Among all of the crap ideas Donald Trump has come up with (running for president being at the top of the heap), his latest "plan" to defeat the opioid crisis might just take the cake.
Trump—who declared the current opioid epidemic a "public health emergency" last October but failed to request any federal funding to fight it while repeatedly calling for cuts in Medicaid, a primary funder of addiction treatment—is in New Hampshire today, where he announced his bright idea on how deal with opioids: Execute drug dealers.
"If we don't get tough on the drug dealers, we are wasting our time," Trump said on Monday in New Hampshire, the state, fittingly, that Trump referred to as a "drug-infested den" to Mexican President Enrique Peña Nieto. "And that toughness includes the death penalty."
While state execution of drug dealers may sound like Rodrigo Duterte's fever dream, Trump has been openly musing on the idea for some weeks now despite condemnation from public health and policy experts. At a Pennsylvania campaign rally earlier this month (and Trump having campaign rallies during his second year in office instead of running the country and/or working on his golf swing is a whole other issue), the President said places like Singapore and China have fewer drug problems because of harsher penalties for drug dealers. Ironically, China is a major source of illegal drugs like heroin and fentanyl entering the U.S., but Trump has never let a small thing like facts stop him before.
While Trump's grasp of history is elementary at best, it's not like the U.S. hasn't tried harsh penalties for drug traffickers and users in the past. The War on Drugs—as drug policy instituted during the Nixon years was called—failed miserably, reducing neither the demand nor the supply of illicit drugs. What it did do was criminalize low level drug offenders, which disproportionately impacted the poor as well as people of color, and decimated largely urban communities as drug users were imprisoned for the crime of liking (or needing) to get high. Today, the U.S. still imprisons more people for drug crimes than any other country on the planet, including, due to the three-strikes laws still on the books, life sentences for simple possession or dealing. Since the War on Drugs began, the number of incarcerated Americans has risen by 900 percent.
Here, let Jay-Z tell you all about it.
Donald Trump, a man whose drug of choice is attention and cheeseburgers, just doesn't fucking get it. "This plan is completely and utterly crazy," says Shilo Jama, executive director of the Peoples Harm Reduction Alliance. "The vast majority of drug dealers are survival dealers. They deal so they can use. This idea is backwards."
Instead, Jama says, communities should implement evidence-based plans like the one recommended by the Heroin and Prescription Opiate Addiction Task Force in King County. That plan, which focuses on prevention and access to treatment, doesn't seek to punish drug users; instead, it attempts to help them get clean through access to treatment and to reduce the harm caused by drug use, including overdose and death, through safe-injection sites and access to life-saving drugs like Naloxone.
Jama says that destigmatizing drug use will do more to save lives than punishing drug users or dealers will. And, he points out, over the long course of human history, the desire for mood-altering states is hardly new. People have been ingesting fermented grapes for 10,000 years, and despite what Mike Pence and his church buddies may think, there's nothing inherently wrong or immoral about liking to get fucked up. That's not to say substance use doesn't lead to problems—clearly, it does—but as long as drug use is stigmatized by society (from the top all the way on down), Jama says, "When we demonize drugs and drug users, people end up using drugs in private, and that's when you see overdose deaths."
There are other reasons the death penalty for traffickers is a bad idea. For one thing, when it comes to opioids, "drug traffickers" are often doctors themselves. As Jane Ballantyne, a professor of anesthesiology and pain medicine at the University of Washington and president of Physicians for Responsible Opioid Prescribing, wrote recently on Politico, "Opioid use disorder is common in chronic pain patients treated with long-term opioids, and our nation’s opioid addiction epidemic stems largely from the overprescribing of opioids for the treatment of pain."
For years, most studies showed that less than one percent of patients who were prescribed opioids for legitimate pain conditions developed a dependence. But, as Patrick Radden Keefe pointed out in a recent New Yorker article, those studies were deeply flawed and frequently funded by drug companies themselves. Purdue Pharma, a privately held company owned by the immensely wealthy Sackler family, is one of the most egregious examples of pharmaceutical companies behaving badly, namely with the marketing of OxyContin, their flapship opioid.
"Purdue launched OxyContin with a marketing campaign that attempted to counter this attitude and change the prescribing habits of doctors," Keefe writes, "The company funded research and paid doctors to make the case that concerns about opioid addiction were overblown, and that OxyContin could safely treat an ever-wider range of maladies. Sales representatives marketed OxyContin as a product 'to start with and to stay with.' Millions of patients found the drug to be a vital salve for excruciating pain. But many others grew so hooked on it that, between doses, they experienced debilitating withdrawal."
Some of those patients then turned to heroin and other deadly street drugs, which can be cheaper and easier to get than prescription drugs. Despite an ever increasing number of overdose deaths, Perdue instructed their sales reps to "assure doctors—repeatedly and without evidence—that 'fewer than one per cent' of patients who took OxyContin became addicted." This was false, and many experts, including Ballantyne, blame a rash of overprescribing for the current opioid epidemic.
The Sacklers are now one of America’s richest families, according Forbes, with an estimated collective net worth of $13 billion. If Trump wants to start executing dealers for the opioid epidemic, the Sacklers would be the people to start with.