Washington's misguided and small-minded response to the opioid epidemic – Washington Post

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Heroin users prepare to shoot up on a street in the South Bronx area of New York City on Oct. 7. (Spencer Platt/Getty Images)

Rep. Tom Marino (R-Pa.) withdrew his name from consideration to head the Office of National Drug Control Policy on Tuesday. He did so in the wake of a Washington Post-“60 Minutes” investigation revealing that he was the prime mover behind legislation weakening the Drug Enforcement Administration’s abilities to go after drug distributors even as deaths from prescription drug abuse continued to rise. That Marino dropped out is a welcome first step, but it is only a small one. The law he championed is just the latest reminder of how misguided and small-minded politicians’ response to the opioid crisis has been.

The cost of America’s opioid epidemic is staggering. Over 200,000 Americans have died from overdosing on prescription painkillers since 2000, including an estimated 17,700 people last year alone, quadruple the number in 2000. That’s only part of the tens of thousands each year who overdose on opioids legal and illegal. In the chilling words of President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis, “America is enduring a death toll equal to September 11th every three weeks.”

Imagine the response from lawmakers if a terrorist attack as deadly as Sept. 11 took place once a year, let alone every three weeks. Lawmakers would call emergency sessions and dedicate tens of billions of dollars yearly to prevent the next attack. Half-measures and mere gestures would be unacceptable. Instead, lawmakers’ response to the crisis has been lethargic at best.

President Trump has received plenty of criticism for nominating Marino, and the denunciations are certainly deserved. In August, the president said he would declare the epidemic a “national emergency,” making more resources available for both prevention and treatment. But he has dawdled for two months, and now promises — perhaps to save face in wake of the Marino scandal — that the formal declaration will come next week. Even if the White House does follow through, though, an emergency declaration is only a temporary step, and the president’s budget shows scant evidence that he is interested in any policy that would make a long-term difference.

But the blame goes far beyond the current president. The law that Marino pushed had bipartisan sponsorship in both the House and the Senate. Both the chambers passed it by unanimous consent — i.e. not one lawmaker objected. A Democratic president signed it into law. In the wake of The Post-“60 Minutes” story, Sen. Joe Manchin (D-W.Va.) and others now want to repeal the law — another welcome step — but the fact remains that everyone was asleep at the wheel when this bill became law.

Simply repealing the law or installing a less-compromised White House drug czar won’t be enough. Lawmakers have to think much bigger. Not only is current funding for treatment, prevention and recovery woefully inadequate, but most numbers being floated on Capitol Hill are little better. For example, the federal government could provide funding for state and local government to purchase naloxone, which reverses the effects of an opioid overdose, and train first responders in its use. While most states now wisely allow the drug to be purchased without a prescription, only some municipalities have provided the drug to the people most likely to show up to the site of an overdose.

There also needs to be a cultural shift in which people ensnared in the opioid epidemic face the legal system. Rather than discourage addicts from coming forward and seeking treatment by threatening them with arrest, we should be treating addiction as a medical issue that demands care. At the same time, more enforcement attention needs to be paid to the suppliers — not just those dealing illegally or individual doctors and pharmacies writing and filling fake prescriptions, but the major companies who have fueled the crisis. A new feature in Esquire outlines how the Sackler family, owners of the company that invented Oxycontin, downplayed the risks of addiction and exploited doctors’ confusion over the drug’s strength to make hundreds of millions of dollars. Major drug distributors like Cardinal Health and McKesson have been fined multiple times for refusing to report suspicious orders. The law pushed by Marino and others freed the distributors to do even more harm — now the pendulum should swing in the other direction, including pursuing action against company executives if necessary.

More Americans died last year from drug overdoses than in the entire Vietnam War. Anger at a withdrawn Trump nominee is warranted, but it’s hardly enough. To stem the deadly tide, far more radical action is required.

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