The Forgotten Public Health Crisis

President Trump’s failure to contain COVID-19 are overshadowing his mishandling of another emergency — the opioid epidemic.

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Darlene Park

President Donald Trump’s catastrophic response to the Coronavirus pandemic mirrors his administration’s ineffectiveness during the opioid epidemic. “His administration has a pattern of not caring or not trying to solve national disasters,” said Amalia Elnems ’21. “It has ruined people’s lives.”

Standing on the debate stage in Cleveland on September 29th, 2020 was Joe Biden, the man who will be the next President of the United States, leader of the free world, and occupant of the office that he has been seeking since his first election as a U.S. Senator in 1972. 

Biden is also the father of a son who has struggled with drug and alcohol addiction his entire adult life, and Donald Trump was not about to let him forget it.

When Biden mentioned the heroic military service of his late son, Beau, at the debate, President Trump seized the moment as an opportunity to bully Biden about his surviving son, Hunter. Trump mocked Hunter for leaving the military for drug use, falsely claiming that he was dishonorably discharged. 

Biden’s immediate response to the President’s taunts was to fiercely defend his family. “My son, like a lot of people at home, had a drug problem. He’s overtaken it. He’s fixed it. He’s worked on it.”

He paused for a second. “And I’m proud of him. I’m proud of my son.”

It was a moment that was watched by millions around the world, and demonstrated not just Joe Biden’s love of his family but also Trump’s shameless contempt for a recovered drug addict. The president’s inability to understand how a father could be proud of his children in spite of their struggles is a reflection of his inhumanity and lack of empathy for others. It is also a reflection of how his administration has ignored those trapped in drug addiction, by failing to address the opioid epidemic that has consumed and ruined so many Americans’ lives.

When Donald Trump was campaigning for the presidency in 2016, the opioid epidemic was nearing its peak, with overdoses causing over 42,000 deaths that year. Although the issue was clearly a public health emergency, it was largely absent from Trump’s rhetoric on the campaign trail. His only plan to combat it was building the wall on the Southern border, which he claimed would “stop the inflow of drugs into our country.” He promised a solution to the suffering, but outlined this solution in vague, confusing, and divisive terms.

This promise, like many of Trump’s claims while campaigning in 2016 and since taking office, was a lie. The epidemic has not ceased since his inauguration; in fact, it has only been exacerbated. Fentanyl, a synthetic opioid, has flooded the black market and replaced heroin in many areas as a cheaper — and more deadly — alternative to expensive prescription pills. Deaths caused by drug overdoses increased from 2017 to 2018, and again in 2019, with a record 50,000 opioid-related deaths in America last year. 

While President Trump has presided over some positive developments, like providing states with monetary relief and increasing production of therapeutic drugs to help addicts, these policies were not his creation but the result of a bipartisan effort in Congress. The SUPPORT Act was passed by Congress in 2018, authorizing this crucial assistance to states crippled by drug addiction. Although Trump deserves credit for signing the SUPPORT Act into law, his administration is still at fault for waiting far too long to combat the epidemic in the first place. His Office of National Drug Control Policy cycled through three separate directors in Trump’s first thirteen months, hampering its ability to organize and effectively take action. The Office did not issue any national drug control plan for either 2017 or 2018, even as drug overdoses and deaths continued to climb. President Trump did declare the opioid epidemic a public health emergency in October 2017, but a Government Accountability Office report found that this emergency declaration had little effect, opening up just $57,000 in special funding to combat the crisis.

Most crucially, President Trump has been trying to overturn the Affordable Care Act (ACA) since his first day in office, and nearly succeeded in the summer of 2017. Repealing the ACA would strip millions from their healthcare, consequently ending their access to free addiction treatment and support. His campaign against Americans’ access to healthcare exposes the emptiness of his rhetoric about ending opioid addiction.

One of the main causes of the opioid epidemic is the overprescription of prescription opioids by doctors. Beginning in the 1990s, the pharmaceutical company Purdue Pharma began an aggressive marketing campaign directed towards doctors across the country. In an attempt to increase their profits, Purdue lobbied these physicians to prescribe more and more opioids to patients. A 2019 study conducted by researchers at the University of Pennsylvania concluded that the introduction and marketing of these drugs by Purdue Pharma “explain a substantial share of overdose deaths over the last two decades.” As doctors began overprescribing prescription pills, more Americans developed addictions that forced their reliance on heroin, fentanyl, and other opioid-related drugs. A vicious cycle of drug abuse emerged across the country. 

The roles that Purdue Pharma and the billionaire family that owns it, the Sacklers, played in causing and exacerbating the opioid crisis has been well-documented for years. The company has been embroiled in various litigation since 2007, when the company and three of its top executives plead guilty to misleading the public and doctors about the risk of addiction from OxyContin. But in spite of this litigation and public outrage, Purdue Pharma has continued to operate, and the Sackler family has kept and even expanded its massive wealth.

In October 2020, though, a new lawsuit created hope that justice would be served to victims of Purdue Pharma’s greedy pill-pushing strategy.

The Trump administration reached a settlement with the company that required them to pay more than $8.3 billion dollars in fees to the Justice Department, criminal fines, civil penalties, and more. The deal seemed to finally be a measure of accountability, but it quickly became the subject of sharp criticism for how the settlement let Purdue — and specifically the Sacklers — off the hook. The Sackler family will only be forced to pay $225 million dollars under the settlement, a tiny dent in their $14 billion dollars of wealth. It is also unclear how much the Sacklers and other executives at Purdue will actually have to pay of the amount required in the settlement, since the DOJ has not been transparent in detailing the terms of the payments. 

Concern over the lawsuit has been aggravated by the company’s history of avoiding responsibility. The 2007 settlement where the company admitted wrongdoing required them to pay $600 million in fines, but that bill only cost the company six months of revenue, and did not include any costs for the Sacklers. After the deal was reached, Purdue refused to change its behavior and continued pushing OxyContin on patients — it had learned that even the most dire consequences it could face were not very extreme at all. There was no incentive to stop breaking the law and destroying lives.

The deal reached in October 2020 similarly lacks these incentives. The new settlement threatens to make many lawsuits pending in state courts against Purdue irrelevant, several of which might have brought actual punishment on the company. Twenty-five state attorneys general announced their opposition to the settlement before it was officially reached, but the Justice Department pressed on, allowing Purdue Pharma to once again evade accountability.

President Trump’s colossal mishandling of the Coronavirus pandemic compounded his failures to stem the tide of opioid addiction. Lockdowns needed in order to stop the Coronavirus’ spread isolated millions of Americans within their homes for months on end, preventing addicts from receiving treatment or encouragement from friends and family. Counseling sessions and rehabilitation closed or moved online, rendering them much less effective at supporting addicts emotionally. Traci Green, a public health expert at Brown University, explains that “social isolation has always been a huge component of drug overdose risk,” making the pandemic the perfect storm to worsen drug abuse.

In September, the American Medical Association reported that over 40 states have seen increases in opioid-related deaths since the pandemic began in March 2020. Suspected drug overdose deaths in May 2020 were 42% higher than in May 2019, a sign that the drug crisis worsened simultaneously with the COVID-19 crisis. Had the Trump administration taken the steps necessary to mitigate the virus and safely reopen the country — like mandating the use of masks, ramping up testing, and implementing contact tracing — then millions of Americans struggling with opioid abuse would not have to be shuttered within their homes, desperately trying to survive a deadly virus and a deadly drug addiction at the same time.

Trump’s approach to the opioid epidemic engulfing much of rural America is one of complacency and apathy. His administration has failed to act on its promises, has sidelined the needs of addicts by stripping them of healthcare, and has refused to hold Purdue Pharma and the Sackler family accountable, even when given the opportunity. As Amalia Elnems ’21 said, “There are steps he could have taken to stop the opioid crisis, but President Trump hasn’t taken them, just like his response to the COVID-19 pandemic.”

President Trump’s remarks to Joe Biden about his son’s recovery from drug addiction only revealed Trump’s disregard for the lives of those affected by drug abuse. Millions of Americans who watched the debate that night, many of whom have been personally affected by the opioid crisis or know someone who has, saw a President who does not care about them, is eager to mock them, and has made the conscious choice to ignore their needs.

President Trump’s campaign against Americans’ access to healthcare exposes the emptiness of his rhetoric about ending opioid addiction.

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