Trump is not to blame for the recent surge in overdose deaths. Dealing with addiction is difficult in the midst of a pandemic, when services are harder to access and individuals are suffering from stress and loneliness. But it is fair to ask whether an administration that touted itself as “dedicated” to ending the opioid epidemic could have done more.
The numbers are still incomplete, but the available information is bleak. The White House drug policy office reported an 11.4 percent year-over-year increase in overdose deaths for the first four months of 2020. Data from the Overdose Detection Mapping Application Program — a federal initiative that attempts to collect real-time data on overdoses — also show that suspected overdoses (including non-fatal overdoses) have accelerated this year. Overdoses in February were 16 percent higher than they were in February of last year. Since then, it has only gotten worse: March overdoses were up 18 percent compared with last year, April overdoses increased 29 percent, and May overdoses rose a stunning 42 percent.
Those sterile statistics don’t capture the horror on the ground. Places where things seemed to be improving are starting to look like they did at the height of the epidemic just a few years ago. Coroners’ facilities are overrun with bodies. Emergency responders are struggling to keep up. Families must navigate the trauma of needless death on top of planning a funeral during a pandemic.
Two factors are driving this crisis. The first is the persistence of dangerous synthetic opioids such as fentanyl, often mixed in with other drugs such as methamphetamine and cocaine. The Centers for Disease Control and Prevention has yet to release final data for 2019, but preliminary data show that despite progress in reducing deaths in 2018, they began to inch upward again last year.
The second is the novel coronavirus, which has devastated the economy and caused a torrent of stress and social isolation that exacerbates substance abuse. Meanwhile, many treatment centers — starved of revenue because of social distancing and confronted with massive new costs for personal protective equipment — have been forced to close or pare back programs. Many teeter on the cusp of financial collapse.
The administration has taken some useful steps in response to the pandemic. It relaxed regulations to make it easier for patients to access medication that helps stave off withdrawal symptoms for opioid users. But for some patients, that intervention came too late. Meanwhile, many mental health and addiction treatment centers received either too little aid from the federal aid package for health-care providers or were left out of the package entirely, meaning they’re desperately holding out for another round of money from Congress.
So where is the president? He hasn’t demanded that Congress do more to shore up treatment centers. He hasn’t pushed his administration to draw attention to the surging deaths. Instead, his administration has too often used the spike in deaths as a political prop to argue that coronavirus lockdowns were unjustified. Lockdowns were always inevitable; the question is whether the government was prepared to deal with the fallout. Clearly, this administration was not.
The lack of leadership on the opioid crisis predates even the pandemic. Public health experts regularly bemoan the administration’s inability to secure any meaningful funding to address the problem. Treatment drugs remain far too difficult for people to access; the White House itself reported in February that almost 400,000 people with drug addiction attempted to get treatment in 2018 (the most recent data available) but failed to do so.
The administration has made much of its effort to curtail the flow of dangerous drugs from outside the country, casting China and drug dealers south of our borders as convenient political villains. But given the ongoing threat of fentanyl, that, too, has been a failure.
Perhaps the president’s rhetoric on the addiction epidemic was empty all along. Perhaps he hasn’t called attention to the rise in overdoses because doing so would put a spotlight on his administration’s efforts in court to dismantle the Affordable Care Act — and with it the expanded Medicaid coverage that so many people fighting addiction rely upon.
Or perhaps Trump isn’t talking about these “forgotten men and women” because he has forgotten them, too.