Opioid Addiction Report Uses Panic to Sell More Federal Spending

At least it's not calling for harsher laws-yet.


Gov. Chris Christie
Ron Sachs/dpa/picture-alliance/Newscom

Let's start with the best news from President Donald Trump's Commission on Combating Drug Addiction and the Opioid Crisis: Their interim report does not call for new harsh laws or punitive measures against American citizens who abuse drugs. It doesn't call for more jail cells or new mandatory minimum sentences. It does not pretend that American can arrest its way into ending opioid overdose deaths.

On the flip side, the commission recommends even greater government meddling in the frequency and manner by which doctors prescribe pain medication, bureaucratic behavior likely to result in more pain sufferers being denied treatment and potentially turning to the black market for dangerous alternatives.

That's the unfortunate irony of the report from New Jersey Gov. Chris Christie's commission, made up of four elected politicians and a former White House drug policy official who want to keep marijuana as a Schedule I forbidden drug.

Read the full report here.

The commission's stated goal is to try to reduce the recent dramatic increase in opioid overdose deaths. The report is deeply concerned about black market access to synthetic opioids and notes that it comes directly as a result of the tightening of access to prescription drugs.

Yet the report calls for more government involvement in overseeing the practices of pain medication prescribers and more state-level monitoring of prescription access to "assist prescribing doctors." Though the report doesn't appear to suggest punitive measures toward doctors who prescribe more than the government believes is appropriate, it's very easy to see how these practices will end up there.

Indeed, given that the news coverage of the report is focusing on the commission's desire to get Trump to declare opioid overdoses to be a "national emergency," it's hard to imagine how its recommendations won't be used as a mechanism to overwhelmingly scale back pain medication prescriptions.

The report says America has a drug overdose death toll equal to September 11 every three weeks. They even underline the "every three weeks" for emphasis. Drug overdoses now kill more Americans than gun homicides and car crashes combined, though the report doesn't mention gun and crash deaths trends had been on the decline.

It is true that drug overdose deaths have been trending upward, and have been for a while. But it's an absurd exaggeration for the report to claim "If this scourge has not found you or your family yet, without bold action by everyone, it soon will."

The report addressed Trump directly, telling him he's the "only person who can bring this type of intensity to the emergency and we believe [he has] the will to do so and to do so immediately."

So if they don't want to throw people in prison, what do they actually want after declaring such a crisis? That's easy: More money. More federal spending to the states.

The first recommendation is for the federal government to facilitate more inpatient clinics getting access to Medicaid reimbursement money for treatment. The report authors know that legislation is technically necessary to make changes, but they believe that if Trump declares an emergency, the Department of Health and Human Services can grant waivers to individual states so that reimbursement can happen more easily, and the availability of treatment will hopefully increase.

The report also calls for federal incentives to increase access to medication-assisted treatments like buprenorphine and methadone to help addicts, particularly among veterans and Medicare patients.

And while the report doesn't call for more harsh laws, it does call for more funding for the Department of Homeland Security and the Department of Justice to fight the flow of synthetic drugs across the border into the United States. It may not want to punish Americans for being drug addicts, but the commission remains committed to fighting the war on drugs.

Possibly the most positive component of the report is the recommendation that the feds assist the states in equipping law enforcement officers with naloxone to reverse opioid overdoses. It calls for the feds to help craft model legislation for the states to make the practice spread. And it encourages support for "Good Samaritan" laws that protect people from prosecution when they call 911 to report drug overdoses if they're also in possession of drugs or under the influence.

It's very much a mixed bag. It's great the commission is resisting the push by Trump and Attorney General Jeff Sessions to make the war on drugs even more punitive. But it fails to acknowledge how government meddling in prescription practices helps contribute to the black market for opioids.

Furthermore, at the end it bulletpoints a bunch of topics they may ultimately address in their final report. One of those topics includes a "supply reduction" of pills via law enforcement pushes, meaning yet more cranking up of the war on drugs. Those punitive measures the interim report is avoiding may make its way in eventually.

For an alternative solution, read Jeffrey A. Singer's recommendation that we consider a harm reduction approach for addicts (which, to be fair, is a concept this federal report certainly includes) instead of trying to tell doctors they have to prescribe less to people who are in serious pain.

Update (August 2): While this commission may not be calling for more punishment, it turns out the Justice Department has its own plans. On Wednesday, Attorney General Jeff Sessions announced a task force to try to crack down on doctors who overprescribe opioids. Read more here.