President Trump speaks during an event to declare the opioid crisis a national public health emergency at the White House on Oct. 26. (Pablo Martinez Monsivais/AP)

President Trump declared the opioid epidemic a public health emergency last week, taking a step toward fulfilling a campaign promise to address this issue if elected to the White House.

“As Americans, we cannot allow this to continue,” he said in a White House speech, where he was joined by New Jersey Gov. Chris Christie (R), chairman of a presidential commission on combating the crisis. “It is time to liberate our communities from the scourge of drug addiction. We can be the generation that ends the opioid epidemic. We can do it.”

Some of the loudest critiques about how the president is responding to the opioid epidemic — which many associate with white, rural voters — come from those mindful of how differently presidents handled drug epidemics in the past.

Actor Wendell Pierce — who starred on HBO's “The Wire,” a show about Baltimore's illegal drug trade —  highlighted the difference on Twitter:

Lost in the debate about black Americans in inner cities vs. white rural Americans is one demographic group that has been profoundly affected by the crisis: Native Americans living on reservations.

The Washington Post's Paige Winfield Cunningham wrote:

More than 52,000 Americans died of a drug overdose in 2015 — a more than 200 percent increase from 16 years ago, according to a Centers for Disease Control report.

The epidemic is especially centered outside cities and among Native Americans and whites. Deaths rose by 325 percent over the same period when you look only at rural areas, and by more than 500 percent among Native Americans and native Alaskans. Death rates among black Americans have more than doubled, though they have risen at a lower rate than among other races.

Although many conversations about people of color and drugs focus on black and Latino Americans, Native Americans fare the worst of all minority groups, according to the Centers for Disease Control and Prevention.

Leon Leader Charge, a member of the Rosebud Sioux Tribe, S.D. and the Oglala Sioux Tribe, Pine Ridge, S.D., worked in the federal government's Substance Abuse and Mental Health Services Administration. He has witnessed firsthand how opioid addiction have impacted the youth in his communities.

"As a community member and through word of mouth, I know our population suffers immensely," he told the Fix. "We have people dying because they are abusing opioids, alcohol and methamphetamines. Their bodies can't take all of that, so they just shut down."

By 2014, whites and Native Americans were dying at double or triple the rates of African Americans and Latinos, according to the CDC.


The reasons behind opioid addiction in Native American communities are vast, but intergenerational trauma related to systemic racism is one of them, according to the Pew Charitable Trusts:

A major source of intergenerational trauma, according to Dekker, who spent much of his career working for the U.S. Indian Health Service, was a mid-19th century federal program that attempted to assimilate Native Americans into the rest of the nation’s culture by shipping thousands of Indian children to boarding schools across the country. Many of the children were abused and most lost their cultural identities.

The practice continued until 1978, when the Indian Child Welfare Act gave Native American parents the legal right to deny their children’s placement in off-reservation schools.

Gloria Malone, a substance abuse counselor at one of the reservation’s long-term recovery houses, said all of her patients “struggle with the brokenness and sorrow of the past.”

Leader Charge, who has a degree in addiction studies, believes that the best thing the Trump administration can do is adequately fund prevention programs and long-term treatment centers.

"Prevention centers save more money than treatment," he said. "And its hard for our people to complete 30-day treatment centers and then go back to the same communities. Chances of recovery are slim or lower if you don't have long-term, sober living facilities."

The White House has not addressed how it will respond to the crisis specifically in Native American communities. But Trump has taken quite a bit of criticism for falling short of his campaign promise regarding the issue. The Fix's Aaron Blake noted that recently:

A “national emergency” would have “triggered the rapid allocation of federal funding to address the issue.” A public health emergency does not do that by itself. Several experts on the opioid crisis are bashing the move as a half-measure, NPR reports. In contrast, other public health officials, including some who served in the Obama administration, are arguing that the “public health emergency” is indeed a better fit.

The Public Health Emergency Fund has $57,000 in its coffers, a number critics say is insufficient for dealing with an issue that Trump acknowledged is killing more than 100 people each day.

Some Native American groups, such as the Cherokee Nation of Oklahoma, are taking the fight against the opioid epidemic into their own hands by suing companies that they believe flooded their communities with opioids.