How Donald Trump Will Make the Opiate Crisis Worse

On its face, Donald Trump’s proposal to eviscerate the position of the “national drug czar” is about the only reasonable proposal to come from an administration that is almost gleefully erratic, confused and outright fiendish.

A relic of the Ronald Reagan “Just Say No” era of drug-war hysteria (and sealed with a kiss of approval from Sen. Joe Biden, one of the architects of today’s mass incarceration crisis), the Office of National Drug Control Policy (ONDCP) is best known for spending your precious tax dollars on alarmist public service announcements—unsubtle propaganda of the kind that made creating a prison state a popular thing—and “official reports” that selectively use dubious data to support spurious conclusions contradicted elsewhere.

ONDCP is also required, by act of Congress to oppose any and all efforts to legalize marijuana or reschedule any other drug; it’s an inflexible anachronism and does more harm than good.

For these reasons, the proposed 95 percent funding cut to ONDCP—first reported Friday by POLITICO thanks to a leaked budget memo—sounds like a sensible move (and it’s a Trump campaign promise besides!).

But since the cut must still be approved by Congress, it is no sure thing.

In the meantime, in typical peripatetic Trump fashion, ONDCP is soliciting members of Congress for input on crafting Trump’s National Drug Control Strategy, the nation’s official drug policy.

Whether or not the office will survive to create such a strategy is unclear, but a group of six senators, all Democrats, are saying that cutting ONDCP might not be such a smart idea after all. It could mean the end of treatment programs—and since there are real fears that Team Trump wants to ramp the drug war back up anyway, drug czar or no drug czar, it may be irrelevant.

“We appreciate any sincere efforts to combat substance use disorders,” wrote U.S. Sens. Elizabeth Warren (D-Massachusetts), Tammy Baldwin (D-Wisconsin), Patty Murray (D-Washington), Sheldon Whitehouse (D-Rhode Island), Michael Bennet (D-Colorado) and Christopher Murphy (D-Connecticut) in a May 8 letter to Richard Baum, acting director of the ONDCP.

But, “[w]e are concerned about the sincerity of this Administration’s efforts in general,” wrote the senators, all but one of whom (Baldwin) are in states with progressive policies on cannabis. “We are concerned that this Administration may revert to a policy that focuses on the criminal justice system over public health efforts.”

Keep in mind that under Barack Obama, a public-health official was in charge of ONDCP. Prior to Michael Botticelli, all ONDCP directors were cops, military men or career Beltway bureaucrats.

And so far, all the people Trump has selected to oversee government agencies or efforts elsewhere in Washington where drug policy is involved—think Jeff Sessions, think Chris Christie—are retrograde hardliners with attitudes and worldviews lifted straight from a D.A.R.E. lesson plan.

No ONDCP would mean putting the Justice Department (or Chris Christie) wholly in charge of plotting a fix to the opiate crisis.

No ONDCP would mean anti-marijuana hardliners crafting drug policy.

It would also mean deep cuts to the $250 million in annual block grants from the Substance Abuse and Mental Health Services Administration (SAMSHA). As a review of recent grants shows, most SAMSHA grants fund mental-health services.

If the Trump-approved gutting of the Affordable Care Act also goes through, 24 million people will lose health insurance—and access to mental-health treatment along with everything else. One of the predictors of a substance-abuse problem is poor mental-health care.

If ONDCP is cut *and* Trump’s healthcare decimation goes through—and Jeff Sessions’s own drug-control strategies mirror his stated desire for a punitive, prosecution-first approach—America’s drug problem will surely get worse.

For these reasons, the senators “are very concerned that this Administration will exacerbate the opiate epidemic rather than alleviating it,” they wrote.

At the same time, Trump could keep ONDCP, put a drug warrior in charge and still make things worse.

He could listen to someone like West Virginia Sen. Joe Manchin—the man whose response to drug companies flooding his state with 780 million prescription pain pills, absolutely a reason why West Virginia has the highest rate of drug overdose deaths in the nation, was to call for a “War on Drugs”—and expand ONDCP’s Reagan-era law-enforcement-first efforts.

At the least, it would be nice to have a cohesive drug-control strategy at all. That’s simple enough. Basic, even—and with drug overdose deaths the leading cause of accidental death in the country, it’s absolutely vital. Can Team Trump handle that much?

As the senators lay out, there’s ample reason to worry that it cannot.