President Donald Trump has proposed his opioid epidemic plan. It has three main strategies:

  • Mount a campaign to persuade young people not to abuse drugs in the first place. This has been mocked as a return to the Just Say No and DARE strategies which did not work the first time.
  • Increase the number of drug courts, specialized courts where arrested drug addicts may seek substance abuse treatment instead of jail time. This has been questioned because a relapse often means jail time anyway, and addicts are likely to relapse at least once. They also seem to rely most often on Vivitrol — thanks in large part to secret lobbying by the manufacturer of Vivitrol and the prejudice against other medication assisted treatments by judges who refuse to believe the evidence that they work well despite being opioids.
  • Allowing money to be diverted by the states from other programs, such as HIV treatment and prevention, when both programs would benefit from more money (which would save money in the long term).

The President’s public health emergency declaration proposes to do this without appropriating any money. Congress may vote to spend more money, but it is currently trying to pass tax cut reform while remaining budget neutral (give or take a $1 billion or so) so that it can pass with a bare majority instead of 60 votes in the Senate. Those efforts are already hampered because healthcare reform was never passed, and the Congress had been counting on savings there to offset the tax cuts’ loss of revenue.

Substance abuse treatment is not easy, but no one already involved in alcohol and drug recovery thinks these steps even begin to go far enough.

During his presidential campaign, Trump promised more money for opioid addiction treatment. A national emergency declaration — as his opioid commission, led by New Jersey governor Chris Chrtistie, advised — would have accomplished that, but there are reasons why he didn’t go that route. And it’s true Congress can and should put more money in the effort later this year, though they are wary of being accused of too freely spending money.

Still, for an emergency, the response from the executive and the legislative branches seems pretty lackadaisical.

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