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Washington’s Gutless Approach to Our Addiction Crisis

While other countries decriminalize, Trump is keeping Big Pharma and Big Prisons happy.

Just before the New Year, Norway’s parliament voted to decriminalize the possession of all illegal drugs, including marijuana, cocaine, and heroin. Drug trafficking and possession will remain illegal. Essentially, drug users will now have the option of going to rehab—instead of jail—if they are arrested with a small amount of drugs.

This concept is rapidly gaining support worldwide, particularly in Europe, and several countries have taken steps toward this new direction in the war on drugs. However, Portugal would be the most direct comparison to Norway’s recent policy change.

The Portuguese government implemented this model of decriminalization in 2001. If someone is arrested with a small quantity of any illegal drug, they are not placed in handcuffs or sent to jail. Instead, that person receives a summons to appear at a panel with a lawyer, social worker, and psychiatrist. The panelists gives their opinions on the best plan for government-assisted treatment for the individual. However, the drug user is ultimately in control and can choose to decline any form of rehabilitation without legal penalties.

This “soft” approach to the war on drugs has been an unquestionable success. Portugal put this model in place at a time when the country had some of the worst addiction statistics in Europe. There were 78 drug overdose deaths per every million people. Albeit, that was only a fraction of the problem America currently faces. Last year, there were 64,000 drug overdose deaths in the U.S, a rate of 185 per million people. Portugal, on the other hand, had only six drug-induced deaths per million people last year, now one of the lowest rates in Europe.

Overall drug use has steadily decreased in Portugal over the last 16 years. Most importantly, this policy change has been a resounding success as a public health initiative. For example, drug-related HIV infections have dropped 95 percent.

Given these results, one would assume that the concept of decriminalization would not be controversial. Indeed, Americans for the most part support the underlying principles of decriminalization. An ABC News poll from last summer found that 69 percent of Americans support a law requiring rehabilitation, as opposed to jail, for first-time and even second-time drug offenders.

Likewise, a Rasmussen poll from a couple years ago found that only 10 percent of Americans believe the country is winning the war on drugs. However, the term “decriminalization” elicits a very different response from the vast majority of Americans, particularly when it involves harder drugs. Only 13 to 16 percent of Americans support decriminalizing heroin, cocaine, or meth, according to a Vox/Morning Consult poll.

Despite the stigma associated with decriminalization, the Global Commission on Drug Policy recommends the policy. This organization is headed by a number of business leaders, several former heads of state, along with many former high-level government officials, including George P. Schultz, who served as secretary of state under Republican Presidents Reagan and George H.W. Bush.

The last report by the Global Commission on Drug Policy also recommended several “harm reduction” practices proven to reduce drug addiction levels, along with addiction’s negative impact on society. The report supported political hot-buttons, such as needle-exchange programs, naloxone (a medication that immediately reverses opioid overdoses), heroin-assisted treatment, supervised injection facilities, among others.

Support for supervised injection facilities is growing throughout the country, particularly in Seattle, New York, and Delaware. The Massachusetts Medical Society also supports this policy. In fact, a study found that the city of San Francisco would save several lives with such a facility, along with $3.5 million.

These facilities allow medical professionals to recommend rehab options, provide clean needles, and prevent deaths in multiple ways. They administer naloxone in case of an overdose, which is roughly 99 percent effective with reversing an overdose death. Also, the drugs can be tested for deadly additives, such as fentanyl. For instance, 88 percent of the drugs tested at the safe injection site in Vancouver contained fentanyl.

Obviously, these are revolutionary concepts. However, while there is overwhelmingly positive evidence in support of harm reduction practices, most politicians are unwilling to risk their careers to make the necessary changes. In fact, one of the top Republican leaders once adamantly supported a groundbreaking approach to the drug war. He said, “We’re losing badly the war on drugs. You have to legalize drugs to win that war.”

Those words came from Donald Trump 27 years ago at luncheon hosted by the Miami Herald. He also blamed our politicians who “don’t have any guts.” However, now that he is in the ultimate position of political power, he has not demonstrated the courage to make the positive reforms he once publicly advocated.

Trump has even taken steps to reverse the tepid moves toward progress made by the Obama administration. The most damaging decision was choosing Jeff Sessions as the attorney general. Sessions ordered all federal prosecutors to pursue the most serious charges (including ones with mandatory minimums) in all drug cases. It was a reversal of Eric Holder’s 2013 instructions to federal prosecutors to consider a variety of factors before charging a non-violent, low-level drug offender with a crime that has a mandatory minimum sentence.

However, the coup de grâce was the decision by Trump last month to appoint Kellyanne Conway as the head of his opioid commission. One could easily describe this as a “gutless” political decision to appoint the ambassador of “alternative facts” who has violated ethics rules to tout the products of the president’s daughter. After all, Trump himself has declared the opioid crisis a “health emergency.” However, he has not dedicated any resources to fight the problem or issued a clear policy direction.

Trump has not embraced modern approaches to treating addiction. During his first White House meeting with the opioid commission that covered many of the aforementioned harm reduction practices, he focused more on his own obsession—a border wall. This aversion to progressive ideas was highlighted by a decision last week by the Trump administration to ban the CDC from using seven specific words, including “evidence-based” and “science-based.”

This flies in the face of the recommendations from our country’s top health officials. Last year, the surgeon general of the United States released a first-of-its-kind report on drug addiction that called for an “evidence-based public health approach” to drug addiction. This is of the utmost importance because our government does not prioritize prevention and treatment. Case in point: A study found that 65 percent of America’s prisoners need substance abuse therapy, but only 11 percent actually get it. Likewise, less than five percent of court-ordered drug rehab appointments meet the appropriate medical standard.

In fairness, Trump picked Chris Christie, who is fairly moderate on this issue, to lead a research team on the opioid epidemic. Christie’s committee came to several conclusions in favor of harm reduction practices, such as removing the legal barriers to naloxone and more funding for treatment.

However, it seems unlikely that Trump will follow through with these initiatives based on his choices in top leadership positions. His first choice for drug czar was Rep. Tom Marino (R-PA) who felt that drug users belonged in a “hospital-slash-prison.” Marino has enacted an absurd level of hypocrisy on the issue of drugs. He is an adamant supporter of harsh prison sentences for illegal drugs, yet he has acted as a gatekeeper for the legal drug pushers that have flooded this country with prescription opiates.

The Washington Post published several articles showing how Congress protected the drug companies that were complicit in the opioid crisis, including one that pointed to Marino’s role in the “Ensuring Patient Access and Effective Drug Enforcement Act,” which reduced the legal culpability of prescription opioid distributors.

America’s problem with drug addiction has ebbed and flowed over the last two centuries. However, there has been an unprecedented increase in the last two decades. The cause of this spike has been a fraud unleashed upon society by Big Pharma.

Purdue Pharma, the manufacturer of Oxycontin, was able to convince many Americans that their product was “non-addictive” with junk science and aggressive advertising. The pharmaceutical company was able to avoid any severe consequences by enlisting the services of various revolving public officials, such as Rudy Giuliani, whose consulting firm helped negotiate favorable terms with the DEA. 

It is the corrupt revolving door between government and the private sector that has enabled the drug industry to exacerbate the opioid epidemic. It starts at the DEA, which establishes the production limits for the overall opioid market. Unfortunately, the money from Big Pharma has entirely too much influence over the agency. Last year, the DEA set a production limit that was 1,300 percent higher than the level 20 years earlier.

Again, the Washington Post has done a tremendous job reporting on the root cause of this problem. Since 2005, there have been 42 former DEA officials who have taken jobs working in the pharmaceutical industry or for law firms representing the industry. Thankfully, Sen. Tammy Baldwin (D-WI) proposed S. 2057: Pharmaceutical Regulation Conflict of Interest Act, which would directly address this. However, this is unlikely to pass because the pharmaceutical industry is one of the top contributors to Congress.

We are witnessing other countries improve their drug policy while Congress and the Trump administration seem unwilling to display the political courage to change the status quo, or disentangle themselves from the special interests that are keeping Americans mired in addiction.

Brian Saady is a freelance writer and the author of four books, including Dealing From the Bottom of the Deck: Hypocritical Gambling Laws Enrich Crooked Politicians, a Select-Few Casinos, and the Mob. You can follow him on Twitter @briansaady