drug Overdose Deaths In The U.S Compared To 2017, 2018 Was The Second-Worst Year For Drug Overdose Deaths In U.S. History And 2017 The Worst
CDC: In 2018, There Was A 4.1 Percent Decline In Drug Overdose Deaths In The United States Compared To 2017. According to the Centers for Disease Control and Prevention, “In 2018, there were 67,367 drug overdose deaths in the United States, a 4.1% decline from 2017 (70,237 deaths). The age-adjusted rate of drug overdose deaths in 2018 (20.7 per 100,000) was 4.6% lower than in 2017 (21.7). For 14 states and the District of Columbia, the drug overdose death rate was lower in 2018 than in 2017.” [Centers for Disease Control and Prevention, January 2020]
¶ 2018: The Rate Of Drug Overdose Deaths Involving Synthetic Opioids, Including Fentanyl, Increased By 10%
The Rate Of Drug Overdose Deaths Involving Synthetic Opioids Including Fentanyl Increased By 10% In 2018. According to the Centers for Disease Control and Prevention, “The rate of drug overdose deaths involving synthetic opioids other than methadone (drugs such as fentanyl, fentanyl analogs, and tramadol) increased by 10%, from 9.0 in 2017 to 9.9 in 2018.” [Centers for Disease Control and Prevention, January 2020]
¶ In His 2020 State Of The Union Address, Trump Took Credit For A Drop In Drug Overdose Deaths
During His 2020 State Of The Union Address, Trump Took Credit For A Drop In Drug Overdose Deaths And A Reversal In The Opioid Crisis. According to Vox, “President Donald Trump used Tuesday’s State of the Union address to take credit for a recent drop in drug overdose deaths and a reversal in the opioid epidemic. ‘With unyielding commitment, we are curbing the opioid epidemic,’ Trump said. ‘Drug overdose deaths declined for the first time in nearly 30 years. Among the states hardest hit, Ohio is down 22 percent, Pennsylvania is down 18 percent, Wisconsin is down 10 percent — and we will not quit until we have beaten the opioid epidemic once and for all’” [Vox, 2/4/20]
[Centers for Disease Control and Prevention, January 2020]
¶ The Decline In Overdose Deaths Was Linked To A Drop In Painkiller Overdose Deaths, A Result Of Previous Administration’s Efforts To Get Doctors To Cut Back On Opioid Prescriptions
The Decline In Overdose Deaths Was Linked To A Drop In Painkiller Overdose Deaths, A Result Of Previous Administration Efforts To Get Doctors To Cut Back On Opioid Prescriptions. According to Vox, “The bulk of the decline in overdose deaths seems to be linked to a drop in painkiller overdose deaths of nearly 16 percent. That’s likely a result of government and other efforts to get doctors and other prescribers to cut back on opioid prescriptions. Although the US still generally prescribes far more opioids than the rest of the world, these efforts have been somewhat successful, with prescriptions steadily falling since 2010. But that’s the thing: These efforts have been successful since 2010 — seven years before Trump took office. Much of the government messaging regarding overprescribing, like the CDC’s 2016 opioid prescribing guidelines, preceded Trump, even if he has kept such efforts going.” [Vox, 2/4/20]
¶ 2019: Opioid Deaths Hit A New Record
2019: Opioid Deaths Increased By 4.6% From 2018, Surpassing 2017 To Set A New Record. According to Politico, “Drug overdose deaths climbed to a record high last year, reversing a historic decline in 2018 that President Donald Trump touted as one of his administration’s key accomplishments, new federal data show. There were 70,980 reported deaths from overdoses in 2019, surpassing the peak of 70,699 deaths in 2017, according to preliminary CDC data. The numbers represent a 4.6 percent increase from the previous year, a trend that the Trump administration and experts say is continuing as overdose deaths spike amid a pandemic that’s taken a toll on America’s mental health.” [Politico, 7/15/20]
¶ Opioid Deaths Increased By Almost 30% In 2020 To A New Record Of Over 93,000
Over 93,000 People Died Due To Opioids In 2020. According to CNN, “Drug overdose deaths rose by close to 30% in the United States in 2020, hitting the highest number ever recorded, the US Centers for Disease Control and Prevention reported Wednesday. More than 93,000 people died from drug overdoses in 2020, according to provisional data released by the CDC’s National Center for Health Statistics. That’s a 29.4% increase from the 72,151 deaths projected for 2019.” [CNN, 7/14/21]
¶ Trump Wasted Time and Money On Ineffective Solutions To The Opioid Crisis, Failing To Live Up To His Promises To End The Epidemic
¶ As A Candidate, Trump PRomised To ADdress The Opioid Crisis And Called For Doubling Down On “The War On Drugs” Approach
In His Primary Victory Speech In New Hampshire, Trump Promised To Work With Those Affected By The Opioid Crisis “To Help You Solve That Very Big Problem.” According to Business Insider, “In the few times Trump has talked about the issue — specifically in hard-hit states like New Hampshire and Ohio — he has said that he will ‘stop the inflow of opioids into the US.’ But he has failed to go into further details. ‘We’re going to have borders again, and we’re going to work with you people to help you solve that very big problem,’ Trump said during his primary-victory speech in New Hampshire in February, referring to plans to secure ‘the Southern border.’” [Business Insider, 9/24/16]
Candidate Trump On The Opioid Crisis: The Administration “Should Apply The Resources Necessary To Mitigate This Problem.” According to Trump’s response to the Science Debate’s 2016 Presidential candidate questionnaire, “We first should stop the inflow of opioids into the United States. We can do that and we will in the Trump administration. As this is a national problem that costs America billions of dollars in productivity, we should apply the resources necessary to mitigate this problem. Dollars invested in taking care of this problem will be more than paid for with recovered lives and productivity that adds to the wealth and health of the nation.” [Science Debate 2016 Presidential Candidate Questionnaire – Donald Trump, 10/9/16]
¶ Trump’s Pledge To Fix Opioid Crisis Remained Vague
Trump Did Not Provide Details Regarding How Much He Would Spend To Address The Crisis, How Much Money Would Be Appropriated, And If He Wanted To Increase Spending In The First Place. According to Vox, “Trump seems to at least admit that the opioid epidemic requires more money into treatment. But all the details necessary to evaluate his plan are lacking: how much he would spend, how exactly that money would be appropriated, what kind of treatment programs would receive funds, and whether he even wants to increase spending in the first place. We just have no idea what Trump means by ‘spend the money.’ (A Trump spokesperson didn’t respond to inquiries about his plan.) The parts we have the most specifics for — the wall, harsher prison sentences on drug traffickers — don’t seem promising, either: They essentially continue the same drug war paradigm that failed to stop the opioid epidemic in the first place.” [Vox, 9/21/16]
¶ Trump Called For Doubling Down On The Ineffective “War On Drugs” Approach To Address The Opioid Crisis
During The 2016 Presidential Campaign: Trump Called For More Of The Same In Countering The Opioid Crisis: Increasing Mandatory Minimums For Drug Offenders And Building A Border Wall, But He Did Not Mention Drug Treatment Or Harm Reduction. According to NBC News, “His drug plan, outlined for the first time Saturday afternoon, promised to stop drugs from coming into the United States by implementing his immigration plan, including a southern border wall, and closing shipping loopholes. He also said he would press the Food and Drug Administration to approve abuse-deterring drugs more quickly, complaining that they were ‘too slow’ to approve these medications. Trump would also seek to reduce the number of prescribed opioids, like oxycodone, methadone, and fentanyl, in the United States […] The Republican nominee also mentioned sentencing reform for the first time on the trail, giving kudos to his running mate Mike Pence for increasing mandatory minimums for drug offenders as governor of Indiana. ‘We must make similar efforts a priority for the nation,’ Trump said.” [NBC News, 10/15/16]
¶ The War On Drugs Failed To Stop Illicit Drug Use Or Prevent The Opioid Crisis
2019: Illicit Drug Users Increased To 13% Of Americans 12 Years Of Age Or Older, Nearly Reaching A 40-Year High. According to CNBC, “Despite a steep decline in illicit drug usage in the earlier years, drug use in the U.S. is climbing again and more quickly than ever. According to the Substance Abuse and Mental Health Services Administration, the number of illicit drug users rose to 13% of Americans 12 years or older in 2019, nearly reaching its peak from 40 years ago. If the goal of the war on drugs was to decrease drug usage and prevent drug-related deaths, it hasn’t made much progress.” [CNBC, 6/17/21]
2020: The Amount Of Money Spent On Enforcing Drug Policies Increased From $1 Billion In 1981 To $34 Billion. According to CNBC, “Yet, the federal government is spending more money than ever to enforce drug policies. In 1981, the federal budget for drug abuse prevention and control was just over a billion dollars. By 2020, that number had grown to $34.6 billion. When adjusted for inflation, CNBC found that it translates to a 1,090% increase in just 39 years.” [CNBC, 6/17/21]
The War On Drugs Failed To Prevent The Opioid Crisis. According to NPR, “Critics say the effectiveness of the drug war model has been called into question for another reason: the nation's prescription opioid epidemic. Beginning in the late 1990s, some of the nation's largest drug companies and pharmacy chains invested heavily in the opioid business. State and federal regulators and law enforcement failed to intervene as communities were flooded with legally manufactured painkillers, including Oxycontin. ‘They were utterly failing to take into account diversion,’ said West Virginia Republican Attorney General Patrick Morrisey, who sued the DEA for not curbing opioid production quotas sooner.” [NPR, 6/17/21]
¶ As President, Trump DId Not Fulfill His Promise To End The Opioid Crisis, And Instead Prioritized Ineffective Solutions
¶ As President, Trump Prioritized Paying For Border Enforcement, Which Experts Stated Would Not Stop The Flow Of Drugs Into The U.S.
¶ Trump Claimed That His “Big, Beautiful Wall” At The Southern Border Would Have A Significant Impact On Preventing Heroin From Entering The United States
Trump Declared A National Emergency In Order To Fund His Proposed Border Wall. According to ABC News, “In a surprise development Thursday, Senate Majority Leader Mitch McConnell announced on the Senate floor that President Donald Trump told him he would sign a border security funding bill that would avert a government shutdown, but also would declare a national emergency in order to get more funding for his proposed border wall. McConnell's announcement caught Capitol Hill off guard. The Senate then voted to overwhelmingly approve the measure 83-16, sending it to the House for a vote late Thursday. The House approved the measure 300-128.” [ABC News, 2/14/19]
Trump Claimed That His “Big, Beautiful Wall” At The US-Mexico Border Would Have A Significant Impact In Preventing Heroin From Entering The U.S. According to Vox, “President Donald Trump has advertised his idea for a ‘big, beautiful wall’ at the US-Mexico border by arguing it will stop the flow of drugs into the US — a particularly timely goal as the US struggles with its worst drug overdose crisis ever in the opioid epidemic. ‘An astonishing 90 percent of the heroin in America comes from south of the border, where we will be building a wall which will greatly help in this problem,’ Trump said on Thursday as he announced that he’s declaring a public health emergency over the opioid crisis. ‘We’ll have a great impact.’” [Vox, 10/26/17]
¶ Over $18 Billion Directed Toward Trump’s Border Wall By January 2020
January 13, 2020: $18.4 Billion Has Been Directed To Trump’s Border Wall, Including Counternarcotics Funding. According to the Washington Post, “President Trump is preparing to divert an additional $7.2 billion in Pentagon funding for border wall construction this year, five times what Congress authorized him to spend on the project in the 2020 budget, according to internal planning figures obtained by The Washington Post. The Pentagon funds would be extracted, for the second year in a row, from military construction projects and counternarcotics funding. […] The move would bring the total amount of federal funds allocated to border fencing to $18.4 billion under Trump, who made the border barrier a priority during his campaign for the presidency in 2016.” [Washington Post, 1/13/20]
¶ The DEA And Subject Experts Refuted Trump’s Claim That A Border Wall Would Prevent Significant Amounts Of Drugs From Entering The Country
DEA: The Most Common Method Employed By Drug Trafficking Organizations Is Transporting Drugs Through U.S. Ports Of Entry (POEs). According to Vox, “For one, most illegal drugs come through legal ports of entry. Trump denied this in his announcement on Friday, but his own Drug Enforcement Administration (DEA) disagrees. As the DEA concluded in 2017, ‘The most common method employed by these [drug trafficking organizations] involves transporting illicit drugs through U.S. ports of entry (POEs) in passenger vehicles with concealed compartments or commingled with legitimate goods on tractor trailers.’” [Vox, 2/15/20]
Deputy Director Of The Mexico Institute At The Wilson Center: “A Wall Alone Cannot Stop The Flow Of Drugs Into The United States.” According to Vox, “‘A wall alone cannot stop the flow of drugs into the United States,’ Christopher Wilson, deputy director of the Mexico Institute at the Wilson Center, previously told me. ‘If we’re talking about a broader increase in border security, there could be some — probably minor — implications for the overall numbers of drugs being trafficked. But history shows us that border enforcement has been much more effective at changing the when and where of drugs being brought into the United States rather than the overall amount of drugs being brought into the United States.’” [Vox, 2/15/20]
¶ Trump Advocated For Failed Punitive Policies Including Mandatory Minimums And Death Sentences For Convicted Drug Traffickers
¶ March 2018: Trump Rolled Out An Opioid Plan Featuring Stiffer Penalties For Drug Traffickers
March 2018: Trump Rolled Out An Opioid Plan Featuring Stiffer Penalties For Drug Traffickers Including The Death Penalty For Some. According to CNN, “The concept of the death penalty for certain drug traffickers is something Trump has been outspoken about, but this will be the first time it will be part of an official administration plan. ‘The Department of Justice will seek the death penalty against drug traffickers when it's appropriate under current law,’ Bremberg told reporters during a phone call Sunday evening. Trump called for the death penalty to drug dealers earlier this month at a rally in Pennsylvania. His plan is expected to focus on sentencing reforms for drug dealers that would stiffen penalties for high-intensity drug dealers while ‘other people languishing in prison for these low-level drug crimes,’ a senior administration official said. ‘The President thinks that the punishment doesn't fit the crime,’ the official said, adding that these penalties would be for dealers who bring large quantities of opioids -- particular fentanyl -- into the United States, not the people that are ‘are growing pot in the backyard or a friend who has a low-level possession crime. His plan will address, and he will address, the stiffening of penalties for the people who are bringing the poison into our communities,’ the official added.” [CNN, 3/19/18]
¶ Trump Praised Singapore’s Method Of Handling Drug Dealers With The Death Penalty
At A March 2018 Rally, Trump Touted The Way Singapore Gave Drug Dealers The Death Penalty. According to CNN, “Trump then touted the way Singapore handled drug dealers with the death penalty. ‘That means if we catch a drug dealer, death penalty,’ Trump said. Trump's talk of stricter penalties for drug crimes has worried some treatment advocates, who have said there is no way the United States can punish its way out of the opioid epidemic.” [CNN, 3/19/18]
¶ Without Citing Evidence, Trump Claimed That States With A “Very Powerful Death Penalty” Have Very Few Drug Problems
Citing No Evidence, Trump Claimed That States With A ‘Very Powerful Death Penalty’ Have Very Few Drug Problems. According to the Washington Post, “Speaking to a group of governors on Monday, Trump again praised extremely harsh punishments as a deterrent. ‘States with a very powerful death penalty on drug dealers don’t have a drug problem,’ Trump said. ‘I don’t know that our country is ready for that. But if you look throughout the world, the countries with a powerful death penalty — death penalty — with a fair but quick trial, they have very little, if any, drug problem. That includes China.’” [Washington Post, 2/11/20]
¶ Experts Argued That There Was No Evidence That Punitive Approaches Do A Better Job Of Decreasing Access To Drugs And Are ‘Often Counterproductive’
Co-Director Of The Opioid Policy Research Collaborative At Brandeis University: “We Can’t Execute Our Way Out Of This Epidemic.” According to CNN, “However, public health experts roundly condemned the death penalty proposal, with some saying it renews the failed rhetoric from the war on drugs in the 1980s. ‘We can't execute our way out of this epidemic,’ said Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University. ‘To be talking about the death penalty sounds to me like a step backwards.’” [CNN, 3/19/18]
Dr. Guohua Li, Professor Of Epidemiology And Anesthesiology: “Relying On The Criminal Justice System To Address Public Health Problems Has Proven Costly, Ineffective, And Counterproductive.” According to CNN, “Dr. Guohua Li, a professor of epidemiology and anesthesiology at Columbia University who has studied the epidemic for more than a decade, also cast doubt on the effectiveness of such a policy. ‘Criminal justice can play a complementary role in addressing the opioid crisis,’ Li said, ‘but relying on the criminal justice system to address public health problems has proven unwise, costly, ineffective and often counterproductive.’” [CNN, 3/19/18]
A 2014 Review Of Research Found That There Is No Evidence That Tougher Punishment Or Harsher Supply Elimination Efforts Do A Better Job Of Decreasing Access To Drugs Than Lighter Penalties. According to Vox, “One of the best studies backing this is a 2014 review of the research by Peter Reuter at the University of Maryland and Harold Pollack at the University of Chicago. They found that while simply prohibiting drugs to some extent does raise their prices, there’s no good evidence that tougher punishments or harsher supply elimination efforts do a better job of driving down access to drugs and substance misuse than lighter penalties. So increasing the severity of the punishment doesn’t do much, if anything, to slow the flow of drugs.” [Vox, 3/21/18]
¶ Trump Proposed Severe Cuts To The ONDCP And Medicaid, The Largest Provider Of Coverage For Addiction Treatment
¶ FY 18: Trump’s Budget Proposal Would Have ALMOST Eliminated Drug PRevention PRogram Funding
¶ Trump Tried To Cut Funding For Nation’s Top Drug Control Office By 95%
Trump’s 2019 Budget Proposed Cutting The Budget For The Office Of National Drug Control Policy From $368 Million To $17.4 Million. According to ABC News, “The Trump administration's FY2019 budget released Monday requests more than $30 billion for drug control efforts, while at the same time proposing a sharp cut to the Office of National Drug Control Policy, which has been leading the fight in the opioid crisis. The administration says it's shifting responsibility for spending on anti-drug programs to the Departments of Justice and Health and Human Services — and away from the White House office — so it can better focus on policy. For FY2018, the White House allocated about $368 million for ONDCP. For FY2019, the administration proposes a mere $17.4 million for the drug czar's office, according to an OMB spokesperson.” [ABC News, 2/13/18]
After Facing Pressure From Republican And Democratic Lawmakers, Trump Dropped His Plan To Cut ONDCP Funding By 95%. According to Politico, “The administration was originally eyeing a 95 percent cut to the Office of National Drug Control Policy, POLITICO first reported earlier this month. The cut would have essentially halved the staff at the office overseeing the nation's response to the opioid epidemic while slashing two major grant programs. But after facing pressure from Republican and Democratic lawmakers — especially those in states ravaged by the opioid epidemic — the White House is proposing $369 million for the office in 2018, amounting to a 5 percent cut. The White House proposal would give the office's drug-free communities program $92 million, down from $95 million this year. The high-intensity drug trafficking program will get $246.5 million, down from $250 million.” [Politico, 5/23/17]
¶ Prior To Its Release, The Trump Budget Proposal Reportedly Eliminated Funding For Drug-Free Communities Support Program, The Leading Effort To Prevent Youth Drug Use
The ONDCP’s Drug-Free Communities Support Program Received $100 Million In Federal Funding In 2017, But Would Have Received No Funding At All Under Trump’s Proposal. According to Politico, “President Donald Trump’s fiscal 2018 budget would cut about 95 percent of funding for the Office of National Drug Control Policy, effectively ending its mission as the lead agency in charge of combating the opioid crisis and other drug epidemics, according to an internal office email and two sources who spoke with POLITICO. […] The agency’s high-intensity drug-trafficking program, which received $254 million in federal funding in 2017, and its drug-free communities support program, which received $100 million, would be completely zeroed out under Trump’s proposal.” [Politico, 5/5/17]
¶ The Drug-Free Communities Support Program Served As The Nation's Leading Effort To Mobilize Communities To Prevent Youth Drug Use
The Drug-Free Communities Support Program Was The Nation's Leading Effort To Mobilize Communities To Prevent Youth Drug Use. According to congressional testimony by Office of National Drug Control Policy Director Michael P. Botticelli in Congressional Quarterly, “The DFC Support Program, created by the Drug Free Communities Act of 1997, serves as the Nation's leading effort to mobilize communities to prevent youth drug use. Directed by ONDCP in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services, the DFC Program provides grants to local drug-free community coalitions, enabling them to increase collaboration among community partners and to prevent and reduce youth substance use. ONDCP provides oversight of the DFC Support Program to include final award determination, program regulation, policy, and its national evaluation.” [CQ Congressional Testimony, 12/2/15]
¶ Trump’s 2018 Budget Cut Drug Prevention Programs Across All Federal Agencies By 11%
Trump’s 2018 Budget Cut Drug Prevention Programs Across All Federal Agencies By 11%. According to Vox, “But he suggests other cuts to public health and anti-drug programs that completely outweigh the tiny gains that ONDCP claims. For one, the budget proposal slashes drug prevention programs across all federal agencies by about 11 percent — from about $1.5 billion to more than $1.3 billion.” [Vox, 5/23/17]
¶ The Trump Administration Claimed The Budget Showed Commitment To Solving The Opioid Crisis, Public Health Advocates Said His $1.4 Trillion Cut To Medicaid Said Otherwise
The Trump Administration Claimed The Budget Showed Its Commitment To Solving The Opioid Crisis. According to Politico, “The Trump administration says the budget shows its commitment to solving the opioids crisis, touting a proposed ‘total federal drug budget’ of $27.75 billion for next year. That’s up from $27.48 billion, when accounting for all drug control-related activities across different departments, according to the document.” [Politico, 5/23/17]
Public Health Advocates Stated That The Trump Budget Figures Are Misleading Since He Proposed $1.4 Trillion In Medicaid Cuts Over 10 Years. According to Politico, “But public health advocates say that figure is misleading, given that many of those funds go toward law enforcement and not treatment of opioid addiction. For instance, the budget calls for $103 million in new funds for the Justice Department to ramp up prosecution of drug-related crimes. The administration also assumes a cut of more than $1.4 trillion to Medicaid over the next decade — between Republicans’ health bill and further changes to cap the entitlement program — and includes $400 million in cuts to the Substance Abuse and Mental Health Services Administration. Those changes could shred the safety net and make it harder for people to access treatment for addiction.” [Politico, 5/23/17]
¶ FY 19: Trump Proposed Severe Cuts to the Office OF National Drug Control Policy And Medicaid
The Trump Administration’s FY19 Budget Proposed An Estimated 93% Cut To The Office Of National Drug Control Policy.
[White House, February 2018]
¶ Trump’s Budget Proposed A 21% Decrease To The Department Of Health And Human Services
Trump’s Budget, While Recommending A $1 Billion Investment In Resources For HHS To Combat The Opioid Crisis, Cut The Agency’s Budget By 21%. According to ABC News, “While the official budget recommends investing ‘$5 billion in new resources for the Department of Health and Human Services (HHS) over the next five years, including $1 billion in 2019, to combat the opioid epidemic,’ the budget appendix also recommends redirecting the ONDCP’s two main grant programs, the High Intensity Drug Trafficking Areas (HIDTA) grant and the Drug Free Communities (DFC) Act, to the Departments of Justice and Health and Human Services. Despite this recommended funding, the proposed $68.4 billion budget for HHS is a 21 percent decrease from the previous fiscal year.” [ABC News, 2/13/18]
¶ Trump’s Budget Proposed Significant Cuts To Medicaid
Trump’s Budget Cut Medicaid And Subsidies In The Marketplace By $763 Billion Over The Next Decade, And Proposed Eliminating Medicaid Expansion. According to the Center on Budget and Policy Priorities, “The budget doubles down in both areas. It cuts Medicaid and subsidies for private coverage in the marketplace by $763 billion over the next decade, with cuts reaching $172 billion annually by 2028. Most significantly, it embraces the ACA repeal bill sponsored by Senators Bill Cassidy, Lindsey Graham, Dean Heller, and Ron Johnson (the ‘Cassidy-Graham’ proposal), then cuts funding for health coverage programs well below the already shrunken levels in that bill. The Trump proposal eliminates the ACA’s expansion of Medicaid to low-income adults and its subsidies that help low- and moderate-income people obtain marketplace coverage, replacing this funding with a block grant whose funding would fall further and further behind current-law funding each year.” [Center on Budget and Policy Priorities, 2/12/18]
¶ FY 20: Contrary To His Talking Points, Trump’s Budget Cut Access To Substance Abuse Disorder Care
¶ The Trump Budget Plan Proposed Some New Funding To Fight The Opioid Epidemic, But It Fell Short Of What Experts Say Is Needed To Address The Crisis
The Trump Budget Plan Included Some New Funding To Address The Opioid Epidemic, But Far From What Experts Say Is Needed. According to Vox, “The budget plan does propose some new funding to fight the opioid crisis, including $245 million over 10 years to let states ‘extend Medicaid coverage for pregnant women with substance use disorder to one year postpartum.’ But it also proposes cuts to some opioid-related programs, particularly at the Department of Justice. At best, the budget maybe adds some tens of millions a year to address the problem. Tens of millions of dollars may sound like a lot of money, but it’s almost nothing in a budget valued at $4.7 trillion for 2020. It’s also far short of the tens of billions of additional dollars that experts say is needed to address the opioid crisis. For reference, the White House’s own Council of Economic Advisers in 2017 linked the opioid epidemic to $500 billion in economic losses — so spending tens of billions would be only a fraction of what the White House says the crisis is costing the US.” [Vox, 3/11/19]
¶ Trump Sought To Cut Over 93% Of The ONDCP’s Funding For Fiscal Year 2020
Trump’s 2020 Budget Proposal Sought To Cut $387 Million Or 93% Of The ONDCP’s Budget.
[National Drug Control Budget FY 2020 Funding Highlights, March 2019]
¶ Trump’s 2020 Budget Proposed Cutting $200 Billion From Medicaid
Trump’s 2020 Budge Proposed Cutting Nearly $200 Billion From Medicaid. According to CNBC, “Critics of President Donald Trump’s new budget are accusing him of breaking a key campaign promise ahead of his 2020 re-election bid. His fiscal 2020 proposal unveiled Monday calls for reductions in funding for Medicare and Medicaid relative to current law […] It would also cut spending on Medicaid, the federal-state program that insures low-income Americans, by more than $200 billion while setting up block grants to states.” [CNBC, 3/12/19]
¶ Trump Proposed Cutting Medicaid Funding, The Top Payer For Addiction Treatment
Stanford Psychiatry Professor Keith Humphreys On Combatting The Opioid Crisis: Trump’s Budget Was “Really Negligent On A Grand Scale,” By Cutting Medicaid, The Top Payer For Addiction Treatment. According to the Washington Post, “On combating the opioid crisis — another promise mentioned in Trump’s State of the Union speech — Keith Humphreys, a psychiatry professor at Stanford University, called the budget ’really negligent on a grand scale.’ The budget would devote $4.8 billion at the Department of Health and Human Services to help stem the epidemic. But like with HIV, Medicaid is the top payer for addiction treatment, paying $1 billion a year, and cuts in that program — as well as in Medicare — swamp anything else the government says it is doing. “If you slash Medicaid and Medicare, you are taking far more out of the pool than you are putting in,” Humphreys said. And he criticized the budget’s recommendation to eliminate most of the funding for the White House’s Office of National Drug Control Policy — an idea Trump has woven into all three of his budgets.” [Washington Post, 3/14/19]
¶ FY 21: Trump Proposed Substantial Cuts To The ONDCP And MEdicaid
¶ Trump Sought To Cut Over 93% Of The ONDCP’s Funding For Fiscal Year 2021
Trump’s Fiscal Year 2021 Budget Proposed To Cut The ONDCP’s Total Funding By 93%.
[White House, FY 2021 National Drug Control Budget Highlights, 2/10/20]
¶ Trump Once Again Proposed Substantial Cuts To Medicaid, Over $900 Billion Over 10 Years
The Trump Administration’s Budget Request Proposed An Estimated $920 Billion Reduction To Medicaid. According to ABC News, “Medicaid is the government-run health care insurance for people with low incomes and disabilities and covers one in five Americans. And according to Kaiser Family Foundation, it finances nearly half of all births in the U.S. Under Trump’s 10-year plan, $920 billion in future spending would be cut, according to the senior administration official and analysts. Like Medicare figures, HHS declined to confirm that figure, saying only that the plan ‘slows average annual growth’ from 5.4 percent to 3.1 percent ‘to ensure a more sustainable program for the truly needy and gives state flexibility to reform and innovate.’” [ABC News, 2/11/20]
¶ Medicaid Played A Central Role In The Nation’s Efforts To Address The Opioid Epidemic, Yet Trump sought to cut its funding four years in a row
Trump’s Budget Proposals Sought To Cut Medicaid Which Pays For A Quarter Of Drug Addiction Treatment In The United States. According to Vox, “Most notably, he calls for slashing hundreds of billions of dollars from Medicare and Medicaid — both of which, as health insurance programs, can help connect people to addiction treatment. Medicaid in particular pays for a quarter of drug addiction treatment in the US.” [Vox, 3/11/19]
¶ Medicaid Provided Coverage For Nearly 40% Of Adults With An Opioid Use Disorder
Medicaid Covered Nearly Four-In-10 Nonelderly Adults With An Opioid Use Disorder.
[Kaiser Family Foundation, 6/3/19]
Adults With Opioid Use Disorder And Covered By Medicaid Are More Likely To Receive Any Treatment Than Other Adults.
[Kaiser Family Foundation, 6/3/19]
¶ Medicaid Paid For Between 35 And 50% Of All Medication Assisted Treatment (MAT) In States That Approved Expansion
Medicaid Paid For Between 35 And 50% Of All Medication And Assisted Treatment (MAT) In States That Approved Expansion. According to an op-ed by Richard G. Frank And Sherry Glied in the Hill, “Several states — Kentucky, Massachusetts, Maryland, Ohio and West Virginia — have addressed the opioid overdose problem by promoting use of effective Medication Assisted Treatment (MAT) in the context of their Medicaid expansions. The result is that Medicaid pays for between 35 and 50 percent of all MAT in those states. They would find it much more challenging to maintain these evidence-based programs in the face of a repeal of those expansions.” [Op-Ed, Richard G. Frank and Sherry Glied – The Hill, 1/11/17]
¶ Study Found That Medicaid Expansion May Be Linked To Fewer Opioid Deaths
Study Linked Medicaid Expansion To A 6% Reduction In Opioid Overdose Deaths. According to the Washington Post, “Expanding Medicaid rolls under the Affordable Care Act may have saved as many as 8,132 people from fatal opioid overdoses, virtually all involving heroin and fentanyl, a study released Friday suggests. The research is the latest evidence that allowing more people to enroll in Medicaid has saved lives and improved health. The researchers concluded that additional access to drug-abuse treatment was linked to a six percent lower overdose rate for states that allowed more people to enroll in Medicaid than in states that did not. That translated into 1,678 to 8,132 fewer deaths in those states from 2015 to 2017, they wrote in an examination of data from 49 states and the District of Columbia. The research, published in JAMA Network Open, was not designed to prove cause and effect. Rather, it found an association between the decline in overdose deaths in the 32 states and the District of Columbia that had expanded Medicaid at the time of the study.” [Washington Post, 1/10/20]
¶ Trump Appointed An Unqualified 24-Year-Old Campaign Worker To The ONDCP, A Year Later He Was The Second-In-Command
¶ Appointee Taylor Weyneth Was Promoted Six Times Within The ONDCP, Serving As The Second-In-Command At 24
Taylor Weyneth Joined The Trump Campaign Then The Trump Administration After Graduating From College In May 2016. According to the Washington Post, “After graduating from St. John's in May 2016, Weyeneth worked in a number of jobs for Trump's presidential campaign, including coordinating voter services, and arranging travel and temporary housing for senior campaign officials. He also worked directly with Rich Dearborn, then director of Trump's transition team, on ‘special projects,’ according to one of his résumés. A spokesman said Dearborn was not available for comment. On Jan. 23, 2017, Weyeneth joined the administration as an assistant at the Treasury Department. He was a ‘General Schedule 11’ employee, according to data maintained by ProPublica. In the Washington area, a federal worker at that level last year generally earned between $66,510 and $86,459, according to government data. He moved to ONDCP in March, his résumés show, and was named deputy chief of staff in July, according to his LinkedIn page.” [Washington Post, 1/14/18]
¶ Weyneth’s Only Professional Experience Was Working For Trump’s Presidential Campaign
Weyneth’s Only Professional Experience Before Becoming An Appointee Was Working For Trump’s Presidential Campaign. According to the Washington Post, “His brief biography offers few clues that he would so quickly assume a leading role in the drug policy office, a job recently occupied by a lawyer and a veteran government official. Weyeneth's only professional experience after college and before becoming an appointee was working on Trump's presidential campaign.” [Washington Post, 1/14/18]
¶ Weyneth’s Ascent To Deputy Chief Of Staff Of ONDCP Was The Result Of Staff Turnover And Vacancies
Weyneth’s Ascent To Deputy Chief Of Staff Of ONDCP Was The Result, In Large Part, Of Staff Turnover And Vacancies. According to the Washington Post, “Weyeneth's ascent from a low-level post to deputy chief of staff is the result, in large part, of staff turnover and vacancies. The story of his appointment and remarkable rise provides insight into the Trump administration's political appointments and the troubled state of the drug policy office. Trump has pledged to marshal federal government talent and resources to address the opioid crisis, but nearly a year after his inauguration, the drug policy office, known as ONDCP, lacks a permanent director. At least seven of his administration's appointees have departed, office spokesman William Eason said. Among them was the general counsel and acting chief of staff, some of whose duties were assumed by Weyeneth, according to a memo obtained by The Washington Post.” [Washington Post, 1/14/18]
¶ Trump Established A New National Opioid Commission Which Was Panned By Critics, And He Chose To Ignore Its Recommendations
¶ Trump Created A New National Opioid COMMISSION Led By Chris Christie
March 2017: Trump Issued An Executive Order Creating A New National Opioid Commission To Be Led By Chris Christie. According to PBS, “New Jersey Gov. Chris Christie will lead a new national opioid commission created Wednesday by an executive order from President Donald Trump that also maps out his administration’s latest strategy to combat the public health crisis. The fight against the opioid epidemic is ‘one that’s incredibly important to every family in every corner of this country,’ Christie said Wednesday in an interview with The Today Show, adding he and Trump ‘both care passionately about this issue and we want to save lives.’” [PBS, 3/29/17]
¶ Critics Panned The New Commission As Redundant And A Waste Of Precious Time In The Fight Against Opioid Addiction
Politico: Public Health Advocates Said Trump’s Plan For “Yet Another Big Presidential Commission” Would, At Best, Duplicate Those Of The Obama White House And, At Worst, Set Back Efforts To Combat The Opioid Epidemic. According to Politico, “Trump won many of those communities — often overwhelmingly. But as president, he's proposing deep cuts to research and treatment in favor of funding a border wall to stop drug traffic, while hinting at bringing back policies like criminalization of drug misuse — and announcing Wednesday yet another big presidential commission to study the problem. Public health advocates say those plans at best duplicate those of the Obama White House and at worst could set back efforts to tackle a problem that contributes to more than 47,000 deaths per year.” [Politico, 3/29/17]
Baltimore Health Commissioner Dr. Leana Wen: “We Do Not Have The Luxury Of Giving This Commission Months To Rehash Facts That Experts, Including The Surgeon General And Coalitions Of Doctors And Public Health Experts, Already Agree Upon.” According to an opinion by Baltimore health commissioner Dr. Leana S. Wen for CNN, “Little is known about the Trump administration's plan to end this public health epidemic of opioid abuse, apart from the creation of a Commission on Combating Drug Addiction and the Opioid Crisis. So far, the White House has only said that the commission will produce a report and look for federal funding mechanisms. But that is not nearly enough. At a time when opioid overdose deaths kill tens of thousands of Americans every year -- including more than 33,000 in 2015 -- we do not have the luxury of giving this commission months to rehash facts that experts, including the surgeon general and coalitions of doctors and public health experts, already agree upon.” [Dr. Leana Wen – CNN, 4/12/17]
Former Obama Administration Official Who Worked To Address The Opioid Crisis: “These People Don’t Need Another Damn Commission.” According to Politico, “Public health experts question the value of the commission. It was just last November when Surgeon General Vivek Murthy released his office’s first-ever report on opioids and addiction, which included tools and recommendations collected from more than a year of research. The CDC also released prescribing guidelines after thorough study. ‘These people don’t need another damn commission,’ said a former Obama administration official who worked to address the opioid crisis and asked not to be named. ‘We know what we need to do. … It’s not rocket science.’” [Politico, 3/29/17]
¶ When The Commission Issued Its First Set Of Recommendations, Trump Ignored Them
Trump Did Not Address Any Of The Commission’s Major Recommendations In His “Major Briefing” Following Release Of The Commission’s Report. According to NBC News, “Trump announced no new policies in the fight against opioids after promising a ‘major briefing’ in a tweet Tuesday morning. Last week, the presidential opioid commission, chaired by New Jersey Gov. Chris Christie, urged Trump to ‘declare a national emergency’ and noted that ‘America is enduring a death toll equal to September 11th every three weeks.’ It recommended, among other things, expanding treatment facilities across the country, educating and equipping doctors about the proper way to prescribe pain medication, and equipping all police officers with the anti-overdose remedy Naloxone. Trump did not address any of the recommendations. Instead, the president repeated his well-worn pledge to be ‘very, very strong on our Southern border.’” [NBC News, 8/8/17]
¶ Trump Declined To Designate The Opioid Crisis A “National Emergency” As Recommended By The National Opioid Commission
Trump Did Not Declare The Opioid Epidemic A National Emergency, As Recommended By His Commission. According to NBC News, “President Donald Trump vowed Tuesday the U.S. would ‘win’ the battle against the heroin and opioid plague, but stopped short of declaring a national emergency as his hand-picked commission had recommended. Instead, Trump promised to ‘protect innocent citizens from drug dealers that poison our communities.’” [NBC News, 8/8/17]
¶ Trump Declared The Opioid Epidemic A Public Health Emergency, Nearly Three Months After First Promising To Label It A “National Emergency;” But Failed To Make Additional Funding Available To Combat The Crisis
¶ Trump Declared The Opioid Epidemic A “Public Health Emergency,” Stopping Short Of The “National Emergency” Declaration He Promised
October, 27, 2017: Trump Declared The Opioid Epidemic A Public Health Emergency. According to NBC News, “President Donald Trump declared the opioid crisis a public health emergency on Thursday and said the U.S. must confront ‘the worst drug crisis in American history.’ The president said 64,000 Americans died from overdoses last year — 175 every day, seven every hour. ‘This epidemic is a national health emergency,’ Trump said during an address at the White House. ‘Nobody has seen anything like what is going on now. As Americans, we cannot allow this to continue. It is time to liberate our communities from this scourge of drug addiction.’ The president said, ‘We can be the generation that ends the opioid epidemic. We can do it.’” [NBC News, 10/27/17]
¶ Unlike Under A National Emergency Declaration, A Public Health Emergency Declaration Makes No Additional Funding Available To Combat The Crisis
Unlike Under A National Emergency Declaration, A Public Health Emergency Declaration Makes No Additional Funding Available. According to CNN, “Trump's move is different from the broad order the President previewed over the last few months. On Thursday, the President directed acting Health Secretary Eric Hargan to declare a public health emergency under the Public Health Services Act -- which directs federal agencies to provide more grant money to combat the epidemic -- not a national emergency through the Stafford Disaster Relief and Emergency Assistance Act. The difference between the two orders is money and scope. If Trump had used the Stafford Act, the federal government would have been able to tap into funds from the Federal Emergency Management Agency's Disaster Relief Fund to combat opioids. A senior administration official, however, said the designation was not the right fit because the FEMA money is meant for natural disasters, not health emergencies. Under the Public Health Services Act designation, no additional federal funding will automatically be directed to the crisis, said an official, but federal agencies will be directed to devote more grant money already in their budget to the problem and take ‘action to overcome bureaucratic delays and inefficiencies in the hiring process,’ according to a fact sheet on Trump's order.” [CNN, 10/26/17]
¶ Trump First Promised to Declare A National Emergency 2 ½ Months Earlier
August 10, 2017: Trump: “It’s A National Emergency. We’re Going To Spend A Lot Of Time, A Lot Of Effort And A Lot Of Money On The Opioid Crisis.” According to NBC News, “President Donald Trump threw the weight of the White House behind the fight against the opioid crisis Thursday and declared it a national emergency. ‘The opioid crisis is an emergency, and I’m saying officially, right now, it is an emergency,’ Trump said at his golf club in Bedminster, New Jersey. ‘It’s a national emergency. We’re going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis.’ Trump’s surprise announcement came two days after he vowed the U.S. would ‘win’ the fight against the epidemic but stopped short of acting on the recommendation of the presidential opioid commission to ‘declare a national emergency.’” [NBC News, 8/10/17]
¶ An Estimated 6,000 Americans Died Of Opioid Overdoses Between When Trump First Promised To Declare An Emergency And His Declaration
An Estimated 6,000 Americans Died Of Opioid Overdose In The Nearly Three Months Trump Took To Declare A Public Health National Emergency. According to USA Today, “President Trump first promised to declare a national emergency to confront the epidemic 68 days ago. Since then, statistics show more than 6,000 Americans have died of opioid overdoses waiting for federal action.” [USA Today, 10/17/17]
Dr. Rahul Gupta, West Virginia Commissioner Of Health And Human Resources: “If This Was Happening In Real Time, When People Are Seeing Boeing 737s Crash Every Day, We Wouldn’t Wait This Long.” According to CBS News, “Several state and local officials are growing impatient with the delay in implementing federal solutions that they say are well-established and necessary. ‘In 2016, every day we had 140 Americans die,’ Dr. Rahul Gupta, the Commissioner of West Virginia’s Department of Health and Human Resources told CBS News. ‘So, if this was happening in real time, when people seeing are seeing Boeing 737s crash every day, we wouldn’t wait this long.’” [CBS News, 10/23/17]
¶ Health Experts Noted That Trump Administration Initiatives Have Not Led To Any Substantial Improvements In The Opioid Crisis, A Problem Only Exacerbated By The Pandemic
¶ Health Experts Highlighted That Trump’s Initiatives Have Not LEd To Any Substantial Improvements In The Opioid Crisis
¶ Head Of The National Council For Behavioral Health: I Can’t Think Of Any Trump Initiatives That Have Made Any Substantial Difference In The Crisis
Chuck Ingoglia, Head Of The National Council For Behavioral Health: I Can’t Think Of Any Trump Initiatives That Have Made Any Substantial Difference In The Crisis. According to the Los Angeles Times, “Another parallel to the coronavirus response: The administration’s consistent opposition to expanding the nation’s healthcare safety net has impeded efforts to get more Americans into drug treatment, healthcare experts said. Chuck Ingoglia, who heads the National Council for Behavioral Health, whose members include leading mental health and addiction treatment providers, said he couldn’t think of any Trump administration initiatives that have made a substantial difference in the crisis.” [Los Angeles Times, 8/23/20]
¶ Leader Of The American Society Of Addiction Medicine: I Can’t Point To Anything They’ve Done That’s Transformational
Leader Of The American Society Of Addiction Medicine: “I Can’t Point To Anything They’ve Done That’s Transformational.” According to the Los Angeles Times, “And Dr. Shawn Ryan, a leader of the American Society of Addiction Medicine who runs a network of addiction clinics around Cincinnati, said the president’s main accomplishment may simply be signing legislation developed by Congress two years ago to provide additional money for addiction treatment. ‘I can’t point to anything they’ve done that’s transformational,’ Ryan said.” [Los Angeles Times, 8/23/20]
¶ The Federal Government’s Failure To Control Coronavirus Drove Up Drug USe, LEd To Gaps In Data, And Made Treatment More Inaccessible
The Coronavirus Pandemic Drove Up Drug Use And Made Treatment More Inaccessible. According to the Los Angeles Times, “But Ryan and others working on the front lines to reduce substance use say the crisis has only worsened this year, as the federal government’s failure to control the coronavirus — even as other wealthy nations have — is driving up drug use and putting treatment further out of reach for many sick Americans. ‘We see a huge storm coming this fall,’ said Kody Kinsley, who oversees substance use and behavioral health programs at the North Carolina Health and Human Services Department. As people lose jobs and health insurance, growing numbers are unable to get care for addiction, Kinsley noted. ‘There is virtually no safety net to catch these folks.’” [Los Angeles Times, 8/23/20]
- There Were Reports Out Of Ohio That Overdose Deaths Were Already Increasing Since The Pandemic Began. According to Politico, “While it will take months to fully understand how the coronavirus outbreak is exacerbating America’s drug abuse crisis, there are already disturbing reports from Ohio, a state that had seen a 22 percent reduction in overdose deaths after years of sharp increases. In Montgomery County, home to Dayton, there were 37 overdose deaths in March, the highest monthly total in nearly three years. The coroner for Franklin County, which includes Columbus, said Saturday that there had been 12 suspected overdose deaths in 48 hours. Lynn, a Columbus woman who asked that her last name be withheld to protect her privacy, said a feeling of isolation led her to use heroin recently for the first time in three months. ‘The general mood right now is bad,’ she said. ‘We’re bored, we’re not working. It’s definitely making it more likely for people to relapse or to use.’” [Politico, 4/10/20]
¶ The Coronavirus Response Forced Health Agencies To Postpone Opioid Research And Pause Data Collection
The Coronavirus Response Prompted Leading Health Agencies To Postpone Opioid Related Research. According to Politico, “But the coronavirus response has prompted leading health agencies to postpone some opioid work. The National Institutes of Health has frozen most non-coronavirus related research, which Volkow said meant postponing vital research into drug addiction. That includes a massive $1 billion project studying opioid alternatives and treatment options that the Trump administration rolled out just last fall. Further, much of the government’s data collection around drug use and overdoses has been put on hold, potentially creating serious gaps in information about the trends in overdose deaths during the pandemic. ‘It’s very, very unclear how these people are dying,’ Volkow said, adding that there’s ‘a very urgent need’ for that data.” [Politico, 4/10/20]