The spotlight thrown on the topic by leaders of both parties shows the potency of addiction as a political issue and the continued impact of an overdose crisis that resulted in roughly 70,000 deaths in 2017, most of them from opioids. It also underlines the ongoing battle to appeal to white working-class voters, a group that was critical to Trump’s 2016 victory and that Democrats hope to court.
Most Democrats believe their path to the White House involves winning back industrial states such as Wisconsin and Pennsylvania whose populations have been badly hurt by addiction, and they see the opioid crisis as way to expose a gap between the president’s rhetoric and his record.
“Trump has been all talk and no action,” Warren said in a brief interview Wednesday about her opioid plan.
She waved off a question about whether the president, who campaigned on solving the opioid crisis, had at least focused attention on the issue. “It doesn’t matter if you don’t back it up with real resources and help for the people who need it,” Warren said. “He hasn’t made it a priority.”
The Trump camp would disagree.
Administration officials say they have made the opioid crisis a signature issue, with the president declaring opioids a public health emergency and first lady Melania Trump highlighting the crisis. President Trump appointed a commission in 2017 that made 56 recommendations on combating the scourge.
The administration has also successfully prodded China to tighten its regulation of fentanyl-related substances. The synthetic opioid is now driving overdose deaths, and most of the illicit fentanyl coming to the United States is manufactured in China.
“From day one, our mission has been the same — to save more of our family members, friends and neighbors dying from drug overdoses,” James Carroll, director of the Office of National Drug Control Policy, said in a statement.
Trump has also stoked controversy by urging the death penalty for drug dealers, an idea many experts say would do little to stop illegal drug use. And he has made the opioid crisis part of his push for a U.S.-Mexico border wall, though most illicit drugs come through legal ports of entry.
Wednesday’s announcements come as the presidential field has recently expanded to include former vice president Joe Biden, who argues that he can connect with white working-class voters who flocked to Trump.
Health experts say that Washington’s fight against opioids has largely amounted to symbolism or tinkering, and that it has not allocated nearly enough money. Trump’s emergency declaration increased awareness but did not result in additional funding.
Leo Beletsky, a law and health sciences professor at Northeastern University, said the federal response to the opioid crisis has been “abysmal.” Warren’s proposed $100 billion is closer to what is needed, he said, but there should be more explicit attention to structural changes, such as integrating addiction treatment into mainstream medical care.
Still, Warren’s approach would be an improvement over Trump’s, he said. “The Trump administration has in many ways fumbled this issue,” he added. “It’s been primarily rhetoric and not really action.”
Warren’s plan is modeled after the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which is credited with stanching the AIDS crisis, at least in the short run. The plan has interested policy experts largely because of the price tag: It’s big enough to make a difference in an epidemic that has yet to crest, they say.
Warren has proposed paying for her measure with a new annual tax on the country’s wealthiest individuals, which she also wants to use to finance other priorities, including universal child care, canceling billions in student debt, and making tuition free for public colleges and universities.
As part of her announcement Wednesday, Warren said she would return the $4,500 in political donations from the Sackler family that she has received since 2012. The family controls Purdue Pharma, which manufactures the opioid painkiller OxyContin.
Purdue is facing a cascade of lawsuits alleging that the drugmaker helped drive the opioid crisis, including by aggressively and deceptively marketing OxyContin. The Sackler family has been the subject of lawsuits by attorneys general in New York and Massachusetts. The company and the family deny the allegations.
A spokesman for the Sackler family said that Warren’s decision to return the money “can serve no proper political purpose” and that the family instead would “welcome a genuine dialogue with the senator that’s fact-based.”
Warren will highlight her announcement Friday with a visit to Kermit, W.Va., a town of about 400 known as a center of the crisis. It was inundated with about 9 million hydrocodone tablets in a two-year period, according to Pulitzer Prize-winning reporting by the Charleston Gazette.
Warren has made a habit of traveling beyond the early primary states, taking her message to Mississippi, Alabama and Tennessee in recent weeks. In the next few days she’ll also campaign in Ohio.
Her pitch on opioids goes beyond the white communities that have been devastated by the scourge. She makes a point of noting that residents of majority-black cities struggled with heroin long before the epidemic reached rural America.
“The crisis has also severely impacted communities of color, exacerbated by existing health disparities,” Warren said in a post published Wednesday on Medium. In 2017, she said, Baltimore had 692 opioid-related deaths, not far below the 833 in all of West Virginia.
Warren is not the only presidential candidate to see a political vulnerability for Trump on opioids.
Sen. Amy Klobuchar (D-Minn.), speaking on Tuesday to the International Association of Machinists and Aerospace Workers, referenced both the Obama and Trump administrations when it comes to addiction treatment.
“There have been some good things that came out of both administrations when it came to opioids,” she said. “But there’s still not that kind of funding we need for beds in this country.”
Jenna Johnson contributed to this report.