As usual, Trump has absolutely no idea of how or why we have this explosive issue. It's still all about him...HIS brother was an alcoholic, causal issues nowhere near comparable..majority of his speech talking about how HE is so much better because his brother kept telling him "don't drink, don't smoke". In August Trump declared this a national emergency. Things haven't been doing so well for him this month, so he scheduled an appearance (with a week or so of teaser statements) to declare it again...guaranteed to do two things: (1) Get him press and TV coverage, and (2) get everyone so worked up that Americans would forget that they are going to be financially raped again, that the Comptroller of the Currency (a banker Trump appointed) has gone beyond his term without Senate appointment, the EPA has raised the approved levels of radiation the human body can tolerate by tenfold, another Kushner holding was discovered that he didn't declare, Pruitt is killing Obama's Clean Power Plan, he appointed a chemical industry guy to protect us from chemicals, engaged Equifax to serve as an interim fraud prevention contractor for the federal government, Justice Dept. changed rules so Ivanka and Jared are now OK to work in White House, AIG - one of major companies that triggered Recession removed from federal oversight, transgender discrimination OK'd. And this all was just October! No mention of the causal source of the issue - Big Pharma. Don't worry America, it WILL get worse.
3
The layered complexity of addiction has now been folded into the anti-science narrative that defines this regime. The opioid crisis is built on a complex construct: the synergy of big pharma and a medical establishment in their thrall and grip; indifference to health care; socioeconomic despair; and a cultural impatience with all long-term solutions, from pain management to depression. The collusion of these factors created the pandemic. The ludicrous admonishment to not pick up insults science and our intelligence. And citing a brother's alcoholism to gloatingly tout personal abstinence is (big surprise) more narcissistic bravado, wildly inappropriate. This crisis isn't about a commitment to avoiding substances or sobriety; it's about a systemic failure of collaborating factors. Focusing on addict behavior and law enforcement as prescriptive measures has the whiff of 1957. Not the 80s. Even Nancy Reagan would see the light, hearing such puerile rhetoric. And finally, no new money, no programs, and a steadfast refusal to acknowledge that addiction can only be addressed through (paid) treatment. Yesterday was more of the same: calculated propaganda to serve a master, perfidy-spouting propagandist. 60,000 Americans die of this subcategory of addictive disease every year. We were warned it's our fault, and to fix it. One more appalling moment in an era marked by them.
2
NYT’s readers likely saw that this President: read from the teleprompter, showed his hands as usual, and switched looking left to right at the prompter, concentrated on reciting and employed his usual adjectives. In other words, he did a job. Meaning....it was a very good job, the best ever stated, he got the job done. Period. Done. End of story.
He said nothing. A nothingburger. Well-done.
3
Words are so easy for President Trump, as long as there aren't too many of them with multiple syllables. Action? Not so much. Deeds require actually doing something. When that something executes public policy, it also demands aforethought. Not going to happen.
5
For what they're worth, a few more personal opinions/reflections on opioids.
1) "Addiction" (https://www.asam.org/resources/definition-of-addiction) does not depend on the drug, but on the person. It originates from a mental disposition, an attitude, a readiness to accept (or actively look for) a "chemical way of escape" from unhappy mental states (stress, loneliness, anguish, remorse, hopelessness, loss, etc.). Actually, opioids are very effective against all kind of "mental" suffering, but this is today an unapproved use. We might become able to reconsider that some day.
2) True "addiction" is a very rare condition with opioids. They are not "recreative drugs", like alcohol or marijuana or cocaine or ecstasy, but are almost always used as "self-medications". [Endnote: I put alcohol in this list with a reservation: although, in the long term, much more toxic and much less effective than opioids, alcohol is often used non-recreationally for the same "tranquilizing" purposes as opioids.]
3) I suspect we might superficially call "addiction" an unrecognized imbalance/defect in a person's endogenous opioid system. This might be the case of the few persons who - after their very first opioid dose - feel a kind of well-being they had never experienced before (an “addict" once told me: "After my first injection, it felt like a missing piece in my head was suddenly fixed in its place... I felt "normal" for the first time in my life, and all started with that.").
Maybe we should take a look at who is truly responsible for this epidemic:
Let the pharmaceutical companies and doctors pay for the rehab. Lets stop making the taxpayer libel for all those who are making money off of a situation they created.
They should open up rehab centers in every big pharma office in every city in the U.S. but that's not going to happen, it will get dumped onto the gov. hence the hard working tax payer.
4
The reason this crisis became so deadly is that the government cracked down on safe and legal opioids, making them very difficult to obtain. So users turned to heroin and Chinese-made synthetics of dubious quality and strength, and starting dying because of the difficulty of dosing.
America has a lot of recreational drug users. Always has. Always will. Let's just try to keep them safe. If you ask me, opioid policy should be written for the convenience of responsible users, and methadone should be available over-the-counter.
4
The difference between Mr. Trump and Ms. Clinton is that while Ms. Clinton would have authorized money to combat this scrounge, Mr. Trump expressed empathy for the victims of it.
Trump supporters are not necessarily "data driven" people. Rather, they tend to be driven by an internal value system and by strong feelings. Republicans in general don;t want the government to do things- they just want their leaders to understand them.
Viewed through this lens, Mr. Trump is responding exactly the way his constituents want.
1
This is one of the many times America needs a real leader, and not an administration of amateurs. Earlier this year, Jeff Sessions stupidly proposed a return to the D.A.R.E. program, who's failures are well-document. And only last week did Trump's Drug Tsar nominee withdraw after it was revealed that he actively worked against the DEA's ability to go after the drug companies. I also wonder what the point was of Trump's opioid commission -- who admitted editing their report significantly just so he would read it -- because he still fails to grasp the severity of the opioid crisis. It can't be fixed with simple, Just Say No messaging; border walls; and an increased presence law enforcement. Once again, the states will find themselves on their own when they looked to the feds for guidance and support, as they work aggressively to address the crisis within their jurisdiction. And they have done a lot - everything from monitoring prescribers; to making overdose reversal drugs directly available to the public; to requiring med school and vet school grads to receive training in pain management; to using data to target and disrupt opioid trafficking networks, to implementing drug court programs; and more. Meanwhile, the feds will continue sitting on their tiny hands pretending to look important.
2
If a year ago President Obama had given the same speech that President Trump delivered yesterday, it would have been hailed by the Times and its readers as an important step forward and a model of compassion and empathy . Incidentally, what does it tell you that Obama never mentioned the drug epidemic during his presidency and Trump just called for an all-out war against this plague?
By attributing Trump's clumsy mismanagement of this issue to his callous lack of empathy for other people (part of his narcissistic personality disorder), we miss the other problem. Trump is just not a good manager. Hence vacant jobs in the State Department, etc. A good manager would listen to the experts, find out who and what is needed, hire them, allocate funds, come up with a budget, etc. He lacks the needed skills.
4
Instead of blaming individuals who cannot control their drug use, perhaps someone should inquire what is it about our society that so many Americans, even though not physically ill, cannot get through the day without them?
2
The Opioid epidemic is a tragic problem and not only has the heroin overdoses killed people that are taking pain medication, but heroin has gotten into our backyards and is killing our children who are experimenting with all sorts of pills and marijuana laced with other addicting properties that leads them to the cheap sale of the heroin on the street. It's heartbreaking and has affected so many family's for so long. It's started in our community as early as 2012 and there were many, many overdoses and tragic deaths. Heroin is talked about nationally as an epidemic that affects people who are given opioids as pain killers, this is true. It also has a much broader reach and children and young adults have lost their lives because of it.
In addressing our horrendous opioid addiction and death problem, Big Pharma is so powerful that it is like the ad with authoritarian woman in the Hanes underwear factory, barking out, "Nothing is going to happen until I say it can happen!" And our dutiful elected representatives comply. Follow the money. By the way, there are 2 drug industry lobbyists for every 1 congress person to make sure our "representatives" do what they are told by Big Pharma.
If we really want to level the playing field in Congress, we need to get rid of Citizens United and move to a publicly funded campaign system like actual democratic countries have. In keeping score, how many legislatives battles have the people won, and how many battles have special interests and big contributors won?
Not enough money coming from Congress to actually address and adequately fix the opioid addiction and death problem? Gee, wonder why?
Since we have a "War on Drugs," why can't we get the money to work on the prescription drug addiction crisis from the Defense Department (a.k.a. War Department). Or why not have the pharmaceutical industry contribute 1% of each prescription drug sale to a fund to deal with drug addiction?
1
This impressive gust of smoke that Trump just blew on opioids, like his recent utterance about 401(k)s, is a diversion. Keep your eyes on the TAX CUTS FOR THE WEALTHY plan. That's the real, pressing story. The tax (over)haul that he's plotting on behalf of the Mar-a-Lago set, and trying to sneak through behind the screen, is more destructive than even the "health care" bomb that McConnell & crew keeps trying to foist on America. Like Trump's public offering in the real estate game - like so many of his business "ventures" - his tax-cut skyscraper is intended to leave him high and dry with cash in his pocket while the stakeholders sink, bags of dirt in their hands. Trump no doubt has caught on that just relying on the dead-and-buried "trickle down" argument won't convince many people who understand that the world isn't flat, so he's pulling out some of his flashier con-man tricks.
We want to see Trump's tax returns. Any tax plan passed by this Congress should not be designed to benefit him and that's the only way to ensure it. Otherwise he's trying to force America to swallow some opioids simply on his promise that they're good for us.
1
Has this president yet to demonstrate that his words mean anything. For goodness sake, no one but a simpleton would believe that "if we can teach young people not to take drugs, it’s really, really easy not to take them.” In other words when faced with life's complexities throw a few slogans (or tweets) at it. Alas, if only life was so simple . . .
3
I have taken opiod based drugs for pain. perhaps they were very low dosage,because they never worked with anything close to miracle efficiency; at best, they have reduced pain intensity, rarely to never relieved it completely. I never experienced anything like a high, but have had a sleepy, rather unpleasant sensation as a side effect, more akin to slight air sickness than euphoria - certain nothing I would voluntarily repeat for its own sake.
I've often had a craving to get rid of pain, but absolutley never to take this or any other kind of drug for its own sake, absent pain.
so, either my brush with this type of drug has been very slight... or different people react in very different ways, making this an even more complex issue to deal with.
1
I am a public service substance abuse counselor, working at the front door of my community treatment system. Two weeks ago, counseling staff in my program received an email from management, directing us to "say the waitlist is a few months, two months but nothing more than that" - so as not to discourage clients who seek help. The truth is, for male opioid users who do not inject (pill users or heroin smokers) who want to detox and go into residential treatment, the waitlist approaches 4-5 months or sometimes longer, due to lack of available funding. Also, some area methadone clinics have waitlists, and there are not enough suboxone doctors to meet the demand. Early intervention and treatment is critical for opioid users, who are at risk of dying while waiting for treatment. Funding for treatment expansion is a critical need, and neglect of that need is tantamount to abandoning users to death and disability. Trump has blood on his hands if he does not make more funding available for treatment.
1
Abstemious Trump may understand the horror of addiction because of an alcoholic brother, but the Trump winery and all the alcohol sold on Trump properties indicate that in some circumstances, he finds horror sufficiently offset by the profits. I am sure he will be able to find some common ground with Big Pharma on this.
1
Three or four cases of Ebola and hysteria reigns, money is allocated, treatment facilities are built in Africa. Another continent! Over one hundred fifty people die every single day and we have to depend on a cheapskate congress to save their lives. As the Puerto Ricans are finding out, only SOME lives are valuable.
3
“I still have not seen the passion for this epidemic that I saw in the AIDS epidemic,” Gov. Chris Christie, the commission’s chairman, said recently.
And just like the AIDS epidemic, we are causing there to be a slow, suffering crawl before any actual substantive change comes about. And just like homosexuals in during the times of AIDS, poor people are, as they typically are, persona non-grata in the eyes of everyone.
All mouth and no action. What's new?
1
That all he does is talk and yammer. He makes grand promises and hopes his blinded- by -their- anger ( or are they just plain stupid?) base doesn’t notice that nothing concrete is done on the issues that really matter. Meanwhile he tries to undo the Obama legacy and further enrich himself and his rich friends which is all that matters to him.
3
To borrow a phrase from Sarah Huckabee Sanders -
"All hat. No cattle."
7
Soon to be ex Gov Christie's remarks are repugnant. NYT called it right on the sloganeering
3
Pure mouth; humbug; empty rhetoric typical of a demagogue. Classical Trump! Remember Trump being effusive in congratulating Philippines' 'dictator' Duterte for a job well done...while Duterte was systematically killing drug addicts, instead of offering treatment and some compassion? The fact that crooked lying Trump declared U.S. drug addiction an emergency, but doing nothing on paper so to mobilize funds to really make a difference, is a testament to his hypocrisy.
2
He talks like such a simpleton, saying "really, really" over and over. Is a great advertising campaign actually going to do anything??
5
The steps we're taking aren't going far enough. We are not asking tough and honest questions, like why so many people are in pain in the first place, and we keep addressing drugs more as a moral failing than a crisis of healthcare.
Without honest questions and answers, and an effective and compassionate community response both locally and federally, we will not get better.
4
There’s a lot of work to be done, and prioritizing it is the first step.
There is a major problem that just about all of those speaking about the opioid epidemic suffer from. And that is that they have never themselves taken opioids. And because of this they are oblivious to a most basic and simple solution to the problem posed by prescribing opioid pain killers which leads to addiction and is the sole cause of the epidemic.
I do take opioid pain killers for a chronic pain condition and therefore know exactly how those drugs make a person feel. Opioid pain meds come in two forms, immediate release and extended release. The immediate release pills release the full dosage as soon as the pill is taken which results in a high that people who have never experienced it before find very pleasurable. On the other hand extended release pills do not result in the user getting high at all for the obvious reason that the drug is released in tiny increments.
So a doctor has a choice of either giving a person a drug that will introduce him to what many find an unbelievably pleasurable feeling, no different than giving his patient cocaine for medical purposes, or to give him a pill that will not get him high at all.
But not only do all doctors prescribe the drug that introduces the patient to a new high, they have no idea that another option in extended release pills. The fact that all those dealing with this issue are ignorant to this most basic fact is mind boggling.
3
Trump and wealthy white mail GoP legislators don't feel our pain. They never will. And they're rich enough to pay for any personal discomfort. They don't care.
This is the same president and legislators that promised superior accessible health insurance for all only to turn around and attempt to gut MEDICAID, MEDICARE and deprive tens of millions of poor and lower middle class Americans of healthcare. That gutted the DEA unit mandated to control opioid use and install a Republican Congressman in an unnatural relationship with opioid manufacturers as agency head. That is buckling to NRA pressure even on bump stocks for semi-automatic weapons.
Not even combining Opioid abuse and prostates into a national emergency could we hope to get a rise from this rich, white male demographic. After all, a national emergency will add $ billions to the budget and complicate their obscene tax reform proposal that is designed to add $100,000s annually to their personal fortunes, enough many times over to pay for any personal prostate and opioid inconvenience.
They simply don't feel our pain. They don't care.
1
We live in a society increasingly driven by instant gratification, which both contributes to the addiction crisis and makes it more difficult to treat. There is not a single, quick answer to the problem, and yet multi-faceted solutions that take years to implement are no longer considered worth pursuing by politicians and policy makers -- especially the ones who currently hold the reins of power. I happen to be a recovering addict, and I know from experience that sobriety does not come quickly, and it requires daily maintenance. I and many other others in recovery constantly remind ourselves that our lives depend on exchanging the drugs of instant gratification for patience, acceptance, humility and gratitude. If our country could only apply these principles to our societal pursuit of a treatment for the opioid crisis, we would have a much greater chance of success. Alas, the supply of these antidotes seems to be shrinking faster than ever. Our current president administers a massive dose of instant gratification daily to his supporters and detractors alike. Our nation is going to need the equivalent of shot of naloxone to survive. We can only hope this incident scares us badly enough to commit us to a long-term program of treatment.
2
When instructed not to take them "it's really, really easy not to take them" ? This, combined with Sarah Huckabee Sanders's recent comment that criticizing generals is unpatriotic, is an indication that we've now broken free from even the pretense of basic rational speech. It's now almost pure form. People in nice clothes speaking from behind a podium. It's only one step above gibberish.
6
Trump reminds me of a current commercial with a bank robbery going on and the security guard tells customers sprawled on the floor, "There's a robbery." When asked if he's going to do anything about it, the guard replies he's just paid to report if there's a problem.
I would hope the President will now back up his words with actions; something we haven't seen much of so far in this Administration.
2
Trump can blabber and read from the teleprompter about the opioid crisis for I do not believe he is buying into this emergency. He is reluctant to spend money on rehab programs/research,for he knows the very wealthy and rich can afford drug rehab centers/programs, the poor not so much.
It is a difficult situation for the US and its healthcare system. Treatment is expensive and not always successful. It seems there are presently various treatment options however, do we really know which ones are indeed successful? Are insurance companies, medicare and medicaid willing to pay for more than one rehab treatment if the patient fails the first time around. It is a complex issue and requires a lot of thought and discussion.
We know someone who is very well off and went to a rehab center in PA. The cost $60,000.00. He told us that he met people there which have been there before, relapsed and were able to pay for a second try at rehab.
An acquaintance of mine's 32 year old son died of an accidental overdose and left behind a toddler and a pregnant wife. I was told that they did not have the money for rehab and his insurance did not pay for inpatient drug rehab. The aforementioned live in upper middle class and middle class neighborhoods.
We all know opioid addiction extends across all neighborhoods and income levels. Unfortunately Politicians in Washington are more interested in giving the wealthy, industry and lobbyists a tax break rather than addressing this complex problem.
4
Follow the drug money. Sales, not action is what Big Pharma demands and pays for.
Fight the opioid crisis with PR but don't fund solutions. Right out of the Big Pharma playbook. And who better Trump to make it look something is happening when it won't?
Trump is the quintessential carnival barker and snake oil salesman brought to us by the Greatest Medicine Show on Earth, sponsored by the U.S. Pharmaceutical Industry.
Where we now live, Utah ranks 7th in the nation for what the state called "drug-poisoning deaths," the majority of which are due to prescription pain medications—oxycodone, percocet, methadone, fentanyl. Our local NPR station is doing a series on the problem, and the problem is huge. On yesterday's show, they focused on how doctors initially were lied to by the drug industry and told there would be no problem of addiction and their patients would be so grateful.
Drug companies spend more than any other industry to influence politicians, and they write the laws and block solutions to the drug crisis. Our
state's senator Orin Hatch is one of the biggest recipients of drug industry dollars, and has worked tirelessly to block government efforts to reduce prices & control the use of pharmaceuticals. (The Guardian).
Even the AMA blocked legislation requiring doctors to get training on the risks of opioids--too "burdensome" the AMA said
Focus on the undue influence of Big Pharma in our high cost of drugs, our many health problems due to drugs, & no acction
focus seems always to be on how people become addicted... rather than why they become addicted.
some are really just unlucky and fall ill, perhaps as the innocent result of exposure as a result of some kind of medical issue, such as a surgery...
but I suspect most, at bottom, have nothing better to do with their lives; all the miseries of addiction feel to them like an improvement over having to face the reality there's no place for them in today's world. look at it this way and perhaps it's not such a bad choice.
2
Despite the fact that Mr. Trump's brother died an alcoholic, I doubt he understands opioid addiction, from which people die quickly and usually young. There is an old saying: there's no such thing as an old addict. I learned this as an addiction/mental health counselor and treatment program developer and manager.
Without funding, Mr. Trump's words are meaningless. I frequently speak with people who cannot find treatment for their loved ones. It doesn't exist or is inadequate in many areas. Only funding, along with an infusion of well-trained treatment professionals, will make a difference for those who are already addicted, hopefully before they die.
2
Why doesn't Congress do something?????? I saw the program last week on 60 Minutes and was disgusted. Really sick to my stomach. Why don't our politicians stop this at the source - BIG PHARMA? Why?
2
You don't turn an aircraft carrier on a dime, and so NYT should give Trump some slack on this one. The mere declaration that this is a public health crisis carries weight. It says that this isn't a law enforcement issue so much as a health issue, and that's the right direction.
As for spending money, well, money alone isn't going to solve this. Money for addiction treatment, yes, But it's silly to think that we should be shoveling money into efforts at stopping drug smuggling. We've already tried that. It doesn't work.
It's disappointing to see NYT dismiss ad campaigns as useless before ad campaigns have been launched. Yes, "Just Say No" and "This Is Your Brain On Drugs" were stupid and ineffective, but that doesn't mean that ad campaigns won't work if properly done. The only way we're going to make progress is to reduce demand, and the only way to reduce demand is to convince people not to use drugs. You do that by telling people the truth about drugs, and so both education and ad campaigns are critical. I'd suggest hiring the folks who do the ASPCA and Humane Society commercials that feature horribly abused animals. Show what drugs do to humans in the same stark, unsparing ways and that might make a difference.
Treatment should be on demand, but it shouldn't be forced. People don't stop using drugs until they're ready. We should recognize that.
So, ease up, NYT. Trump is an awful man and an awful president. But he doesn't deserve to get hammered for this and like this.
1
This represented just an opportunity to place Trump in front of the camera where he can display not only his ignorance of the problem, the hypocrisy of his administration proposals to address it, but his complete lack of empathy, grace, and intelligence as exemplified by his middle school vocabulary.
3
"President Trump’s brother died an alcoholic, so it’s hard to dispute that Mr. Trump understands the horrors of addiction."
Is this the same Donald Trump who maliciously cut off family health insurance to his brother's sick grandson (Trump's great-nephew): the same brother he is now using as a "Statement of Understanding"?
1
I'm old so I wasn't trained in "Just Say No" control "Just Say No "to sex because there won't be any more covered birth control. "Just Say No" if you get pregnant because, unless you're rich, you won't be able to find a provider for an abortion. "Just Say No" because if you get yourself addicted to anything (even to receiving help for addictions) the funding won't be there but a crippling deficit will be...
I say "just Say No" to the nonsense spinning from the White House. Thank you NYT for calling it like it is!
16
I understand that prescription painkillers are not the problem currently. It is foreign cheaply-made carfentanil. It is used to sedate elephants and added to heroin to give it a kick. This is the cause of opioid related deaths in the U.S. these days.
Prescription painkillers have not been casually given to any patient since 2014, by any legitimate doctor at least. Cancer patients and chronic pain sufferers must be in the care of a specialist.
5
As a practicing physician, it seems clear to me that one of the causes of overprescribing of opioids is the several- year old government mandated in clusion of pain (scored from 1-10) as the fifth vital sign in patient encounters. The traditional four vital signs, pulse, blood pressure, respiratory rate, and temperature are all objective and cannot be faked, whereas patient reporting of pain level is entirely subjective and not verifiable. Failure to record this fifth "vital sign" can have negative financial consequences for physicians and hospitals. Is it at all surprising that drug-seeking individuals would exaggerate their level of pain in order to receive drugs when they know that there is bureaucratic pressure from the government to believe them?
9
doc, this speaks to the how, but not the why.
or as we say in Hollywood, what's my motivation?
Why not a word about President Obama signing the bill that tied the hands of the DEA? Forgot, Obama is immune to criticism. He did a sensational job. Left the country to deal with DACA, North Korea, the ACA, stagnant wages, rising inequality, Iran, etc.
2
Donald Trump claims to have lived a drug- and alcohol-free life, and, of course, we believe him because he has shown himself to be a truthful man with a strong moral code. His deep concern for his fellow humans is displayed almost daily.
3
Yesterday I read a horrifying article on the Reuters site about all the lucrative industries popping up around the sale and rental of human body parts.
Maybe Trump is hoping to help all these 'businesses' out and get rid of the sick people he scorns at the same time.
2
Why does Trump get a pass for having a brother who died from alcoholism? It is clear he does not understand or care to understand the nature of the problem and who it impacts. This is a national crisis and the best we can hope for is FLOTUS pushing an initiative about the addiction crisis.
Trump was the beneficiary from his alcoholic sibling's death in many ways that were instrumental later in how he "ran" his business. His retrospective emotions about this sibling's demise may be considered mixed, at the very least.
1
Just like the way she's fighting cyber-bullying!
2
If this epidemic continues to grow at a compounded 20% rate it will reach 100,000 deaths by 2020 and 200,000 by 2024. If the death and overdose curve is not bent downwward by the next presidential elections, it could eclipse many other issues and become Trump's Waterloo.
2
Of course Trump didn't allocate any funding to fight drug addiction. He is busy trying to arrange some tax breaks for millionaires just now. How can free up funds to pay for drug treatment when he's cutting taxes for his friends and family?
Besides, Republicans do not believe that the federal government has a role to play in dealing with addiction. Rather, they believe that addictions of all kinds fall under the category of "personal responsibility." As Trump said in his speech, all it takes is telling kids not to take drugs and it's easy not to do. Those that don't heed this advice have only themselves to blame, and will have to find their own way out of it, or not. And, many taxpayers resent their dollars going to treatment programs for people that they consider weak-willed and who they believe could quit if they wanted to. The poor, the addicted, the disabled, the elderly--none of these populations can expect much sympathy or assistance from the Republicans they voted into office. Not when tax breaks for millionaires are a priority.
3
1) A key issue is INFORMATION. Opioids are very effective and safe drugs if used correctly (see "Opioids themselves are surprisingly nontoxic even when used in substantial daily doses for many years." Cecil Txbk of medicine, 20th ed., 1996, p. 52). However, since the margin between the safe and the lethal dose, especially for occasional users, is relatively narrow, they are extremely dangerous if used without knowing them, and above all, without knowing the substance (fentanyl is not the same as morphine) and the dose one is taking.
2) That said, I cannot understand the deep reasons behind this long and tragical epidemic of opioid "abuse" and opioid-related deaths in America. Even when taken without a reasonable medical indication, opioids are not "recreative drugs", they are essentially self-medications (although, too often, inappropriate and counter-productive). Are hopelessness, unhappiness, loneliness, anguish so widespread and so deep in your country?
3) Of course, the very existence of a black-market for opioids (and other drugs as well) is a key factor in all this: drug prohibition is possibly the greatest folly in human history. It has created lots of social and personal problems without solving the one it was meant to solve.
5
Not wanting anyone to die because of addiction to any drug but I must ask where was all of this concern when communities of color were being decimated in the 60's, the 70's,80's,90's by opiates? The answer in the 80's was the sophomoric campaign Just Say No! From the draconian Rockerfella laws in N.Y. to the massive incarceration of addicts for four decades across America little attention was paid to treatment.The new pushers are not wearing hoodies and standing in doorways for today they wear lab coats and carry prescription pads.Recently a lot of the so-called experts have been pushing Methadone as an answer to the opiate problem. I would suggest before we think Methadone is the answer we consult with communities of color so they can tell of the scourge of Methadone Clinics. Methadone is more addictive than heroin and a proliferation of Methadone Clinics can only further enrich the drug industry.Communities of color should be consulted so they can enlighten us about what worked and didn't work in their communities to combat the death sentence of active addiction.
11
For Trump, talk (in front of cameras) is sufficient. He needs the optics to work, not the obligation to correct the problem. So, speaking forthrightly about correcting the issue of opioids abuse is more than adequate since the public "sees" Trump addressing the issue. Schedule some "soft" airtime with Fox & Friends to chat up how sensitive and caring is the Presidential directive. Meanwhile, eviscerate the health care system to gut actual care and support for those most in need, and collude with opioids manufacturers to improve their profits while increasing the actual crisis.
2
279 days in office and now it's time for bold action. Imagine if all the Trump tweets were directed at a true crisis.
1
Did Tom Price ever give our money back? Remember his private jet use, and his contrition, and his promise to pay it (actually, just some of it) back? We could use it to buy ad space somewhere, telling people not to do drugs. All the addicts and chronic pain sufferers I've talked to have commented on how easy it would have been to stay off drugs if only they had seen some really, really, good advertising.
2
This is not the first time that a major problem has been caused in part by irresponsible pharmaceutical marketing. We should ban marketing of all prescription drugs to prescribers and to the public. The companies should of course make scientific information available.
That won't solve THIS problem now that the cat is out of the bag. We should of course prosecute traffickers but interdiction is not going to work. It never has. Treatment should be available but it isn't going to make the problem go away. We shouldn't expect more of treatment than it offers. We should make legal maintenance opioids available to those who seek it. Some people function quite well on them. We should hold addicts responsible for stealing or endangering others, but not criminalize being an addict.
A major change will come about only when Americans restore their sense of spiritual meaning and dignity that has disappeared into a materialistic pleasure seeking dead-end culture of death.
2
Who is the master that makes the grass green?
It is you, NYT. You do not grasp Trump and the right wing's genius. He throws us ravenous dogs the red meat while the racist nerds rip apart any decency hard fought and barely won.
In 2006 Rush Limbaugh admitted being addicted to pain medication-Oxycontin revealed by authorities as one of the medications he 'doctor-shopped' for. He ultimately pleaded guilty and avoided jail time by admitting his addiction and accepting a stint performing 'community service'.
Here is a radio personality with an audience of upwards of 20 million listeners and Wow!-was this ever a 'hair on fire learning moment' that got swept under the rug. And this wasn't abscure news at the time. Today it would be seized upon by many from the 'right hand side of the aisle' and proclaimed to be 'Fake news'. But locally in Palm Beach this was big news, especially when Limbaugh was forced to take a 5 week leave away from his 'Golden Microphone' to enter 'rehab' to get clean. Do you get that? Rush Limbaugh had to get clean.
But this was a 'white guy' addicted to drugs which broke the time worn mold we have that that only blacks were drug addicts, pushers, enablers that hung around schools and playgrounds lookiong to get kids hooked.
And what did the pharmaceutical industry do? They held their breath and hoped for the best, hoped Limbaugh's addiction would merely be a dust-up, and blow over once Limbaugh's attorney's got to massage away jthe damning truth using the age-old 'Deny, Deny, Deny' defense, and Voila! A supreme 'learning moment' drifted off into the sunset, and with it took tens and tens of thousands of lives, ultimately crippling entire communities throughout our country.
7
I read what was published on Limbaugh and found the quantity of prescription drugs that he was using unimpressive and in the range accepted by many physicians for chronic. Had he not had had a disagreement with a member of his household staff, had he not been a mile wide celebrity target this would have been a non issue. May be he was headed for more trouble and it is best for him.
The real news there was the unprecedented use of search warrants in the doctors offices instead of the usual procedure of using a subpoena to get a specific patient's file. Unfortunately that was upheld by the courts and is a serious blow to patient privacy in Florida since a subpoena can be challenged in court before it is satisfied.
2
The ill informed, incurious president breaks the only promise he made that he actually should have and could have kept. Just like Ronald Reagan and the AIDS epidemic.
7
Trump's inability to focus any longer than the movie depiction of the Eye of Sauron in the "Lord of the Rings" trio is the true evil. Empty words about prolonging the failed War on Drugs begun by Tricky Dick coming from an empty mind, inhabited only the chimera of his ego...
3
Trump's comments on opiods:
...It is a tale (told by an idiot?) full of sound and fury, signifying nothing...
2
...or, to quote another Shakespeare character, "Words, words, words..."
Got a problem in Trumpworld? Call it evil, problem solved.
5
Trump only put Lipstick on the Opioid PIG! He got a photo op, and, in HIS feeble mind, a win, which HE desperately needs.
6
"...Scott Gottlieb, commissioner of the Food and Drug Administration, advocated expanding the use of medication-assisted treatments, such as methadone, buprenorphine and naltrexone, citing evidence that they are effective in reducing overdose deaths."
Certainly the availability of these resources is a very good thing.
But underlying this recommendation is the quintessential Republican version of the virtuous business cycle: see a market, create a problem, enlarge the problem, sell the solution.
This "epidemic" was years in the making, and an obvious cause for alarm.
At the beginning the source of the problem was the unholy combination of Big Pharma business and government acquiescence, not to say enthusiastic support.
Its a wee bit late for any politician to ride in claiming the mantle of savior. Late and offensive.
Trumps incompetence shines forth every time he opens his mouth and ignorance pours out.Here in Ohio,in the Dayton area we have more then 500
Dead.These are not adolescents experimenting,these are people in pain,prescribed too many opioids by Doctors.Because the drug used in these pain pills is so deadly ,frequently too much is taken and death follows .The pharmaceutical companies know this and are often sending huge amounts to
FERTILE. Areas.I hope some Senators and or the public sue the pants off these legal drug pushers
Pushers
As one who was addicted to coke in the 80's and shot up meth through the 90's, I'll tell you this...
It is not the job of the government to babysit you and keep you off drugs. It is not the responsibility of the the taxpayer to take care of you because of your desires to escape instead of manning up and taking care of your life.
It is your job.
14
Bravo. And congrats on getting clean.
3
And when your drug use costs me more for your lost productivity, increased policing, increased health care costs you are my problem. My investing in your recovery and use prevention in order to get a productive citizen helps us all.
3
Dear Randy L. As an alcoholic who has not had a drink of alcohol for slightly more than 26 years I totally agree with you that it is the addict himself or herself that must take the major responsibility to quit doing what he or she is doing. For me personally A.A. aided me in my continuing to remain sober but in the final analysis
it was/is me who decides every day not to pick up that drink.
2
Of course it’s all words it’s all deflections to keep the media busy focusing on his empty words, Clinton’s dossier, JFK’s documents etc., instead of Niger, tax cuts and anything else of any substance that the rump gop is doing to us.
1
Donald Trump does not believe in Public Health.
Donald Trump does not believe in science.
Donald Trump has no interest at all in providing relief by making resources available to carry out long-term treatment, even of his very own base people, so deaths from addiction will continue to escalate.
Not a chance that a #metoo counterpart can provide what is needed during 2018 and beyond.
Only a change of president will do. And since that will not happen soon, you, ordinary Americans including without a doubt DT's ordinary Americans, will just have to keep on suffering and dying.
Only-NeverInSweden.blogspot.com
Dual citizen (ordinary) US SE
3
Barack OBAMA let thousands and thousands of dope dealing thugs out of prison and back on the streets, you have to realize a large part of the illegal drug trade is attributable to these lower level street managers.
This is partly why heroin is making a come back.
That combined with the ease of legal opioids and bingo-instant crisis.
3
As someone who lived on the fringes of a poor black neighborhood, I have to tell you that you are wrong.
In the US, elite white college men and white executives deal the most drugs and use the most drugs. They have the cash, the frat houses and estates to use as stash houses, the private planes, and most important, police officers cannot touch them. Our wealthy white dealers are above the law.
Any low-level minority seller shivering on a street corner all day just to make a few dollars could tell you that. They envy the power and freedom that the elite white sellers enjoy.
1
Did anyone expect anything different from Donald "A Legend in His Own Mind" Trump? He's the biggest windbag in the history of national politics. I nearly vomited when I heard him refer to his deceased brother. If he had one shred of normal human emotion over the loss, he would have "put his money where his mouth is." My brother was killed by a drunk driver almost 30 years ago and I've spent hundreds of hours working with people suffering from substance abuse since then in his memory and given money to support local AA and NA groups. Talk is cheap. Walk the walk, Mr. President.
5
Let's do the math. How many Americans are killed by opioids every year? How many by guns? And how many by terrorists?
This administration cares nothing about the lives of Americans. It's a tinpot despot government interested only in extending its own power. And our elected officials are aiding and abetting it.
3
Trump has assaulted women, lied continuously to the American people, connived with Russians, played fast and loose with his taxes, helped bring this country to the brink of nuclear war and turned the U.S into the laughing-stock of the world.
And is now planning to battle opioid addiction with "really great advertising."
There are probably tens of thousands of families, if not more, who voted for him on the basis of his campaign promise to do something real about the opioid crisis.
I wish them the best of luck. Their children are going to need a lot of it.
31
Well, really great advertising has made many a fortune. Aspirin is aspirin is aspirin, but really great advertising has elevated name-brand aspirin, which is no different than any other aspirin, to a point that it costs much more than generic, and folks still buy it. Really great advertising convinces folks to buy clothes that don't fit and food they don't really like and cars that are ill-suited to their needs. Really great advertising gets bad politicians elected.
Whether anyone wants to admit it, really great advertising actually works. That's why companies spend $1 million per minute for Super Bowl commercials, above and beyond the millions it costs to produce the ads themselves. In fact, really great advertising might be one of our best hopes here. We've pretty much tried everything else. What we haven't tried is advertising that cuts through the crud and delivers a message that resonates.
This so-called crisis did not start with Trump but he is the one ultimately in charge. And really if Congress doesn't give a rats behind, it isn't going to matter what Trump wants. By declaring a national health emergency (this really is not any more of an emergency than the cocaine crisis in the 1970s) it free up funds to "help".
Obama and laws makers of the last congress intensified this so-called crisis by restricting how and when doctors can prescribe strong pain medications. They only cared about the addicts and didn't give a single thought to how real people were going to be harmed.
To de-escalate this crisis, treat peoples' source of pain and get mental health services to people BEFORE they choose to self medicate. And if anyone really cares about stopping addiction, make it illegal for doctors to prescribe anti-depressants to people for pain control and ban Adderall.
This is one of the clearest examples of the lack of competency of this President. Because opioid issues touch so many, perhaps the country might soon realize that the news of this President's deficiencies, is quite real, and not fake.
2
Trump talking in stages - that would be the very, hugely, or bigly stages. Nothing else clicks with him. He's so impulsive and distracted that he cannot even obviously comprehend. I would guess it is very difficult for his staff or anyone to have more than a few minute conversation with the guy, so how could he be educated about even a topic as important as what he calls "the opioid crisis" that he's going to fix. Sounding like he's calling on Angel Nancy Reagan to help "just say no" and make everything ok.
Yesterday we wondered what kind of funding Trump was authorizing for his fix-it program. Today we find out he's not offering any funding. As usual one big blanket u rah rah statement, a lie, in fact, as among many Trump lies, is what people have in regard to "healing" a sick nation from "the crisis!"
Face it. The man loves to hear himself talk and get cheered. Nothing concrete in the midst of his talk and the cheers. He fabricates. He teases. He does not produce. The pattern resounds.
This time families who hoped the news meant something can just hang their heads.
3
Trump lacks knowledge about addiction and this 90 day emergency declaration is proof he does not understand the science of addiction nor state of opioid crisis. Despite his campaign pledge to families in hard hit states, once they voted ...... Nothing.
1
The opioid crisis has been allowed to explode because the victims' collective profile serves no desired ideological narrative. Conservatives don't care about them because they're too working class. Liberals don't care about them because they're too white.
1
“I still have not seen the passion for this epidemic that I saw in the AIDS epidemic,” said Gov. Chrisie. True, since opioid use is not contagious therefore not really an epidemic. HIV/AIDS at first mostly infected (gay) men who had sex with other men (a small percentage of the population) who therefore began a large and very effective lobbying campaign for research money, drug development, education and treatment. They still are.
Very legal Alcohol and Tobacco kill many more people each year then fatal overdoses. Since they die slowly, instead of withing hours of their last self inflicted dose, it does not get much newspaper, TV or social media coverage.
No president can wave a magic wand and solve this complex problem. Blaming Trump for the failure of a new effort the day it began is ridiculous. National emergency orders are rightfully reserved for actual emergencies like an Ebola breakout not a 100 year old complex drug abuse problem. Most people (>99%) take their pain medicine as prescribed and have no problems.
2
One of the few truthful NYT letters.
2 facts and one personal observation:
In recent studies 9/10 opiod users don't want a treatment center(so throwing money at it is a liberal fallacy).
Most opiod(over 50%) users concominantly abuse ETOH, Meth and some combination of barbituates and methadone/Heroin. Naloxone works on 2 of these. Many EMS providers see the same person overdosing 2-3 times a week. This is a (this statement will make me look bad) awful use of our tax dollars for people(frequent overdose people) who are not paying significant amount of taxes.
I have friends who work in jails in Pa. who say that less then 5% of the opiod use is only one drug. Everyone uses multiple meds- Meth,Crack Suboxone, Methadone, bath salts etc.
1
Drug history of the U.S. from the 1950's to today:
1950's - Heroin - which hurt Harlem big time
1960's - LSD, heroin - hippie time
1970's - Cocaine, heroin, pills - uppers, downers - disco time
1980's - Cocaine, heroin, pills- uppers, downers - Wall Street time
1990's - Crack, crack, crack - crack addicted babies time
2000's - Crack, meth, opioids - more addicted babies time
2010's - Meth, Meth, opiods, opiods and heroin makes a comeback. When will this end?
Which president in these decades found a way to STOP or greatly reduce drug addiction? There are solutions, but it costs money. Who wants to pay for this? Drug addiction is a disease, but it's not a disease like cancer, so middle class tax payers do not want to pay for this, even though some of the addicts are middle class.
2
How I wish the Editorial Board would cease from spurious conclusions when trying to make a point:
"President Trump’s brother died an alcoholic, so it’s hard to dispute that Mr. Trump understands the horrors of addiction." Hard-to-dispute? Really?
The Editorial board is talking about a man who was malevolent enough to do the unthinkable; cut off the "Family health insurance" of his "alcoholic" brother's severely ill grandson (Trump's great nephew). Please do not give this man some type of cover. Mentioning his brother today- was nothing more than a PR Stunt. If he truly cared about drug addiction- how about commuting the sentences of hundreds of thousands of black and brown men and women incarcerated for the same health crisis- drug addiction; Crack (poor man's cocaine), heroin and meth and remove their felony status? That- would be an act worth remembering- not using the name of a deceased brother for one's own publicity.
7
Trump said that the plight of Puerto Ricans, after the hurricane, is partially due to their own inaction to help themselves, so who can believe that he doesn't hold a similar view of drug addicts. He may have been profoundly affected by his brother's death to alcohol, and his choice to not imbibe may be due to that incident. So his proposed advertising campaign to encourage people to just say no to drugs, while a noble sentiment, is totally unrealistic. Most addicted people see themselves as having no choice. They are taking an easy, and least costly, road away from their troubles. Troubles that stem from a poor education, lack of job opportunities, and myriad other causes.
A real leader would be proposing real solutions and would seek the means to implement them. He/she would not be offering platitudes as Trump has just done. A real leader would be consulting with the sharpest minds available to find actual answers. A real leader would be visiting the local clinics in the hardest hit areas and talking to the care givers there.
I don't expect Trump to do any of this. He doesn't really care.
26
Prediction: In about two weeks Trump will give himself a 10 for his dealing with the opioid epidemic. Art of the Deal?
2
They should make it easier, not harder, to get a bottle of these things.
Anything to help dull the pain this new national nightmare of an administration is causing to those of us not in his "base".
2
"The Affordable Care Act improved access to addiction treatment by expanding Medicaid, which covers three in 10 non-elderly adults with an opioid addiction. Yet the [current] administration and Republicans in Congress have repeatedly tried to repeal the law or slash its benefits". Yes, the ACA, which bears the black president's name was aimed at helping all Americans with pre-existing conditions and making health care affordable but millions of lower and middle income white males afflicted with this disease overlooked their health benefits and enthusiastically championed the Republican nominee's message of racial exclusion focused on the GOP's relentless race-baiting of repeal and replace the health care law. It's too late to be sorry or have regrets now.
1
All talk, no money. But what else did you expect from a "builder" who routinely stiffed his contractors, his lawyers and his partners?
3
It was touching that Donald Trump referred to his late, lamented brother Freddy Jr., who died from alcoholism in 1981.
Readers with access to the Internet might Google Freddy's grandson, William. From an early age, young William suffered multiple medical problems, requiring hospitalization and expensive medical attention. Donald Trump had provided the youngster with health care coverage.
However, when Freddy's son and daughter-in-law contested the will of Donald's father, Donald Trump withdrew all medical coverage from the ailing infant, who had been diagnosed with cerebral palsy.
"Why should we give him medical coverage?" asked Donald Trump.
Thus, the heart-rending story of Donald's love for his brother is belied by the facts. The ruthlessness and cruelty exhibited by your president is breathtaking, but no surprise at all.
NOT my president
5
Chris Christie is attempting to rewrite history when he claims that “I still have not seen the passion for this epidemic that I saw in the AIDS epidemic." The US government did nothing to address the AIDS epidemic for years. It was forced into action by radicals who demanded it, who staged non-violent demonstrations, shut down government agencies, developed research protocols, and took care of the sick. It will take the same to get the US government to do anything meaningful regarding the opioid crisis. Never forget that our politicians are owned by the pharmaceutical companies that manufacture prescription opioids. Get mad, start organizing, raise money, and take action.
1
Everyday, nearly 100 people die in the U.S. from opioid overdoses caused by widespread addiction to powerful prescription painkillers. The crisis started in the 1990s when the US pharmaceutical industry began strongly marketing highly profitable legal narcotics, particularly OxyContin, to treat common pain. This slow-release opioid was vigorously promoted to doctors and, with very lax regulation and very slick sales tactics, physicians, nurses and patients all were assured it was safe. In reality this deceptively innocent & supposedly safe drug was actually a very dangerous luxury morphine, doled out like super aspirin, and highly addictive. The result was a profitable commercial win/win for BigPharma and a public health disaster for everyone else. Desperate efforts to reduce distribution has produced the side effect of a resurgence of heroin use and the emergence of a deadly, black market version of the synthetic opioid fentanyl. Today's deep opioid crisis affects all regions, income & racial groups and must be tackled with strong funding for treatment and ongoing public health prevention programs. Big Pharma should be heavily fined and return its ill/gotten gains for its role in causing this disaster.
25
Although I agree with most of this comment, I feel that placing blame primarily on "Big Pharma" lets some truly guilty parties off the hook. As extensive investigative reporting from the NY Times, WaPo, and elsewhere have clearly shown, the federal regulatory and law enforcement failures subsequent to meddling by members of our corrupt federal legislative bodies that blocked efforts to shut down "pill mills" allowed this problem to explode. There is plenty of blame to go around.
2
This line of thinking has been repeated so often that it has become suspect, and with good reason. OxyContin was never recommended for so-called common pain. Rather, it was always designed for use by folks with chronic, severe pain so that they wouldn't have to take so many pills. Oxycodone, the active ingredient, has been around since World War I, and its potential for abuse has long been known. People didn't just wake up a decade ago and say "Gee, Oxycodone can be habit forming." To suggest otherwise is ridiculous.
If you want to blame someone for the prescription abuse "crisis," blame the Food and Drug Administration. The government, after all, approved OxyContin. I think it's true that OxyContin never should have been approved, given its potential for abuse. We're talking ten or so Oxycodones wrapped up into a single pill--what did folks think would happen? But you can't blame Big Pharma. They only took what the defense gave, which is the way capitalism works. Regulation was the same as for any other prescription drug, so it is baffling that anyone would call it lax. You could also blame doctors. Any physician who believed that OxyContin wasn't addictive wasn't smart enough to be a doctor. Any fool knew better.
Prescription painkillers are godsends to many people who would not be able to lead anything resembling normal lives without them. Most people who are prescribed these drugs never develop problems. We need to remember that.
At least include some accuracy. Having faced the chilling effect of pious opinions like yours and politicians looking for quick gains, I know Drs. who carefully prescribed and discussed dependency and addiction with patients back in 2002. I also know the chilling effect of State DEAs bullying Doctors and Pharmacists a decade ago who were doing everything right but were an easy target - much easier than the criminal enterprise that accounts for most of the deaths from opioids. Just because the media says prescription opioids, doesn't mean the users obtained them from Physicians. Remember the old days when marijuana was blamed as a gateway drug to heroin? Now the blame is placed on opioids, Pharma, healthcare providers, etc.. All of this is a way for our attention to be diverted from the real issue: this nation's failed War on Illegal Drugs and failed legal policies on drugs in general. We will all suffer when our loved ones and/or we suffer from the pain of cancer and many other conditions and will be forced to endure the agony of our ignorance and our government's decades of lies.
2
What happened to the great brilliant Jared Kushner, who was tasked for this issue?
7
There is no doubt that Purdue Pharma and its owners, the Sackler family, knowingly created the epidemic and profited enormously from it. It, and they, should be morally and legally compelled to help reduce it. The current issue of The New Yorker magazine contains a riveting, long-form piece on the subject. It's as horrific a tale as that of tobacco industry executives of yore.
Francesca Turchiano
7
Show us the program. Show us the money. Allocate the funds. Most leaders have an outline of ideas, costs, and backers when they give this kind of speech. Hollow promises are being made. The base will believe Trump is going to do something about the opioid epidemic. That's good enough for them, the gullible base.
1
The drug companies who profited from this need to pony up big time to help mitigate what they've done, voluntarily or otherwise.
4
He just wanted to pretend to do something about the crisis because his supporters need him to do something.
If he believes that resisting drugs is easy, then he does not understand addiction and its social/economic context.
5
I'm dealing with a health problem that could be alleviated a great deal by having an opiate prescription. Because of recent attention on this issue, and 'cracking down' on use of painkillers, the baby has been thrown out with the bathwater. I have honestly considered seeing if I could find some illegally - but stopped at the 'thinking' phase of that one. It did, however, occur to me - which is alarming. I don't want them recreationally, I want them to stop being in pain.
22
There really are a large variety of non narcotic medications, procedures and physical therapies that can greatly help with severe pain, so I hope you can find access to pain specialists who are knowledgeable in these area! Best Wishes.
Emmy, if you are in legit pain that has a real physical cause, there is no reason you can not get relief, not a fix, from opioids. But keep in mind, its not a fix. Opioids do not fix pain that has physical causes...that can be diagnosed as such.
But if doctors can not find a physical cause for your pain, they should not be prescribing opioids. If you have back pain, not determined to be caused by real injury or disease, opioids are not going to work, period. "Pinched nerves" (due to disc issues) do not stop being pinched with opioids. The pain remains, and while the edge might be taken off...its short term, and more of the drug is needed to reach a tolerable level...and thats where the addiction slips in.
Honestly, I understand. I was given a scrip for Vicodin for breakthrough pain about 7 years ago. Because I use it so infrequently, I never have had the constipation side effects. n August I had a neck injury. I went to an Urgent Care center. I told the doctor I was there for a collar and the constipation medication- because I would be using my pain pills more frequently over the next couple of weeks. Without even looking at me, the first thing the doctor said was, "We do not write scrips for opiates." Honest-to-God. I LOUDLY repeated that I wasn't THERE for the opiates because I had my own.
That's how brainwashed some doctors are. Thank God I got that prescription with my primary care physician in 2009- before all this panic and overreaction started.
And I used that Vicodin for 9- 10 days. The pain resolved and I haven't used it since. There's many of us who don't get addicted to it. I truly feel for you. Maybe you need to find a doctor who will treat you like an adult.
BTW, it did NOT make me "high". It just made me feel normal enough to do my daily functioning.
1
Once again the NYT editors advocate the same solution for every problem - more federal government spending. Does it ever occur to anyone that perhaps this is a problem better addressed at the state or local level? Yes, the FDA has a role here, but the basic problem of prevention and treatment is a local, not federal, issue.
2
The opioid crisis has engulfed small towns and states that do not have the resources to fight the issue. Health pandemics are an issue in which the federal government is the most appropriate and effective response, as the opioid crises is in fact now a national pandemic.
1
Addiction is behavioral and substance abuse. Both. In that order.
One can cause the other. But behavioral behavioral is more dangerous, and more difficult to address.
Sticky Fingers by Joe Hagan connects the dots for both. Valuable book. Well reviewed by The New York Times’s best.
From Rolling Stone et al to President Trump. Straight Line.
Narcissism rules. It’s addictive. It’s old news. Post WW II.
Money talks. Drugs make men rich, kill kids.
Money will not alter addiction. Not one bit. May make it worse.
We must change ourselves. Top down.
Parents must parent again.
We will not make us great again with denial and rank narcissism.
Virtue is its own reward.
We are no longer virtuous. Our leaders follow us.
The callings are riddled.
Our teens know.
1
“If we can teach young people not to take drugs, it’s really, really easy not to take them.”
This is not sloganeering. Slogans have a conceptual core, or at least sound catchy. This appears to be a desperate attempt to come up with a sentence that is simultaneously tautologous and contradictory.
As for how it's reminiscent of the shameful persecution of minority drug addicts in the 80s and 90s, there is simply no chance of that happening now because it would not be the faintest bit politically expedient to target white addicts. Instead, Trump and whichever lucky soul gets to be the next Health Secretary are just going to ignore them and leave them to their fates.
1
And now, apparently, Trump’s beleaguered AG, Jefferson Beauregard Sessions III, brilliant man that he is, is proposing to crack down on marijuana use. He states that marijuana is a well-known “gateway drug” to opioid addiction. His sources for this wisdom are “all the cops I talk to.” With ignorance like this leading our country heaven help us. I’m certain all the states that have recently legalized both medical and recreational marijuana will comply immediately.....this should prove very interesting.
13
It is unforgivable that a man so benighted can interfere so profoundly with the lives of others across the country.
2
When all you have is a hammer, everything is a nail.
2
If you want to understand one of the most important roots of the opioid epidemic then the New Yorker article about the Sackler family is a must read. It gives full dimension to a family cartel that used their expertise in medicine and marketing to deceptively oversell their drug OxyContin as a safe, nonaddictive pain medication to doctors happy to accept their add campaign. The details of this article give a new perspective on who the drug pushers really are. Stunning in its detail.
https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-e...
4
Oh get with the program.
Just like the wall (which is beautiful and costs zero), Trumpcare (which will replace Obamacare, cost less and give more benefits), foreign policy (every country will love us, do our bidding and give us money), tax cuts (that will cut the deficit and debt to zero, produce growth, create jobs), immigration (only highly educated and rich immigrants from Scandinavia only), this policy will eliminate all drug abuse in America painlessly, and without a single penny spent by yesterday.
Or did you not read Edsall's Oct 26th brilliant, well-researched write-up explaining the 'gone caseness" of republican voters. How affect rules, and by default, cognition is dead; and how that drives republicans' voting behaviors. To date, it is the best explanation of the current dystopia.
Trump is looking at the following. Republicans will vote for him regardless of what they espouse in 2020. So will more white women and Hispanics than 2016 - now that he has kicked Puerto Rico, and gutted education, EPA, and justice. The best democratic minds, by contrast, have zero vision, and are seeking common ground with white nationalists. In 2020, democrat voters, the weak willed, self-indulgent whiners, will sit out the election over one self-righteous fit or another.
It is completely rational for Trump, given the reality he faces, to define a solution to all opioid addiction as a matter of announcing intent only.
Kalidan
1
What did we expect? An Presidential display of actual leadership? An articulate, intelligent, in-depth analysis of the problem, a commitment of all necessary federal resources to address it, a comprehensive short and long term plan of action? Nope. The dope reverts to talking about himself. The scourge continues and he'll be on the golf course this weekend, swinging away. MAGA!
5
In national (and international) epidemics as the opioid crisis there are clear correlates between public perception, economics and politics. The opioid criris strikes different democraphics than other epidemics: white, middle-class, young. Medicine, and medical economics are involved: In development of pain killers there was a clear profit motive on the part of pharmaceutical firms that fudged on the dangerous trade-off between pain-relief and addiction. There was a national and international campaign to rethink and reeducate to stress less the danger of addiction in favor of pain relief. In adversising campains geared at physicians the benefits of opioid pain killers prevailed in physicians' mentality over their concern for addiction. That was something new in the medical and pharmaceutical industry during the last 20-30 years. Those innovations were plaanned and carefully pre-conceived and executed, all driven by huge profits to the pharmaceutical and medical-clinic practice industries prescribing such opioid pain killers often with the full awareness of causiing public harm. The nation has yet to realize this clear correlation between our American culture and its "medical-industrial complex" to modify Eisenhower's term: Medicine can and now clearly does cause huge national harm and a crisis in the very field it swears under oath not to harm. We must begin to realize that incompatibility between medical capitalism and public health concerns. It is a national crisis!
3
What the government should be doing is offering treatment to the afflicted while going after the pushers with a vengeance.
1
Yes, the pushers! We have to go after the drug companies, and the doctors that over-prescribe the stuff. Oops.. this just in from the lobbyists: "Stick to ridiculously naive ad campaigns, and don't mess with our profits, or else no re-election for you."
My theory: Look for consistency. The issue here is the same as every other behavior from #45. He utterly lacks the capacity for normal human empathy. So he is not at all moved emotionally by the opiod stories or statistics. I would guess, "lock 'em up!" is in his black heart, but even he knows that would produce a firestorm even among his base and so he stays his itchy twitter finger. Why else would he not see 50,000 deaths a year as an emergency? The other factor is one I honestly have not explored. Watch a ton of Fox News and see what they say about it and if they're even covering the story, because that seems to be where he gets a lot of his "facts."
1
Recall back in April when a call was made to Duterte in which admiration was expressed regarding progress in his war against drugs. This president has hinted about turning the police loose for street justice. Notice how ICE operates more and more inhumanely. This is our direction. Good luck, America.
I think it's a harder sort of epidemic to treat much in the way that AIDS was early on. I am guessing that many people just don't care much, possibly including Trump. It's easy to think it won't hit you, because you, and your nice Christian children, won't engage in the behaviors that cause it (i.e.: accepting opioid prescriptions from doctors for pain, experimenting with heroin, etc). Look at how freaked out people got over, what? Maybe 4 Ebola cases in the US? It's because people didn't have the sense that they could prevent themselves from getting Ebola if it were to hit their communities. And maybe because Ebola, unlike opioid addiction and AIDS, unleases its gruesomeness all at once and not over a period of months or years.
14
Oh, please. This President and this Congress wouldn’t know a plan to escape a paper bag! Trump peddles a serious sounding attack on addiction while he eviscerates the insurance healthcare that the addicted might try to use to escape; Congress plans a budget that shrinks everything but the deficit and will shift the real costs to the middle class and into state legislatures (closer to the problems); and Jeff Sessions is Johnny-on-the -Spot to incarcerate anyone with dark skin who also happens to be addicted to opioids. Yup. We ought to have this problem licked in no time.
2
Your editorial shows almost as much a lack of awareness of opioid addiction as does the president.
First, of all with regard to expanding use of methadone and buprenorphine, no one has yet demonstrated that those are the most efficacious treatment for people who become addicted to opioids after being prescribed them for a legitimate pain complaint.
You also fail to note the role benzodiazepines play in over 30% of opioid overdose deaths.
If any of your editorial writers knew about opioids, you'd have pointed out how ludicrous it was for Trump to be calling for the banning of an opioid which from reports he meant Opana. Opana is oxymorphone which is the analgesic metabolite of oxycodone, the opioid in Percocet and OxyContin. I don't understand why it makes sense to ban the metabolite but not the drug which is metabolized to it. But, of course, why bring science into a discussion of drug addiction.
Finally, as to Trump's call for non-addictive analgesics, we already have many available that in many forms of chronic pain provide more relief than opioids. The problem is most doctors have so little education in pain management, they aren't aware of these.
Another demonstration by Trump of his utter ineffectiveness and unfitness for office. He can't stop himself. He's the living embodiment of what he means when he says "really big, really great." That is, emptiness.
The primary target of any policy that deals with opioid addiction should be non-users who might become users. Addicts should be put on maintenance not sent to rehab at taxpayer expense because it is a farce, and sellers should get two-strikes and you're out for life, at best. Vast money should go to addiction prevention for very young people. Once you are an addict you need to be paying for own mistake, not riding your junkie way to clean on the taxpayer dime.
The fog under which people consider addiction policy is alarming in itself, full of illusions. Junkies cannot be cured by "treatment," there is probably a 1% success rate and those 1% would have stopped by themselves anyway. Any junkie will tell you, treatment is for avoiding responsibility, taking a break, gathering your strength so you can returning to using and is a joke. And addict dies of old age dreaming of a fix. The false idea that addiction is treatable has created a high-profit rehab industry that lobbies for more of the taxpayer's cash while showing no results.
1. Register addicts and give them prescribed dope in exchange for turning in dealers and users, 2. slam the prison door on black market sellers, 3. prevent young people from starting with big money for drug education. And, 4. make introducing a non-user to dope a separate serious felony. Misery loves company, that needs to stop, junkies need to be isolated. Anything else is illusory PC-driven money-wasting naivety.
2
As usual, the braggart-in-chief makes a statement signifying nothing. There is no way the opioid epidemic will be addressed with health care being dismantled by the Republicans. As it is now insurance companies have intolerant policies toward addiction. When my son struggled with his addiction I had what I thought was excellent medical coverage. However, our insurance allowed for three inpatient programs in a lifetime. Like many addicts in the grip of this addiction, he fled the treatment facility about an hour after checking in. Well, that counted as one inpatient stay. In short order, he ran out of options for treatment.
I am continuously amazed at the ignorance of those in government that refuse to se that addiction is a complicated disease, there is no quick fix. We are losing a generation of beautiful young people while the Republicans are determined to make it even more difficult to get help.
2
Trump is more interested in a show than results. He's also cheap when it comes to spending money on other people. He and his Republican enablers would be happy to deny healthcare including addiction treatment to the poor. It's a moralistic, and conveniently self serving, approach that hates 'rewarding' bad behavior with resources.
Shame and criminal justice punishment are their style. But they're happy to make it look like they care and are taking action - as long as it requires minimal real resources.
Remember, tax cuts aren't going to fund themselves.
1
It is contemptuous that the president stands up a month ago and states that the opioids epidemic is a "national emergency" and that he will sign all the paperwork to provide the resources to fight this scourge, then yesterday he plays his shell game. He offers trite rhetoric and $56,000. This amount wouldn't even fly his Secretary of the Interior home to Montana.
I'm so tired and angry at being lied to and cheated. I can now empathize with all Trump's business victims, i.e. Trump University, casino contracts, etc. Now he swindles this entire country. He may be "winning" but we certainly are not.
2
How does this differ from our "war on drugs"? Certainly, these opoids effect "white" citizens, so we can't use the black strategy of "lock "em up", but without additional monies, the availability of the ACA and Medicare, this is empty rhetoric. Both black and white citizens suffer the same drug escape from the harshness of life,
Although the whites are Trump voters, that will make no difference to this
Administration. We all know their commitment to their donor class, who really need their taxes reduced substantially. So much noise without any change in policies.
1
More words...? And what did we expect?
If opioids were an environmental or business regulation - he'd bring the full force and weight of the Govt to solve it.
2
By now it should be clear that Trump has not had much experience doing anything concrete. His fanboys may call him a builder, but as a real estate developer, he managed to take a multi-million dollar inheritance and turn it into six bankruptcies and hundreds of lawsuits for cheating contractors. Trump's not a builder, he's a promoter. It wasn't until "The Apprentice" that he moved beyond tabloid celebrity status.
So, it's no surprise that most of the time, Trump really seems to be more of an actor pretending to be president. There are plenty of actors who learn the movie craft and go on to be bonafide producers and directors. But that's not Trump; for him, all problems are someone else's job, e.g., Congress.
In truth, Trump has no idea that complicated tasks require organization, planning, and detail-oriented work. Candidate Trump was famous for his lack of debate preparation and for his miserable handle on the facts. It's common knowledge that he doesn't read and can only understand short pre-digested summaries of the news presented to him. In Trump's world, details are for assistants.
So why should his lack of action on the opioid crisis surprise anyone? This is a man who believes that, as President, his words should magically be transformed into actions. You'll never convince him otherwise.
8
What policy initiative announced by Trump has had any details?
His disaster relief is the best, he guarantees it. His health care policy is the best, believe him. He will revive the coal and steel industries with nothing more than the stroke of a pen. And he will single handedly eliminate the scourge of opiate addiction with "This is Your Brain on Drugs" commercials. Because they have worked so well in past drug epidemics.
I am not a great admirer of Bill Clinton. But he got one thing right - one core thing. It's the economy, stupid. Begin there. Fewer recovery programs, and fewer war on drugs programs will be needed.
2
Apparently Trump does not understand the real lesson of his brother's alcohol addiction: that addiction is irrational, as evidenced by his brother warning him about alcohol while continuing to drink himself to death. The lesson to Trump should have been that a "just say no" approach does not work if you are an addict or a potential addict. The people who actually do get how addiction really works are in the boardrooms of the drug companies who cynically chose to create this opioid crisis for their own profit. Maybe while we are educating young people about the downside of drugs we could also "educate" a few of these people in the boardroom by sending a few of them to jail?
5
The opioid epidemic is only a symptom of the the real epidemic America is suffering from, a pandemic of anxiety and despair. You want people to stop taking pain-killing drugs? Stop inflicting pain on them. Give them jobs, and a real reason to believe in a better future. At the same time Trump gives lip service (the only thing he knows anything about anyway) to solving this problem, his cohorts in Congress are about to inflict a devastating tax "reform" on most of America that will only worsen the desperation. Why do we tolerate this insanity?
43
Gene - yet the issue of acute pain caused by injury or disease is real. And its more the issue with the Rx drug industry, Purdue Pharma in the case of Oxycontin, PUSHING their drugs as a cure-all, and necessary therapeutic tool, that contrary to their marketing are highly addictive substances...which are NOT easily quit by merely going cold turkey. Add their lobbying powers and this crisis is not simply a lack of jobs (which is a canard) its more about billionaires running the tables, and our elected employees being swayed by their ploys.
As a nation we are not addressing the real medical needs of a small segment of the population where real pain management for real needs is crucial. Prescribing opioids for every pain under the sun, should never have been allowed to become a systemic practice...amd the doling out of them should have been severely restricted.
The vast majority of deaths - 200K+ - since the mid 90s due to opioid addiction were not jobless, or hopeless people. Esp. In the first 2 decades.
One aspect of this epidemic not being addressed, is the American reliance on far too many Rx drugs, most with destructive side effects. That too many Americans are claiming to be in "real pain" that doesnt need, and can not be fixed by opioids, but are being wantonly handed opioids as miracle cures. And we're gobbling them up like Skittles.
There is no job fix here. And its certainly not gonna be a job fix from the Fed govt. This is so much more then a jobs issue.
Thank you for this comment. It seems there is a big blank space after prescriptions for drugs, drug treatment and half-way houses. People need a life and friends worth returning to.
Exb...if an addict has eradicated that return-to life...what do "we" do hand them one?
This is not a jobs-fix problem. Its so much more, and way more complex.
What about all theblack and latino recovered addicts out there? Did we hand them back a new and good life? Or did they have to rebuild, from scratch, and stay sober?
You guys are all putting the cart, the cargo, the passengers way ahead of the horses.
Im all for giving addicts the necessary help, and making it 90% cost free, but we cant hand them back a perfect life, after they destroyed it.
Smells like people want this sort of fix, because its now seen as a white peoples problem. Whites are victims, while people of color are free-will addicts.
This is not a jobs related issue!
Given the content of the rest of the essay, why did you even bother to include the first sentence. It's conpletely unsubstantiated by facts. trump is only capable of blowing a lot of hot air and puffing himself up. He is the ultimate empty suit.
3
No one has grasped what’s needed to combat the problem ... certainly not you.
At its core America's drug problem is a CIVIL RIGHTS issue.
It's 2017, and while it's legal to marry across races ... marry the same sex ... and *of course* be completely free from insitutionalized bigotry when it comes to race and sexuality.
... and while we've made such great progress there somehow most Americans believe I don't have the right to treat psychological or physical pain how *I* see fit ... with narcotics.
Somehow things seem to just be getting worse and instead of a slow progression towards equality the trend is to now prevent those of us with spinal cord injuries, pancreatitis, MS, etc .. and god forbid cancer or other more rapidly terminal illness (pain is terminal all by itself) from receiving treatment even from doctors.
"People who can't get prescriptions are buying pharmaceuticals from illicit sources and dying. oooh ooh. I know what to do let's force *everyone* to buy from illicit sources so they can ALL die!"
Trump does not understand addiction. Just his own pain!!!!
And that has nothing to do with being at the tippy top of a compassionate government, in the midst of an opioid crisis.
Likely Trump felt forced to declare an emergency. But my guess is that Tax Reform, in the form of stealing from the poor to give to the rich, is more the type of “emergency” he cares about.
Yesterday, Trump effectively declared that the govt - if you can reach it - wants you to stop taking opioids. That’s about it!
Just stop.
But provide a way to do that? Nope! The govt is instead focused on vacuuming up money and feeding it to the already wealthy.
My disgust with this Bad-Ministration grows deeper by the day. As real problems are given fig-leaf solutions, while in the background our treasury is being raided - so the wealthy can avoid what the little guy cannot.
We are sinking deeper and deeper into being an ignominious empire in decline.
2
Why is it news that that trump isn't funding efforts to help save lives from opioid addiction? Trump has already said how he wants to deal with the drug crisis: extermination.
As reported by the NY Times on May 23, trump called the president of the Philippines, Rodrigo Duarte, to congratulate and praise him for using death squads to murder every drug addict they can find. Thousands of bodies are found in the streets.
“I just wanted to congratulate you because I am hearing of the unbelievable job on the drug problem,” he said. “Many countries have the problem, we have a problem, but what a great job you are doing and I just wanted to call and tell you that...“we had a previous president who did not understand that"... “but *I* understand that", said trump.
Why doesn't the Times point out what trump said? His own words, in the official transcript of the call, implicate trump for his criminal neglect, his demonstrable resistance to taking effective action. Remind the world how trump thinks. The truth can be ugly, but we still need it. Trump wants drug addicts to die. He has no use for them. They make America weak, just like Puerto Ricans, Mexicans, Refugees, the sick and less fortunate. Keep repeating this until he is bullied into acting like a human being, let alone our president. Time and time again the press, Republicans and his supporters have dismissed trump's horrific statements as anything but literal. Get Real Times.
3
He doesn't care. People with addictions are invisible to him. They are Losers. Sad.
And the commission that presented him with options, headed by the unctuous Chris Christie, was window dressing, if even that.
Nothing will follow from his words yesterday. And we kid ourselves if we think otherwise.
My guess is that he admirees the Sackler family for its brilliance in coming up with a drug that has netted them billions.
2
I predict very little will be done, but the Nancy Reagan lip service and the funneling of cash to crank education progams that are proven not to work.
However... the war on cannabis will blossom into a nation wide propaganda and military exercise. Lots of mandatory min. and incarcerations and civil forfeitures. Time to invest in For Profit Prisons and Military upgrades of our police force.
Dang! Just when Ca. was about to come on board with it legalization in Jan. Shocked! Shocked I tell you!
Just say grow!
Advertising? Really?? This "program" is as hollow as Trumo's (and the Republican Party's) soul. We already know that treatment works and that advertising does not. There is no bargain basement solution to the opiod crisis but that is all Trump offers.
3
What Trump, as person and President, knows doesn’t mean he, or any of US, understands.At whatever level.Had his brother died of a type of cancer, he would not have died as “a cancer!”His brother died as a brother.Son.And in a range of other roles;self as well as imposed identities.”Alcoholic” remains a stigmatizing,unhelpful,descriptive,pejorative label.Explaining little.Trump labels.NYT writers should know better!The priority,national public health emergency,is not about use of a range of legal meds,which are misused.Many supplied by our own Big Pharms. Or use of various “drugs.”Both effect millions.It is, rather,our daily, enabled, violating WE-THEY culture;its temporary as well as sustained outcomes.Its toxic, infectious results more than match the use and misuse of meds and “drugs” as it enables ABUSE of selected people.Health problems.Even deaths.The spread of incivility.Lack of daily doses of flowing or titrated mutual respect.Caring.Trust.Mutual help, when and as needed.Between family members.Friends.Strangers. Neighborhoods.Communities.Increased money,which is not timely, or used for effective-evaluatable- efforts, over time, and not for mantraed principles of faith,by influential individual and systemic stakeholders,will be wasted.How has the ongoing institutionalized barriers between alcohol, “drugs,” tobacco, and sugary sodas (NIAAA,NIDA, FDA, etc.) saved a single life?Increased the well being and health of people?Drug problem?A multidimensional PEOPLE problem!
This is what happens when you hand the reins to a party that has long professed their hatred of government with repeated calls to "drown it in a bathtub."
Now these clowns are caught in the middle between their insistence on doing nothing and the need to appear as if they are doing something.
What's the old saying? You "get the government you deserve?"
1
Trump didn't issue an official proclamation. It was all another photo op/publicity stunt. He is pandering to White rural voters--his base--without providing any substantive relief. Cheap! Don't worry, Trumpists. He is already getting full marks from Fox News!
A true President would need to acknowledge decades of racist oppression that were using drugs as an excuse to throw brown and black people in prison. With Trump--not a chance!
Of course he needs to get behind legislation to actually help people. But he is doing what he has already done again and again--grab the spotlight and throw the mess to his toady minions in Congress to clean up, like the Emperor he thinks he is. Now nothing is being done, and Trump is grandstanding yet again. He is not an emperor; he is the apotheosis of an empty suit.
3
Trump only *acts* to enrich himself, his family, and his cronies. For his "base" it is all posturing and soundbytes.
2
Though they are fewer now, as one reads these comments there are still people who want to give this president the benefit of the doubt. Why would anyone extend such an intellectual courtesy to a proven, serial, patholgoical liar?
Until and unless Mr. Trump demonstrates he is capable and willing to tell the truth, every statement issuing from this WH should be met with the suspicion and distrust they have earned.
Given Mr. Trump's uneasiness with veracity, the chances that this statements about the opioid crisis lead to any tangible results are slim indeed. Unless, of course, they are fat.
2
At the top of the list: Ban all advertising of drugs! When I'm watching the national nightly news, and it does not matter whether it is ABC, CBS or NBC almost all the advertising has to do with drugs that will made you feel wonderful!
4
He does not care about anyone or anything except himself.
2
I believe we are where we are as a country with the opioid epidemic to a large extent because of a deep sense of hopelessness and despair, joblessness, poverty. But how does that explain how our family, white, middle class, can fall prey? Our son "experimented" as did many of his peers in high school, but once those white pills hit the streets, the classic trajectory followed: Oxy then heroin. His brain reacted with a capital "E" Euphoria, as opposed to others who were able to not experience such a response. This while hanging on enough to finish college and begin a career, yet all the while, addicted. He is alive, but struggles still. There is no silver bullet. The train has left the station a long time ago and it is on a crash course. Without specific policies, i.e. labeling addiction a disease so that medical facilities are created to treat the multi-pronged psycho-social-physical complexities of this disease, Trump's words are empty false promises.
2
Not to mention that Trump spoke with so little understanding of the awful phenomenon of addiction.. as usual he referenced himself..bragging that he is not addicted to anything and mischaracterizing his brother's struggle in the process. He could do something good here for this national plague but his narcissism prevents him from any real leadership on this..obviously didn't really read and certainly didn't heed the report headed by Chris Christie That actually had sound ideas in it. I am keeping your son in my prayers...owr family was not as fortunate.
Whether he realizes it or not, his advisers certainly grasp it; the sinister nature behind this inaction is that the opoid epidemic is a morbid solution to itself and in a sense the healthcare crisis by eliminating 50,000 at risk individuals annually this alleviates the strain on an over-taxed privatized healthcare system that makes no sense.
The far right fear mongers about the control governments have over healthcare and the populace as a whole in socialized healthcare systems, yet here we have the very phenomenon they warn of occuring in real time at their hands. This isn't an opoid crisis, it's a culling of "undesirables" and of those who are simply unable to "bootstrap" themselves into recovery.
Never underestimate the evil that any of us are capable of.
3
President Trump giving this crisis his attention is a great step in ending this crisis. What did the last President do? Those who are looking to criticize Trump at every turn refuse to admit that this will help. Of course more money would help. But this attention will help as well.
Great. So let's replace half of the defense budget with 'Trump's attention.' Let's replace Trump's plan to cut the taxes of corporations and the 1% with Trump's attention. That will be enough to solve those issues too; won't it?
2
Not really, no. He's basically just waving his hands around attempting to sound presidential, and failing miserably. Without action, a plan and financing behind it, this is just words. He lacks empathy. If it doesn't affect him, it's not important.
3
Trump’s declaration was simply a publicity stunt, much like all of his other public appearances, all designed to check off campaign promise boxes in his mind as he campaigns daily for re-election in 2020.
His commitment to fight the opioid epidemic is just like his botched healthcare reform, hurricane relief, tax reform, Middle East interventions, Iran and North Korea crises botched messes.
Trump is all talk and no results!
3
We will not cure drug addiction until we find ways to reduce the health problems that necessitate their being prescribed. The Republicans additionally have recently thwarted FDA efforts to stop illegal sale of opiates. What gives?
2
Drug companies contribute more to politicians than anyone else. That's what gives: The drug companies.
1
I had a dream, our president decided to lead the country by modeling a rare but critical trait required to confront one’s addiction . It’s called insight and can be one of the first steps in recognizing and changing one’s dysfunctional choices. So, Mr. Trump could lead the way by acknowledging his addiction to constant praise, adoration, and greed. That would really be a huge contribution to our Nation’s health!
There is an article in the New Yorker suggesting that the Sackler Family, known as patrons of the arts, bears a large responsibility for the crisis. Perhaps they could contribute to its resolution.
2
Why are so many young people choosing to escape with a slow needle death?
This is the question we should try to answer here. No hopes, job security and massive income inequality are certainly sources of this devastating scourge.
The states hit the hardest have severely lost employment and the communities have disintegrated. Ohio, Massachusetts, New Hampshire and West Virginia, Kentucky are reeling with the deaths of their young today from fentanyl and carfentanil. NOT prescription drugs.
3
The solution to this problem is addressing the pain, emotional as well as physical, that leads to the need to use and abuse these drugs. That will not only require drug treatment programs, but also collaboration with mental health services as well. It will not be as easy, or cheap, as a full page ad in the Times to make a dent in this. The real question for Republicans is how to help the new addicts and still be able to lock up the minorities and the poor because they are not sick, they are criminals. Certainly, we can't expect higher taxes to address this, so the question is whose pocket are they going to pick to pay for it? For Trump, the way he "supports" such efforts is to just keep telling you the check is in the mail.
1
Is anybody surprised by this? Talk is cheap and that individual in the oval office knows that. But, hey, he made the statement and, therefore, will take the credit for it and when nothing pans out, blame somebody else for his incompetence. The GOP is on the way to brake the bank, so, where will the money come from? Let us judge him by his actions and not his words.
Purdue Pharma has made billions with Oxycontin, over the dead bodies of many. Then they made themselves look nice by funding museums, institutions and so on. That is blood money, pure and simple. Why isn't that money being used to fund the necessary programs to turn back the tide initiated by their creation? What steps are going to be taken to prevent that from keep happening? Why are they still is business?
Please Read:
"The Family That Built an Empire of Pain | The New Yorker"
https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-e...
When you do the talk you must also walk the walk.
2
Remember when we had a government that actually analyzed problems and implemented useful solutions? It's hard to recall, but I think it used to happen. Sad.
3
I hear the call for more funding from all corners, from the NYT readers to the Governor of Connecticut. I have yet to hear where the funds should come from, except vague references to federal money.
There are, to my way of thinking, three possibilities. First, other aid programs could be lessened to provide the funds. If this is to be done, which ones get gutted? Second, taxes could be increased to provide the money. As someone who uses his addictive substance, alcohol, in a responsible fashion I am not entirely in favor if this option. Third, the Federal government could just print more money or issue more bonds. This leads to inflation or debt, neither of which are good things either.
I am especially interested in the notion that the Federal government should provide funding so that the states can try different solutions. Why does the money need to be funneled through the Federal government? Why don't the states raise the money for their experiments directly, thereby eliminating one level of bureaucracy and the associated costs thereof? The ultimate source of the funds is the taxpayer, so its not as if Federal funding is created out of thin air.
1
Yes, taxes are painful. But would you not consider that the social and economic benefits could be much greater than the cost? I learned some of the basics of Benefit-Cost Analysis in school. It's disappointing that most of what we see, in actual practice, is only Cost Analysis.
Phillyb - I agree that in some cases the benefits outweigh the costs. But, why does this need to be enacted at the Federal level? Each state has a different situation, so why shouldn't the taxpayers in NY pay for NY's problem and those of OR pay for OR's problems?
1
I heard the speech and told my husband "one good thing Trump is doing". I was happy. I just have to remember that each time I say something good about Trump I am wrong.
1
Words, he's got the best words. And that is all that Trump and his administration have. They can't meet deadlines, ramp up agencies to meet emergencies, redact Kennedy Assassination documents in time to meet a deadline that was established 25 years ago, appoint qualified people to fill positions. It's difficult to get much done when Trump only works 4.5 days per week and then golfs and tweets at one of his resorts the other 2.5. We have barely a part=time leader. So we get part-time results...
3
Scrolling on my computer this morning...I read "Mr Trump on Opioids" as the title of this editorial. For a moment the complete title of the piece was hidden, and the thought entered my mind, if only for a few seconds, that the real problem with this President was more severe than I had thought.
1
By the way that Trump and this editorial speak about how to deal with the addiction epidemic posed by heroin and opioids, it makes it sound as if its impossible for anyone with an addiction on any level to quit without medical intervention.
However this is clearly not the case. Many, if not most, people addicted to pills do not need inpatient treatment or even counseling to be able to quit. All that they need is the decision to quit, perhaps enforced by attending meetings of groups like NA.
People are perfectly capable of dealing with cravings on their own, just as smokers deal with cravings for nicotine. And the rehab industry has yet to come up with rehab for smokers, trying to convince them that they are not capable of quitting on their own. And as far as the addiction to that good feeling they get from opioids, they can deal with that too on their own just like alcoholics manage to do so on their own, as alcohol rehab is another things the rehab industry has yet to be able to convince people is the only way to deal with it.
The only people who need institutionalized rehab are hardcore heroin addicts, for whom the issue is not so much dealing with their cravings, but relearning how to live as their whole idea of life has been altered to one in which getting high is the sole purpose of their existence. And the bulk of the treatment for those people is not about quitting their use but learning how to live again, like to plant vegetables instead of getting high.
1
Tens of thousands of Americans are dying each year because of Opioid related causes. Apparently, they are all hardcore heroine addicts and in Mr. Stavsen's opinion, not worth saving.
1
A few thoughts:
Though the president does not seem to realize it, he is not the first to propose teaching kids not to use drugs. Nancy Reagan's "Just Say No" campaign didn't work in the '80s, and it will not work now. But by all means, let's spend a lot of money on a really great advertising campaign.
While I do not mean to understate the seriousness of opioid abuse and overdose, what I'm seeing now at all levels, including among cable news commentators, is hysteria, including the much-repeated idea that this is the worst drug crisis in history. Anyone remember crack? How about meth? Both were devastating, and both were similarly touted as the worst ever, and the drug in question exponentially more dangerous than any other drug, impossible to treat or recover from. So, this is very serious and requires serious measures. But don't let's keep repeating the same errors we make every time.
Interesting that while we are told that guns don't kill people, people kill people, so limiting access to guns is not the answer, with drugs we say, it's the drugs, and if we can limit access we can stop the problem. It never works. That doesn't mean we shouldn't track opioid prescribing carefully, but opioid prescribing is down significantly, and many users now skip pills and start with heroin.
It's complicated and nuanced, and we just don't do those things very well.
1
There are roots to the drug problem, and it is multi-faceted. Listening to Trump on just about any issue, it becomes clear to me that he is not interested in the details of anything, let alone the dynamics of addiction. I'm guessing he'll get his team together and brainstorm a slogan as a method of addressing it. Make Us Sober Again. MUSA.
1
Nobody knows what's specifically in the tax plan yet, we only know it will go to the top 1% because the republics have devised it.
1
Why would a real-estate developer / reality-show host care about opioid addiction? Maybe if he had the misfortune of a family member suffering from it; otherwise he'd need to be a public servant to be moved to action.
It's easier for the PR king to hire an ad agency then have his administration do real work, hire the staff or invest the money in dealing with any major crisis. And if he did hire a czar their only goal would be personal profit for themselves and their cronies.
2
There’s nothing like labelling drug addiction a “pre-existing condition” to keep funds needed to treat people safely in the coffers of the insurance and medical industries, among others.
Maybe someone should point out to Trump that West Virginia, home of many of the coal miners that are part of his tedious verbal loop about all the great things he’s doing for the USA, has the highest death rate from overdoses. As if he’d care.
3
While Trump is rolling out his "really great advertising" campaign, I hope he reinstates funding for advertising and assistance for people to sign up for insurance under the ACA.
2
Read the article in the New Yorker (October 23, 2017 edition titled "The Family that Built an Empire of Pain."
https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-e...
It describes the Sackler family and their closely held company Purdue Pharma, the maker of OxyContin and it successor drugs. Why worry about imported opioids when one of the biggest manufacturers of opioids is a US company.
Congress needs to regulate that business much more closely.
1
My son is in rehab for addiction to cocaine.
I am lucky because we live in Italy where rehab is state-funded.
Unfortunately, anyone who has had an addict in the family can tell you that rehab is not a guarantee of stopping nor is it an easy process. The patient (this is considered an illness in Italy) has a very lengthy and hard road ahead. Even if the patient manages to come out the other end, the inevitable prison sentences in his/her past plus the understandable discrimination makes it very hard for them to pick up a normal life and find a job. Any job. Families go to pieces. When you are not visiting them in prison you are wondering if they are dead in a ditch. When it rains you look outside and wonder if they have a roof.
So, what I have to say, for what its worth, is that rehab is a start, methadone and other drugs are a start but if you don't put a very serious framework in place, your strategy is going nowhere.
So, yeah. advertising should fix it.
2
It's a little puzzling where it's going, since his understanding is based on his brothers drinking and smoking, and he doesn't seem to care about alcohol and tobacco addiction. The bar at Mar-a-Largo is a gateway to alcohol addiction, poor health and desperation are gateways to painkillers (defunding Obamacare won't help,) marijuana isn't a gateway to anything, and talk is cheap. At least he has acknowledged the problem - that's more than Reagan could manage during the AIDS crisis. I guess it all depends what course of action will prove the most profitable for the drug companies.
2
Poppies in the window box.
Allow people to grow small amounts of cannabis, coca, and poppies to make help people manage pain naturally. Less money to drug companies.
1
As far as Trump is concerned, yesterday was a really, really big success and it was really, really, very easy. He accomplished the propaganda sound bit he wanted.
I wonder if at some point he will discover that, hey, who knew dealing with drug addiction could be so complicated?
Movin' on. To the next really, really tremendous propaganda sound bite.
1
Trump's brother died of alcoholism but there was no empathy as he treated the brother's family like dirt later on because he wanted the money from his father.
So, there is no understanding coming from Trump. And where is the needed money going to come from? Trump and the GOP's tax cut plan? The amounts necessary would surely cut into the 1%'s projected 'take' so reason would dictate it's not going to be a priority for the GOP.
Reagan threw hundreds of thousands into jails, that might be something Sessions would go for. It would help his private prison donors for sure. Problem is that the epidemic has taken hold in white America. Now that IS a spot of bother for the likes of Sessions and Trump.
So they may actually have to pony up some money. Let's not shower praise upon the Trump until the check clears.
Trump had better be careful here. He may have overstepped with this latest outrageous dereliction of duty "just say no" approach. as many of his base have family members who suffer have even died because of the opioid crisis. His slap in the face may well come back to haunt him - first with an even greater plunge in his approval numbers and then in the midterms and 2020, if he's still around to run at that point.
1
Let’s not put all the blame on Mr. Trump. He is just carrying out the wishes of the Republican Party: Death for millions of people, especially if they’re poor or middle-class. Since they don’t support other forms of regulation (such as birth control, environmental regulation, health insurance, gun control, public education, international diplomacy, etc.), this must be their answer to all the country’s problems.
1
The thing is, the government doesn't even need to allocate billions of dollars to address this problem. Thirteen states have already indirectly provided a solution that decreased opioid related deaths by 33% over 10 years. States with legalized medical marijuana have seen opioid addictions/deaths dramatically decrease. And the government doesn't even need to spend billions on this, it simply needs to allow it to be in the market. Cannibus is a medically-recognized painkiller with zero reported deaths from overdose. What's more, we don't even need to keep relying on pharmaceutical companies who have misled Americans for decades on how dangerous opioids (aka narcotics) are for the average user. Don't spend billions! Help reduce opioid deaths, legalize medical marijuana!
1
One of Reagan's biggest mistakes during his term in office was a failure to appropriately respond to the AIDS epidemic. He effectively wrote it off as a gay-disease and mostly swept it under the rug.
One of Obama's (many) terrible choices during his term was the lack of serious attention and funding towards the opioid epidemic.
Obama completely neglected the epidemic and it grew much worse during his presidency.
The best he could come up with was "Prescription Opioid and Heroin Epidemic Awareness Week" towards he very end of his Presidency.
This is a serious disease that is ruining the lives of massive numbers of Americans. Every two weeks, we are losing the equivalent of the number of lives lost in the 9/11 attacks because of opioids. It is killing more than hurricanes, wildfires, and crazed gunmen combined.
U.S. pharmaceutical companies, lobbyists, corrupt politicians from both sides of the aisle and the corporate cheerleading squad (FDA) are responsible for the opioid crisis.
And yes, "One would have hoped that Mr. Trump would be eager to deliver real relief for an epidemic that affects millions of American families".
Absolutely.
This for now is disappointing.
But at least "He declared the opioid epidemic a national public health emergency" and even though I would have preferred it to be declared a "national emergency", I take that over completely ignoring it for 8 years like the last guy.
Let's keep pushing for more rather than just whining about Trump.
This is a start.
2
Trump's brother, Fred, was addicted to alcohol. Trump, himself is addicted to tweeting. No amount of advertising pointing out the potential dangers of either activity would have kept Fred's hands off the bottle or the president's fingers off his phone's keyboard.
1
I agree wholeheartedy with your position, except, other than that ineffectual airstrike on that battlefield airfield, was that in Syria?, Mr. Trump, yes I called by his nama, instead of rotgut psychopath, which is what he is, has never backed up anything, any of the lies he utters, with action.
It's easy to always blame others for mistakes, errors and failures that he's caused, committed, or otherwise colluded to commit a crime. How easy then is it to attach pain and suffering to innocents, unknown faces suffering in the dark?
Perhaps this is why he cannot sleep at night. This might suggest to some that he is waiting for the phone to ring, for that call that there is a need for him to make a decision, to use arms much more devastating than reducing already insufficient medicaid money, or education funds, or meals on wheels, and the list goes on, medicare. But it will not ring. Dickens would say he is haunted by the premonition that he will be bowed down by chains he forged in life. Not likely.
He certainly has no empathy for anyone. The concept is too complicated in its simplicity. And one does not have to be born with it. But the junkie is an easy mark. POTUS can say what he wants, but the answers are in the hands of community healthy clinics and others closer to the patients, which is what a junkie is, and the few additional funds needed. These must not be the ones skimmed by greaseballs, not the ones at the bottom, either, but some better, more equal abilities.
Further, I see the comments that allow this to continue...empathy, lost jobs with no hope of getting another, big pharma, distributors, trauma.....society has run them down...while they may come into play....remember people who drink and drug to excess...and I have been there....do it for many reasons....but never forget they love the way it makes them feel and it takes them away from where they are.....a world that has problems. First step is admitting there is a problem, and it is my fault and responsibility to do something about it to see that it stops. Reach out....but stop expecting society to do all the work....put in the time....and face the truth.
The Trump Administration would like to see all of us on opioids so they can move forward unhindered with this disaster of a presidency and feed even more of our tax money to the rich.
Any time you hear him proclaim that he's working on a problem whose solution would help the American people, you can assume nothing is being done beyond a speech and a few tweets.
How much longer are we going to be held hostage by what amounts to a faux government?
1
Trump cannot fathom money for anyone but the very rich in Tax Breaks and exemptions. He is just good at saying a lot without putting money where his mouth is. We have to suffer for a while as his Attorney General is still living in the 18th century, just look at what he thinks of many issues facing the country, his solutions are very 19th century and earlier. Trump is just not capable to even questioning them as he made sure he has only 'yes sir" people around him.
The overdose menace kills close to 50,000 Americans each year. I wonder how many Americans did Al-Qaeda, ISIS, and Taliban combined killed in the last decade; believe you me it is not because of our being in 127 countries fighting either overtly or covertly. History tells us that when we were friendly with all those 127 countries, we did not spent the fortune we do now on the production of war machinery but we did have a lot of USIS centers where the youth of those countries gathered and read about the good old USA and dreamt of one day going there to possibly visit and study. Now Trump is adamant on reducing the soft power of US and project the big hammer. Just imagine if we reduce 5 F-35s a year, how many families can we save each year right here in the US. What kind of logic is it that we are spending $600 billion on killing machines and almost nothing to save over 50,000 Americans right here in the USA? Trump and the Republicans in the Congress are working for some other America not the ones we all live in.
2
Trump is not the only one who doesn't grasp what's needed to combat any major problem in America, not just the opioid crisis. His administration has failed to respond with appropriate speed to the devastation left by hurricanes in Texas, Florida, the US Virgin Islands, and Puerto Rico. Our legislators have failed to do anything about the increasing number of massacres by firearms because they value the NRAs opinion more than the safety of Americans. There's nothing new here. If anyone was to read about how AIDS was handled in the first decade they'd be shocked at the indifference and ignorance it was met with. After all it was a disease that ravaged them, not white heterosexual Americans.
The destruction of working America is proceeding according to the GOP plan which coincides with what the Koch Brothers and their ilk want. An America where money rules and most of us are easily replaced. Think of Aldous Huxley's "Brave New World" or "1984" by George Orwell.
11
It is increasing difficult to write about a man whom I simply hate.
Nit picking:
NO Trump does NOT understand addiction just because his brother died from alcohol abuse. What's been reported tight here suggests that he hated his brother, and like his father, blamed Fred, Jr. for being a failure. It is also reported that Trump cut off medical benefits for his brother's infant son - using the infant as leverage in a family battle - revealing a reptilian man who could do anything to get his way.
So, if anyone thinks this President will do anything to help others - except as a byproduct of gaining more attention, power or wealth, they are mistaken.
Nit two: save me quotes that support your position from a self righteous Chris Christie. Why give another duplicitous self serving grandstander the stage?
Sad that the Prez cannot find a good man with qualifications to work for him. It isn't that they don;t exist . .
21
Once again, an on-point comment!s
If only you had a way to infuse that into Trump’s closed brain.
Just as we have highly, specifically-trained Oncologists to study and treat cancer, we should have Addictionologists, health professionals highly and specifically trained to study and treat the disease of addiction. Programs expressly designed to satisfy this need should be provided.
The objectives of this training program should be to recognize addiction as a neurophysiological/neuropsychological disorder and to treat it in a manner similar to the way we treat other diseases of the central nervous system. Accordingly, we should have programs to train individuals who are expert in studying the causes and treatment of addiction. By understanding better the multitudinous factors leading to addiction we could provide the means to prevent and lessen the harmful effects of addictive behavior.
The concept of this program is to treat addiction in a manner similar to the way we treat other diseases such as cancer, diabetes and depression; that is, as a chronic disease. The goals are reverse the addictive behaviors in those patients who can be made to abstain from addictive substances and to reduce the morbidity and manage and improve the lives of those who cannot.
6
Ben,
those specialists already exist, primarily psychiatrists who have taken fellowships in addiction.
There is however a problem of how we view addiction. Although in medicine it is supposed to be viewed as a disease, having it is considered sufficient to be an expert in how to treat it. We don't consider people who have diabetes, heart disease, or diabetes to be experts in the best treatments for those diseases but somehow we think that being a drug addict qualifies someone to be an expert on it.
2
Enough psychiatrists, counselors and treatment facilities would make all the difference. Thank God we have a President who actually does things FOR the people for a change.
We definitely do not really have an addiction model that is both clearly defined, evidence based and effective.
There are abundant self styled experts, often with a reason to tout their point of view ( payment). As Steve mentions, a number those who do front line treatment are addicts who are sober, but who have no rigorous professional training.
It isn't just more treatment facilities that are needed, it is more research and approaches which do not operate on old wives ' - or old addicts' - tales but on science.
Sadly, this issue is being hashed out with the irresponsibility that characterizes so much of the behavior of politicians. We all know how differently individual people respond to medications, and yet the current attitude towards Opioids displays little of this awareness. For millions of people who suffer with chronic pain, opioids provide the only means for living a life that's even remotely normal. And the risk of addiction among those who've been prescribed an opioid for pain, the addiction rate is extremely low, with various studies showing a maximum of 12% and a minimum of 1%. The people who are at the greatest risk are those who've taken up the drug recreationally, and those who've been previously addicted to drugs like heroin and cocaine.
People suffering from chronic pain already have to suffer during most of their waking hours; it's cruel to deny them access to relief based on the "one-size-fits-all" that results when medicine gets politicized. The science should lead the politics, not the other way around.
8
The original War on Drugs was lost as measured by the amount of money and profits being made by cartels, booming defense industry profits and rising political campaign contributions. They are greater than ever.
The only difference between 1971 and 2017 is that then it was a person of color nimby problem; whereas today, it is in my backyard. The same basis for the demand for drugs that motivated the hopeless and helpless 46 years ago has not changed. Just the racial demographic and geography have grown to engulf the forgotten working class who now are among the help-hopeless.
Milton Friedman orated and wrote that the drug epidemic will not be defeated as long as market forces create demand. There is so much money to be made. There is too much helplessness and hopelessness. This country needs economic recovery for others than just the investor class.
Spending money on interdiction, incarceration and advertising "just say no" are wasting resources and creating false hopes. I doubt that Dr. Friedman would support a southern border wall as a means of ending the drug epidemic. End the need and you will end the demand.
5
But he's got the best words, the biggest words. People tell him all the time how great his words are. He gets standing ovations for his words.
I weep for my nation.
16
I think the ovations are for his hand movements. Not his words!!
Let us now observe the vaunted Laboratories of Democracy in action. See how they, to a one, leapt into action, devising innovative programs to address the urgent needs of their citizens. Let remember this civic virtue the next time we're promised the states have superior judgement and knowledge of local conditions.
Let's also remember that most opioids used are legal. Three pharmaceutical companies account for 85% of sales. A few years ago their marketing began recommending opioids for chronic pain. Perhaps the FDA could withdraw its approval of opioids for that purpose?
1
Every single day there is a tragic death from this crisis. The question, besides one of easy access, is why? Why are people taking these harmful drugs to begin with? I have read article after article, listen to discussions at the hospital, hear from SW and psychologists. But everyone seems to have a varying position, from cheap and easily accessed to personal accountability.
But my question is this: What is so painful in our society that people feel the need to numb their feelings in such a dangerous and lethal way? This is not about getting high or stoned, it is about anesthetizing themselves. And I see a correlation between lack of mental health access, and I am talking about coverage for plain and simple 1-1 therapy, not long term substance abuse. We just cannot go and talk to a professional anymore. It has become way too expensive, most insurance plans cover the minimum and most providers do not accept the insurance due to poor reimbursement. That leaves one to have to pay out of pocket. And it is simply unaffordable.
As for the kids, when is the last time have seen a school nurse in a school? They do not exist anymore. It used to be they had offices you could go to during school if you had a headache/stomach ache. And you had someone to talk to. They would see patterns. They knew your kids. They knew who was stressed out, who missed school, who lost weight, who dozed off in class. We had more eyes watching. And caring.
Who is watching now? Who is caring now?
12
Pathetic excuse for a human being!
11
It's always the MONEY!
Proof positive that the cash needed to build the wall takes priority over the health and safety of addicted American's.
2
In the rush to address the "opiod emergency," let's not forget that there are millions of Americans--myself included--who use prescription opiod-based medications to manage chronic pain. These medications allow us to live a more-or-less normal life: they are, indeed, lifesavers. While I can't find any statistics, I suspect that the majority of us carefully--and responsibly--follow our physician's directions. It is we who are being ever-more-tightly squeezed by attempts to reduce/cut off supply. Finding a physician who will prescribe (especially long-term) or a pharmacy that will fill has become, for many, a constant struggle. Please: remember that some opiods are medicines, and not all who use them are addicts.
29
Opioid addition is a terrible thing but we have to remember that many of us use these medications responsibly. When used correctly to treat chronic pain, opioids don't make you "high", they just treat pain so you can function normally. Just like not everyone who has a drink becomes an alcoholic, not everyone who uses opioids is an addict.
Yes, we need to help those who become addicted but we can't lose sight of the medicinal benefits of these drugs.
28
The problem with Trump's view is that he thinks all people became addicted to opioids because they want to have fun and get high, not to relieve severe and long-term physical pain.
My husband has severe back pain and, not wanting to be on opioids, was prescribed high doses of ibuprofen, which did absolutely nothing. He switched to marijuana (in a legal state) and got immediate relief.
If a relatively mild, natural drug like marijuana exists, one that can provide BOTH physical and psychic pain relief to individuals, why hasn't it been completely legalized yet? Oh, I forgot -- Trump's administration is counting on keeping jails full and law enforcement busy.
34
The status quo only cares about quick, reliable proven streams of revenue in a straight line from one pocket to another and pharmaceuticals provide that revenue stream. Medical and recreational cannabis regulated by the state (or otherwise) is yet unreliable, unproven and disruptive to the current flow of cash that results from human suffering, and is thus a threat to the status quo. They don't care if something works or not, they care about disruption of markets and more importantly profits and kickbacks.
1
I don’t care anymore. America truly sucks as a country and as an idea. Our country is dying because it’s always been about money and greed. Our enemies China , the Taliban and the cartels south of the border thank you for your business.
17
Harry, I share your frustration at times. Greed and selfishness have been major themes in our collective narrative. When Washington's army starved at Valley Forge, local Pa farmers sold their products to the British for pounds sterling. Lincoln railed against the war profiteers and Teddy Roosevelt fought the robber barons.
But, Harry, the clutching, greed of a few does not overshadow the generosity of the many. For every, Trump, there are ten Joshua Chamberlains. Americans who embody our values and live them daily.
Before you lose faith completely, please spend a day with our military and recent veterans. They will, I hope, restore your belief in our people and our purpose.
America is still the country of possible change. Yes, it has always been about money and greed, but it is the country that has HAD SOME OTHER IDEAS, like freeing slaves, making admittedly too tentative steps to universal health care, etc. GET politically active, DO SOMETHING, get active, and DON'T DESPAIR.
Of course Trump makes a big display with little-to-no substance – that is his way of doing things. He sells an idea claims victory and moves on. The more I see of his pronouncements and events I’m only impressed by the total lack of depth. He is the consummate salesman, the only question is: What is he selling? Like all salesmen, he is selling himself as a wise all-knowing person and selling the product, idea, concept, whatever confirms his self-assessment of omnipotence.
I trust that there is a human inside somewhere, but well-hidden and he never sees the light of day. That We-the-People continue to cheer and buy into his act says more about us than it says about Trump. We don’t care about substance, we only want our collective ego’s stroked and entertained by a great showman who has no sense of actual empathy (there are many salesmen just like him in the world).
We’re on the path to Trump declaring himself President for Life with an army of supporters who just love the show for the sake of the show. So sad that our experiment in a Republican Democracy is about to fail because we like the show and hate the work of being the actual sovereign of this nation.
8
The only truly "really big and really great" thing on display yesterday was the depth and breadth of Trump's ignorance and vacuousness in his claims of how he will order the production of advertising to reverse the opioid crisis. Sure, slick ads depicting gritty reality have a role in this blockbuster, but it's more a walk-on cameo than the star of the show.
What Trump, our "reality" president, doesn't appear to realize is that public advertising had next to no role in the rise of addiction in America, at least not advertising directed toward the consumer. The role of advertising in reversing addiction needs to be directed mainly at the prescribers, not the viewers of the evening news programs, which is where about 90% of all drug ads are broadcast, aimed at people my age, not exactly the prime target that needs to reached. TV and billboard ads are passive, feel-good efforts, and only barely that.
If Trump really wants to bring addiction under control, he needs to study --in depth-- the phenomenon, from the desperation that sends people to dealers to the complicity of Phrma itself. But that is a mental challenge that is a bridge too far for Trump. In-depth knowledge does not lend itself to a wee-hour tweet storm, the president's favorite source of information.
Right now the only "No!" that needs to be said is to Donald Trump. No, sir, you can and must do more. That will take money, money that you have the authority to order be used. Start there Mr. President.
12
He got a great photo-op, though. All he cares about.
I feel like he talks way to much if he learned not to react to everyone he would be more successful and i don't like him as a person and as a person he makes so many mistakes and I just want him out of office but, if he changes his ways and learn to listen to people and do the actions for the country instead of attacking everyone for a little thing they say he would be fine. He blames everyone for what he messes up as me being in High School I can tell that there needs to be a change and needs to happen quickly
3
Trump may understand the horrors of alcoholism, but he seems not to understand the problem at all. The problem is in the individual's desire to be drunk , high, or stoned; not, simply, the drug itself. Denying an addict or a drunk his drug of choice is a first step toward recovery , but you're still dealing with someone who has the personality traits and, perhaps, genetic predisposition for addiction. Trump seems to have concluded that the problems he saw came from the bottle, not his brother; so he does not drink. Good first step, but the underlying problems are untouched and you are left with a "dry" drunk with all his personality traits and dysfunctional beliefs intact. Abstinence in addiction is necessary, but it doesn't "fix" the problem. That requires looking at yourself as the problem and doing something about it.
7
Trump won by preying on the dissatisfaction and despair which is likely the underlying cause of the opioid epidemic. Helping - really helping - would cost votes. On the other hand, using public money for an advertising campaign linked to a Trump initiative ...
4
"Talking stages" makes it sound as if he is progressing towards action. I, for one, am not counting on DJT to take any reasonable action on anything at all. He rescued his career by playing a businessman on TV, and now he's playing a president on TV, but he's bad at improv, and he certainly has no idea how to accomplish something in the real world.
8
As a mental health professional, we need interventions not words, slogans, and "'really great'" ads. That, of course, takes money and the President has offered none. If this is a "national" (as Mr. Trump stated emphatically a few months ago) rather than just a "public health emergency," it deserves funds so that states can develop interventions. If the tax cutters can't even spare a dime, how about a temporary nickel per prescription tax to fund the programs needed to address the crisis that is killing more Americans, especially young adults, that died in Vietnam or in the AIDS crisis.
Once again Trump is all words and zero feeling, regardless of the topic. Empathy appears anathema to him. A president without empathy is a failed president. Narcissistic people have to fake empathy, and Trump even fails at that. He is hollow. He is performing. In this case he talks about his brother’s struggles. I, of course, cannot put myself inside Trump’s skin and I don’t doubt that episode of his life was hard, but I can most definitely hear and see him. I am unmoved by his presentation. Anyone who’s ever engaged in a conversation with a narcissist will see the well known pattern of turning the conversation to be about himself.....how he’s never touched a drop, how he has managed, how he heeded his father, (in other words, I am the golden child and brother was a failure). Well, as we know, he is a failed president in oh so many ways. His legacy will be as a cold failure.
76
Trump is the hollow drum John Kelly should have named, as he resigned from Trump's White House.
3
What a great time to let ACA die amirite folks? Republicans will have to pick a lane soon. Baseline care is needed so a single payer system with an opt-out private market is a good compromise. I can't see how we can continue to let drug addiction and homelessness go without robust inpatient treatment centers and containment facilities that allow us to bypass, prisons, which should be for violent offenders, not addicts or destitute homeless people. It sure would be nice to have leaders with vision at this juncture.
2
Honestly, what did you expect from Trump? Real concern, let alone real money?
Trump's speech is just lip service to keep the base happy. He probably thinks that his followers won't notice that no real help will be coming their way.
And he's probably right to think that his base voters won't see that he's all talk and no action, given their reactions to date. No matter what he does, it doesn't seem to diminish their support.
I wonder what it will take before his base voters realize that they've essentially bought a lemon, and this time, there will be no lemonade.
4
As long as there are many people who choose to abuse potentially addictive, mind-destroying drugs, there will be someone who finds a way to produce, distribute and sell them. The suppliers do not give rise the market. The market gives rise to the suppliers.
The question is: How do you influence or persuade people not to risk using such products in dangerous ways? I wish that I knew. I wish that those in government knew? I really doubt that they do.Until then, I remain unconvinced that simply throwing more money at the problem will accomplish much.
4
"How do you influence or persuade people not to risk using such products in dangerous ways?"
Find them a respectable job, with security, benefits, and a decent wage; maintain clean and safe communities and superior schools; and treat them with a little respect for Pete's sake.
Maybe try not giggling into your lapel whenever you speak of the "dignity of honest work" >nyuk-nyuk-nyuk<
Never happen, though, because like prison we would rather spend billions in (middle class) tax money on "programs" than offer anybody anything that looks like real help.
Because all the people making these decision are totally self-made, completely free agents owing nothing to nobody.
1
Just more "rah, rah, rah feel good promises" without any real action.
Trump sure talks the talk but doesn't walk the walk.
If Trump was really serious about opioid addiction he'd free up some
big time money to help combat the problem but I guess finding money
to pay for tax cuts for billionaires like himself is more important
than really doing something about opioid addiction. Just more proof that Trump cares a lot more about money than he does people.
And Trump could go even further and advocate for stricter controls
on the manufacture and sale of opioids. Less opioids available in
the market means less pills available to cause addiction. Paying for treatment and education is necessary but costs money and is after the fact. The market has been flooded with powerful opioids for years
by drug manufacturers who are only interested in profits not public health.
Don't deny potent pain killers to those who really need them but better
to strictly regulate and limit the supply of addictive drugs on the market to make addiction less likely than to spend the money on education and treatment to solve the problem after addiction has happened.
1
The grim reality is that Trump and the GOP are boxed in on this issue, and we are thus unlikely to get the type of sustained and large scale initiative from the Federal Government that the opiod crisis demands.
There are no conservative or market-based solutions to this problem, so we are left with half-measures, incoherence, and warmed over talking points from the 1980/s that have become synonymous with failure.
The most effective way to address this issue is by dramatically expanding access to treatment (health care),taking on the pharmaceutical industry and vested corporate healthcare interests, and pouring money into programs that are already established and scaled to deliver coverage and care to wide swaths of the population.
All this is evident, while the GOP budget calls for cutting a trillion dollars from Medicaid, one of the only programs with the reach to make an immediate impact. Our politics are killing us.
2
Count on a decade or two to see actual progress. That's our model, We'll need to be sure some rich people are able to make a profit from ending the problem of opioids. The profit has to be more than the profit in producing them.
3
Why are there countless of these drugs (legal and illegal) available for use? The country falls short when it comes to drug regulation/legislation and the pharmaceutical industry, drug prescription abuse, drug trafficking and social economic imbalances. Unfortunately, treatment of opioids is as temporary as a band aid unless this country gets to the root cause of the problem.
It’s also ironic that decade after decade, drugs have been rampant in this country mostly affecting poor disadvantage neighborhoods and all of a sudden there is a crisis.
2
No talk of regulating Big Pharma. This is where it starts - Big Pharma. To start, Big Pharma should be treated like the tobacco industry - no more advertising. Then go after the doctors that prescribe their poisons. I had minor wrist surgery and was given a prescription of 20 oxycodone pills. I took one, got sick to my stomach and threw the rest of them away. A friend of mine brought me some marijuana; we smoke a joint together and the pain was gone. And marijuana is not addicting. Any addiction a person has to marijuana is in their head. There are no side effects and no withdrawal symptoms when one stops using marijuana. I say this from personal experience.
2
You know what's really funny? We carp all over lower class addicts and say nothing at all about the respectable doctors who write hundreds of prescriptions for this stuff.
We moan about the loser users, and fail to do anything about corrupt officials, especially at the border, who send this shadow of death on to the heartland for the cost renting a Prius.
Our concern isn't about stopping the plague or fixing the damage, our concern is about loading more and more pain on the poor people who suffer the results.
Not the rich people, though, because they're not criminals, they're Party Animals.
4
Though treatment to prevent deaths from overdoses and tackling illegal supply are important, the key to protect the health of our society from opioids is to invest heavily in reducing demand.
Our society has been successful in greatly reducing smoking by getting the tobacco companies to pay for strong advertising against themselves, which has made smoking “uncool” and which has been mainly not passed to the next generation. The pharmaceuticals that market opioids should be made to do that to a much larger degree, since their damage is greater.
The rules on prescription also need to change so that opioids prescriptions become the exception, not the rule and even then, the quantities should be typically smaller. Why do people leave the dentist’s office after a small procedure being given dozens of opioids pills and worse, typically told to make sure they take all the pills to the very end, even if they are not in pain? Why is injected morphine the only available painkiller for women in labour in many hospitals? When are we going to make all of this prescribing illegal, uncool and history?
As the Washington Post recently reported, a solid majority of Democrats and Republicans are opposed to increased federal spending on addiction. The Board repeatedly appeals to our better side, but the fact of the matter is that the public views addicts and criminals without much sympathy. I suspect that they believe that their plight is their own doing and they would rather see their taxes spent on more worthy causes. There is nothing wrong with appealing to our best instincts, but it is naive not to acknowledge that this is an uphill battle.
Michjas
Meanwhile, step carefully over the syringes (which are wonderful in their profusion in the parks and at the beach), the bodies, and the stolen wallets. Move spritely through the shootings.
And pay cheerfully for the lifelong hospitalizations, the ruined cities and rural towns, and the army of police, judges, social workers, and orphanages.
Have a nice, selfish day America.
Obviously you never visited New York or LA during the crack epidemic.
This one should be even better, because you won't have to travel to enjoy it. Like a really good eclipse.
I can't stand President Trump, I think he's a world-class jackass, but if he's able to reduce the number of opioid-related deaths in this country below 50,000 by 2019, I promise to hold my nose and vote for the jerk.
Oh, one caveat, so long as, in the meantime, he doesn't start a nuclear war.
It wouldn't have been hard to come up with a good plan.
He could have copied from the smart girl's paper.
https://www.hillaryclinton.com/issues/addiction/
Of course, that would require caring enough to invest in and solve the problem, rather than revert to marketing and a photo op.
7
"Big ads."
.
That's a relief. And here I thought the Clown's policy was going to be a useless rehash of previous attempts to reduce drug usage in this country.
.
Oh, but there's the big, beautiful wall to go along with that great big advertising. All we need now is a tweet storm from the executive bedroom at 3 am and we'll have the perfect trifecta of an anti-opioid program.
.
How completely and utterly ineffective. What else would I expect from a dangerously incompetent Clown?
11
Action here actually requires little money. As regulation of these drugs has been loosened and it is very easy to obtain large quantities, simply tightening controls and enforcing common sense regulations would be very cheap to decrease rate of new addicts.
People should be asking though why is there such a need for pain killers in American society? This contrasts to many other societies. Looking at the complex sociological and psychological pressures in our society that magnify the experience of pain is critical to healing. One of them, which has existed for many years now, is the public dysfunction we witness on a daily basis.
Another is the notion of social connection and fabric. I don't think that is really a money fix. It is a determination is for our leadership, whether in government or outside of it, to want the populace to have meaning and purpose in their lives and therefore, happiness. Happiness will affect the level of perceived pain and thus the need for opiates.
2
David
I agree with much of what you say, and I agree that the source of the problem lies in the perverse way we have built our damnable American culture.
But demand comes from a variety of sources and the key one here, at least at the start, was the medical industry and their insurance accomplices.
American medicine, still, is based on a search for the magic pill. Our insurance industry, just like the people who sell sponges and boots, is wholly predicated on squeezing money from anywhere it can, without let-up. Where to get money more easily than from sick, desperate people? And what could be cheaper than throwing a bottle of pills at every problem?
Limited doctor face-time, no messy on-going consultations, and easy-to-get massive discounts from Big Pharma which makes up the difference by lobbying government not to negotiate prices and charging individuals many hundreds of times the cost producing this awful stuff.
Then, of course, there are the wonderful doctors who build personal fortunes creating piano-killer businesses that keep them in amazing houses and expensive vacations while allowing them to build fortunes to pass on to their extraordinarily worthy children.
Not all doctors, of course, but even the "good ones" refuse to police their worthy colleagues, and participate in the illicit trade indirectly.
Our society is enough to drive any rational being to seek escape. Our medical and insurance industries opened the hatch and pushed them through.
1
There is much truth in what you write. Much of it all goes back to what is truly meaningful and therefore has value and purpose. The politician who does the right thing because it is for the good of people; the physician who does the right thing for his or her patients because it is in the best interests of the patient. Or the insurance company that is devoted to the health of their clients.
It isn't as much to me about making money. If they are doing good work that is benefiting people, then that's fine with me. And you probably would agree. It is about making it while others suffer and better solutions exist.
2
Trump will always be in the talking stages because he doesn't understand any of the problems he is supposed to help solve. He covers up for what he doesn't know by talking tough, hurling some choice insults, and blaming President Obama, counting on all his supporters just nodding their heads in approval. And then five minutes after the speech is done, he forgets what he ever said.
41
You cannot grasp what you don’t care about...and you need empathy to care about those with addiction.
86
You need more than empathy: you need information. The treatment of substance disorders is highy complex, and substance-specific. Trump would do well (sign) to learn a bit before he starts issuing directives.
2
You still don't get it: Trump says what he thinks his current audience wants to hear.
Next time Trump says something that sounds like a good idea, like declaring the opioid epidemic a national emergency or protecting our 401Ks, don't think "he gets it!" Ask "Who was he talking to?" instead. This latest incident shows that even White House announcements should be met with skepticism. "I'll believe it when I see it" should be everyone's motto.
58
When it comes to the public good and wellbeing Trump is always insensitive and class biased, as to be illustrated by his extraordinary zeal in getting somehow the repeal of the ACA which really failed, or now a non-committal half-hearted response to the opioid issue, when he would call it a public health emergency but never would offer a problem solving plan, if any, nor any funds needed .
19
Well, I suppose that first sentence noting that the president’s brother died an alcoholic was fair game. If Trump can’t emotionally handle tactics like this, then he should never have presumed to wade into the swamp. But I look forward to the tweets with some anticipation – you can get just so much of your entertainment from streaming.
For someone who calls himself a Republican president, it’s a big thing to create a new priority that, full-blown, undoubtedly will require many billions in new funding to address, at a time when the Senate is looking to keep projected deficits low enough to allow a tax package to slide in under Reconciliation and avoid Democratic filibusters. The editors argue that what Trump has done isn’t enough to effectively address the severity and human cost of the opioid addiction emergency challenging our people, but I suspect that now that a budget plan has been passed and once the tax package slides through, whatever IT turns out looking like, he’ll be less concerned about the optics and ask that Congress fund this initiative adequately – wherever they find the money, or even if they don’t.
He wouldn’t have made such a deal about this if it weren’t a major priority to him; and that’s the first step to seeing it work. So far, this is nothing but good news.
1
"For someone who calls himself a Republican president, it’s a big thing to create a new priority that, full-blown, undoubtedly will require many billions in new funding to address,"
Any evidence that he is going to fund it or just claim his proclamation as another of his "accomplishments"?
As for the first sentence, it seems that was meant to be kind, not an attack--- saying that perhaps he really might care about the scourge of addiction. Or are you saying that it shames him that his brother died an alcoholic?
4
Lynn:
It didn't occur to me that the editors were being kind to Trump; but, of course, you must be right.
As to your response to the rest of my comment, did you read it?
Hey, Richard, you forget, my friend, that money is going to be required for that wall with Mexico. Never mind that the problem is one that was caused by the US pharma industry, while the Mexicans from the state of Xalisco just knew an opportunity when they saw one. They are good, free enterprise capitalists just minding their own "business".
Pickup Sam Quinone's book, Dreamland. I know you can afford it.
1
So Trump is going to end the opioid crisis by advertising. Judging by how well that has worked in the past, we've already lost the war.
69
How is Trump's "new" attack on these drugs any different than Nancy Reagan's lame "Just Say No" campaign of decades past. Lame beyond description.
64
That was my impression - more back to the future. Just say, "No!"
So when your doctor hands you a prescription for Oxycodone, tell him or her to forget it.
1
I was recently a juror on a case where the plaintiff was an opioid addict. It was fascinating and bemusing to hear testimony under oath of the various physicians who supplied this person with hundreds of American-made pills each month. Under cross-examination, the doctors had no adequate response as to how they allowed it to happen. This is where the root of the problem lies, with drug companies and the physicians who enable them.
121
Indeed. The problem is virtually non-existent in Europe where doctors don't prescribe opioids as if they were candy.
1
And the corporate distributors of the pills, like McKesson. The 60 Minutes/Washington Post expose of this just played a few weeks ago.
Yep, not at all the fault of the person abusing the PRESCRIPTION. Typical NYT response; blame anyone but the person responsible.
Per usual Trump is trying to have his cake and eat it to. By symbolically recognizing the severity of the problem, he can appear to take action without actually having to commit money or resources towards a solution.
In a way, this is the best stance for Trump to take, he can hold onto the support of communities destroyed by the epidemic while simultaneously chipping away at the very services that they need, such as those provided by the Affordable Care Act. Ultimately, Trump has decided that service to himself, rather than to the people, is his utmost role as President.
23
TV ads targeted at children will not solve this problem. These are adults that lost their job, have no hope of getting another one, and have "checked out". They are Trump supporters, and Trump spoke to them during the election, and got their votes.
Now, it's seems, he's forgotten who these people are.
55
Doctors with prescriptions are the source of the addition.
Of course he understands, he just isn't going to do anything. So a call to action, followed by silence will suffice.
25
Well, it’s a shock but face it: Trump has no use for reality or solutions to real problems. He’s a showman, playing s role, in a fictional world.
77
We'll continue to play whack-a-mole with America's addiction crisis- whether it be heroin, crack, meth or booze as the substance of choice- until we address the root of the problem, and I'm not referring to the pharma industry that everyone's pointing their fingers at (although they're partially to blame for this). The true root is trauma, often beginning in early childhood in the form of physical, sexual or emotional abuse. The relationship between childhood maltreatment and opioid addiction is well established and while the figures vary widely, a large majority of users consistently report a history of childhood trauma.
Child maltreatment alters key regions in the brain, reducing volume in two parts of the hippocampus while increasing limbic system activity, priming individuals for a heightened fight or flight response and a reduced ability to manage everyday stresses. High levels of stress hormones continue to pump through the body years and decades after abuse has occurred, creating a brain wired for addiction.
If you give a kid with no trauma history and a stable home environment an opioid prescription following a car accident, chances are that he'll manage ok. But, if that kid has endured years of abuse, good luck to him. Read Felitti's ACE Study to learn more.
If we're going to solve the addiction crisis, we'll first need to address the elephant in the room: trauma. America has a child abuse problem.
31
I strongly disagree, but if this is true New England needs to re-vamp children & family services. As a recovered addics, I have spent alot of time in meetings and the only thing that can be said for sure is that we ALL take drugs/drink because it feels good. I have been successful only after taking Suboxone, which does NOT get me high, nor does it allow me to get high in other ways. I do meetings and keep my emotional and spiritual self fit, so that I can continue to walk proud among my peers. I am on a very low dose, but if I had to pay for it every day I would not be able to afford rent. As it is, doctors have to jump through hoops to be given a license to prescribe it, and they are hard to find. My doctor is so overwhelmed that sometimes I have to wait for meds or pay for them, so we are spending this month eating ramen. I am one of the fortunate ones. I am grateful.
2
What an insult to the many good families who have lost a cherished loved one to addiction.
As if they are not in enough pain, they must now endure your accusation of child abuse.
The only case of which I am personally aware was of a well educated young man with a good job, a young man from a good and loving family who did begin his path to addiction through legitimately prescribed pain medication.
Whatever the reason one person becomes addicted while others do not, to paint all such cases with the broad brush of childhood trauma caused by parental abuse is irresponsible and cruel.
2
Marion, I understand your perspective and of course there are many examples of people who have been lost to addiction with no history of trauma. However, the fact of the matter is that a majority of addicts do have a history of childhood trauma, much of it severe. I base my comment on study after study, and on working with female addicts myself. My comment was not intended to be cruel- it was intended to highlight the elephant in the room so that we can begin to address a primary root of the problem.
2
The moment I heard about how the Trump administration was going to deal with the opioid crisis, I thought “Too little, too late.”. When I heard that the Attorney General tied the crisis to marijuana use, I lost it. Does he think that all the people in West Virginia were smoking pot before they became addicted to a drug prescribed by their doctor? I highly doubt it. This administration is so out of touch with what is happening in our country that it frightens me. We have people in two states, and Puerto Rico, that are struggling to survive. Yes, the opioid crisis is real, and should have been addressed long ago by this administration, but right now we have much more pressing needs. We have children in every state that are homeless and are being under serviced by the education system, made worse every day by the Secretary of Education. God help the future of our country.
28
Your observation, beario, taken together with Aimee's (supra) lead me to think that Trump et al.'s maleficent, dishonest governance today will actually aggravate the abuse of narcotics tomorrow.
The inanity of outright prohibition coupled with the steady, categorical reduction of health & social services coupled with the astounding profits to be made by many stakeholders from these products coupled with the disappearance of political honesty in Congress, the Judiciary and the Executive coupled with ... the connections stretch to the horizon and beyond.
And so is it any wonder that, in the face of all this "coupling", the average American might say, "That's it, I'm throwing in the towel and getting high"? Moreover, I'm surprised Sessions isn't recommending capital punishment for opioid users just as he did for those convicted of marijuana possession; maybe Jeff is just protecting his investments in Big Pharma.
1
"President Trump’s brother died an alcoholic, so it’s hard to dispute that Mr. Trump understands the horrors of addiction."
I laughed when I read that opening line. It was the laughter like Tom Hanks in "The Money Pit" when he sees his bathtub crash through to the floor below: the laughter of hopelessness mixed with hysteria. No, I respectfully suggest that Trump does not understand the suffering of substance addiction because he is a heartless but functioning sociopath.
He does not understand the fear of women he has cornered, he does not understand the loneliness of his wife and children that is so plainly written on their faces and obvious to everyone in the world except himself. He does not understand the terror of twenty million people about to lose their health insurance. He understands absolutely nothing but flattery and revenge.
200
He cut off healthcare for his deceased brother's infant grandchild when he was in the hospital with seizures and cerebral palsy. He probably blames the victims of this crisis the way he blamed his brother for dying.
2
Let’s be honest about American society’s comfort with allowing certain segments of our population to sink and drown. We view some people as being unnecessary when they are left out of the new global economy. The same goes for
addicts. If gun-murder rates shot up overnight from 13,000 per year to 60,000 per year people would at least be calling attention to the matter. Overdose deaths of addicts are rather like suicides—on the whole we as a society don’t really care.
Opioid medications, abuse of such medications, and heroin (and even fentanyl) have been around a long time. Before opioid pills it was Valium, and before that cocaine, and before that barbiturates, and so on. And always alcohol. And then there is the king killer, tobacco—sold at every convenience store and grocery.
Another dog and pony show to demonstrate faux concern.
55
Unfortunately, choosing the word "opioid" to denote a drug crisis was a poor choice. Most adult Americans do not know or understand the actual meaning of the word "opioid". It is difficult to have an "opioid" epidemic when nobody understands the word. Time to come up with a new description or a catch phrase of some kind.....
5
Pegged it. The term I was given when I studied to be a counselor was "substance abuse." This includes not just opium-based analgesics but the whole gamut from weed to alcohol to glue. "Opiod," however, just rolls off the tongue. Requires no thought. Blame placed: problem solved.
He isn’t releasing any money because he doesn’t care. This is lip service to his constituency, who will undoubtedly get a different version on Fox News. This combined with the trillion dollar tax cut is front page news today. I feel so incredibly sad for Americans.
29
Big Red state problem, that's why he is addressing it.
1
Jeff Sessions said marijuana is a gateway to opioids in the face of overwhelming evidence to the contrary. A study published by the JAMA in 2014 showed that opioid addiction was reduced on average 25% in legal medical marijuana states. Trump is right, it will take a long time to reduce opioid deaths because of people like Sessions and "just say no" Trump.
57
We need more detox centers, rehab centers and halfway houses with immediate access. As a hospital social worker, I have routinely seen my patients ask for help, only to be discharged home from an opioid-related medical hospital admission because there are no beds available at detox and rehab centers. Once they’re discharged home, it’s too late. At one detox center, patients with Medicaid are told to call every morning at 8am to see if a bed is available that day. How many addicts are going to make that call at 8am? I’m told to fax the patient’s demographics and medical record, and maybe within a week the patient will receive a call that a bed has become available.
Medicaid patients, charity care and self-pay patients need same day access to care. Every politician should spend one week working with a social worker in a hospital emergency room, and then make their policy decisions.
78
Rachel, I too work in a hospital and was wondering where the treatment beds were--not even mentioned. How can that be?!?!?! Are they really that clueless? Addiction is a treatable disease and people need a place to get clean other than a suboxone clinic!! That'll keep them alive but they also need talk therapy treatment. We have people dying while waiting on beds. I couldn't agree more, immediate access to detox, residential treatment and halfway house would help alot more than changing prescribing rules
Unfortunately, what you describe is true not only for patients with addiction but those with any mental illness. As hospitals have gone from institutions where the primary goal is to care for the sick to where it is to make a buck, many have reduced or shut down psychiatric units because insurance companies pay so little for mental health services that it doesn't pay to provide them.
Rachel
RN Case Manager here. You bet they should spend time watching you do your ER Social Work job. And they should spend time on an oncology unit, or a neuro unit, or in a Children's hospital. Then try to tell us the Affordable Care Act is a sham. They don't have a clue. It's all a big show for them, led by the reality TV Star, Donald J. Trump.
MIMA
1
Because 'Just Say No' worked so well! The DARE program has been in schools more than 25 years and our drug usage has increased dramatically.
23
The expert in addiction are often former addicts in eternal recovery. They know. They’ve seen it all. Almost.
These good folks say fentanyl rewires the central nervous system. This was said about crack decades ago.
Charles Darwin expressed a view about natural selection. Those most fit survived.
Substance abuse addiction does not afflict most of us. It affects few.
The expert know that recovery is a function of attitude and will power. There is no magic here.
The most successful treatment centers are stumped with fentanyl.
Let’s hope there’s a way out that starts with a change in attitude.
Money thrown at this problem will not deter. Nor will money assure recovery.
If enough die, kids will learn. In the last analysis, this is where it starts. http://www.mcleanhospital.org/biography/bertha-madras
Addiction is as old as man.
It’s our nature. We must learn.
2
From the great know-nothing, a replay of just say no to drugs.
Uniformed and failing to realize the connection between some of his destruction of grass roots help in Obamacare, Medicaid, Disability, he thinks words and superlatives at that, will just stop addiction. They won't.
Policy and funding at local levels for treatment of addictions is well known, there are many effective models of addiction treatment to draw on.
Together with comprehensive rehabilitation within communities. Trump again seemed to be out of touch with now and backward looking. Again he fails to do his job for Americans.
9
Had Mr. Trump a true concern about the ravages of opioid drug addiction, he wouldn't have been so quick to herald the demise of the Affordable Care Act in order to replace it with a health bill that doesn't cover treatment for it.
Case closed.
54
Adult drug addicts are a reason why healthcare is unaffordable. They should go cold turkey for the good of the nation
Addiction does not care about your political affiliation, financial position, or your station in life. The single most important factor in recovery is the willingness of the addict to accept help and change their way of life. Without willingness, recovery fails.
I was lucky to undergo four months of inpatient treatment, and I have stayed clean for six years. Most of my friends in rehab relapsed, as is often the case after inpatient treatment (check out the relapse rates). I needed a year of aftercare, and I am still in continuing care (therapist, psychiatrist, prescription medicine, and 12-step support groups). I was desperate and willing to go to great lengths to get clean. I still have urges, but I have learned to not act immediately on impulse.
What I needed most--and still need--is support. I feel safest among other recovering addicts who have years of clean time. The most inspiring words I have heard are, "I need your help," and "your life has value."
26
How can the Board expect this man to come up with concrete strategies and programs to address the opioid crisis when he's demonstrated such a poor grasp of healthcare policy in general?
He's a photo-op president, not a problem solver. Moreover, he really doesn't care--despite his having watched his brother die of alcoholism and adopted a rigorous abstinence in his own life.
Because if he cared as much about this as he does about tax reform or Muslim bans, or taunting North Korea, he'd do something about it.
No, he's paying lip service to a very real problem that's far removed from his rarified hours on the golf course or preening for senators as they plot ways to hurt "hard-working" Americans by making the ACA fail and passing pro-wealth tax reform.
Without pledging money and or holding accountable those Republicans (along with Mariano) who helped feed this crisis by loosening regulations on drug distributors, this president is just another empty suit.
Taking a real leadership role requires a basic empathy and desire to help people hooked on incredibly potent drugs that kill faster than previous drug epidemics. It can't be dismissed with bromides, punitive attitudes, or moralizing. Nor can it be helped by ignoring or worse, sabotaging the most basic advice of drug and addiction specialists.
27
I suspect he's referring to fentanyl as the 'evil' drug he wants to ban, which I think the medical fraternity might have something to say about that, given that it's on the WHO's essential medicines list, being used in anaesthesia, epidurals and intractable cancer pain.
Disappointing and alarming (but not surprising) to see a return to the 'just say no' rhetoric that's a proven failure. The only thing that's simple about simple solutions is the people suggesting them.
54
No, I believe he's referring to Opana which is the trade name for oxymorphone. The form of fentanyl involved in opioid overdose deaths is already illegal.
His budget calls for cutting billions of dollars from drug treatment, does he really care about opioid crisis ? This is a joke. We cannot take him seriously but I liked his speech, I am glad that he is bringing attention to the crisis, I hope he will follow with action..
12
But Trump and the Grand Old Phonies are about to proscribe important medicine for America's poor, addicted and dying masses.
Relief is on the way, Americans !
"Take two tax cuts and call me from the morgue": GOP 2017
Compassionate conservatism is back...and it's never been more fatal.
182
Socrates, You hit the nail on the head. Republicans you can always count on to do more for their own pockets and nothing for ordinary Americans. What a shameful party of hypocrites and immoral white old men.
2
The absolutely vacuous POTUS has no conception of the problem. To think anything else is to inhibit a demented delusion.
17
This piece and most explorations of the topic seem to gloss over the primary source of these drugs and hence this scourge: Big Pharma. There should be no talk of spending taxpayer dollars on treatment until we develop the courage to call out the corporate beneficiaries of these drugs. Otherwise this is just another bail out - negative externalities spun off from mega corporations that have to be absorbed by our society.
15
We need treatment too.
We can never expect Trump to fulfill promises or declarations of assistance. Nor can we expect that he will understand or care about the misfortune of others. These next three years plus will be our great misfortune, and we will be faced with the consequences of Trump's dangerous policies for decades.
He is an empty suit topped with an empty mind good only for insults and lies.
Any credit that accrues to Trump and GOP masters in the House and Senate will be in the measurement of the damage they will do to our country. They are complicit and, as has been said, derelict in their duties to benefit all citizens and not merely the most wealthy.
23
Can you at least be honest about this problem. It is not an epidemic. Opioid abuse is not an infectious disease. No one dies from an opioid abuse that is not fully complicit in his own demise. I don't know but I rather suspect that people turn to drugs when they can not find anything worthwhile to do with their lives. It might be easier for them if we eliminated the minimum wage and thereby gave them an opportunity to get to work and start to move up. But of course you and the left would rather have them be unemployed and and turn to drugs for relief from their misery.
5
Whoa, unfortunately not the reality, Bob. Your explanation blaming the victims makes no sense for the current, dramatic, 'epidemic' use of these drugs.
As the statistics and new reports explain, the increase is due to the rampant, unrestricted prescribing of these painkillers to average people with pain from work-related injuries, surgeries, etc. (sometimes from a simple procedure such as dental work!).
The drugs themselves are HIGHLY physically addictive -- I've read the body can become addicted in a week. The blue-collar laborar has been especially hit hard since they can suffer work-related injuries (as reported in NYT).
Big Pharma wins, Americans loose. Blaming the victims doesn't solve the problem.
11
I think you might be wrong here. Addiction is not that simple. Many people become addicted from painkillers prescribed after surgery.
1
One of the definitions of "epidemic" is extremely prevalent or widespread, so I think this problem qualifies as an epidemic.
6
Who in the name of heaven could have expected Trump to understand the problem, do much that is useful or sensible, of show any empathy for the addicted or their families.
If he and his family could see a way to make money on a solution, the country might see some progress. But if they don’t see their way to profit from this tragedy, don’t expect much from that end of Pennsylvania Avenue.
11
Still better then Obama who did nothing nor talk about it.
Seem like the opinion section present only one side of the issue these days
2
Is that what Fox News is saying?
1
Someone who is driven to drug use by economic despair will be facing the same stark despair once they are drug free, for however long that lasts. All our skinflint do-gooders propose is to create a new for-profit industry devoted to getting people "clean" again and again instead of profiting off their being in jail. Without a job paying a respectable wage waiting at the end of the pipeline, we can only expect the cycle to repeated over and over. That however would take a serious rethinking of social policy which tax cuts for the wealthy simply do not address, so platitudes and tiny violins are all you're going to get from Trump and his crowd, including unfortunately many Dems.
9
Where is the evidence that the "despair" felt by people who become addicts is primarily economic? Or even that most of them experience "despair" prior to becoming addicted. These drugs are powerfully addictive. And more importantly, which no one here or in authority wants to admit, they provide extreme pleasure when a person starts using them.
1
Why do you assume that the cause of addiction is economic misery? Look below at some of the comments describing overdose deaths in affluent suburban and rural areas. I saw junkies in Iceland and Norway where the welfare state is still robust and health care is universal. It is a shibboleth of the left, supported neither by research nor by historical experience, that addiction can be cured by raising minimum wage or improving economic conditions of the poor. I do think that addiction has complex socio-psychological causality but using it launch a predictable invective at the GOP is intellectually dishonest.
Maybe he can get Rush Limbaugh to do some of the "really big, really great advertising."
Kidding aside, HuffPost reports: "Trump’s 2018 budget calls for reducing funding for the opioid epidemic by $97 million compared with 2017 levels, said Democratic Sen. Patrick Leahy, vice chairman of the Appropriations Committee. Trump’s budget also calls for eliminating programs like the anti-heroin task force that have proved effective in states like Vermont, Leahy’s home state."
Talk is cheap, Trump. Even yours.
24
There is one and only one thing Trump is in favor of, and that is Trump. He spouts speeches written by others to sound good to the masses, but he has no policies at all, for anything most assuredly not the opioid crisis.
Trump will just leave it to Congress. But what is the Republican Congress in favor of? Staying in power; keeping their jobs. That means following orders of their contributors, including big Pharma, like a bunch of mindless toadies. Even if Congress considered creating laws that would address the opioid crisis, big Pharma lawyers would ensure that the laws had enough loopholes as to be ineffective.
These discussions seem like batting our heads against a solid wall. Congress and the President don't work for the people. Important discussions remain important, but they don't ever get to Congress, so an aura of futility is beginning to descend. One can see why Flake and Corker are quitting.
15
Once again, Trump wants to project the appearance of doing something without actually doing something.
And once again, in offering an oversimplified solution, he demonstrates that he doesn't understand the complexity of this problem.
As Kurt Vonnegut wrote, "So it goes."
14
"...it now spares no state, race or income group.."
Let's add one more...age.
I had a discussion with a county coroner who now spends more time on overdoses than on car accidents. (Heroin overdoses have more than tripled in a reasonably wealthy suburban/rural county in just 2-3 years.) He said that it's amazing how many people in their 40's, 50's, and even 60's are now dying from overdoses, mostly due to the fentanyl in the heroin.
Yes, there is more that the Trump Administration and Congress can and must do. Let's at least give some credit, however, for President Trump's initial steps and use of the bully pulpit to raise awareness.
3
He's all show, no substance. And it's purposeful and manipulative. As some of the media were throwing roses at his feet for something he should have acted upon months ago, they revealed their eagerness to distract thinking individuals from the cold facts: Words are cheap. They are meaningless without resources to prevent the spreading and then the treating of the addicted. There is no magic wand to assuage this NATIONAL emergency unless there is money available, a lot of money. If in all his greed, he is resistant to spend OUR tax money on the health and welfare of HIS responsibility - we, the people - then the Congress needs to step up to the plate. Another question mark when it relates to moral compasses. But one I hope is answered with compassion and concern.
7
You ask us to believe that Donald Trump cares about the misery and addiction caused by same GOP he used, abused and is now discarding... the GOP whose policies of the past 40 years have brought us to this crisis status and then criticize his hamfisted, contradictory and ineffective response? Welcome to the DJT show...
8
This is a waste of time by Trump. People need help and they need it now! He needs to come up with affordable health plans that include help for addicts and there needs to be a national regulation that restricts the amount of opioids that can be prescribed to an individual unless they have terminal cancer or another terrible incurable illness. But because of tax cuts and money needed for Trumps precious wall in the southwest there is not likely to be any substantial money allocated for this national problem. Even the conservative Governor Christe who was put in charge of defining the problem understands the need for resources to address this terrible issue. The problem is the resources are not going to be appropriated
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Christie is all talk, just trying to redeem himself. If he cared, he would open more Medicaid beds at detox and rehab centers. This would save lives, and save money spent on revolving door hospital admissions due to opioid-related illness.
1
Since when did this guy had a clear understanding of anything? Clearly, his dislike for doing his homework and reading anything substantial to at least inform himself is just as foolish as his tweeter habit. The only casualty, by the way, is the whole nation! This nightmare has no end in sight.
11
The cause of the opioid “epidemic” is the same that the cause of the rise of Trump. A sizable minority of whites (especially rural whites) in this country feel that history has left them behind. And they are right. The 1950s are gone and not coming back. The rest of the world cannot be locked out. If you don’t read, think and educate yourself throughout your life, you are nothing. So people have a choice: to adapt or to block out reality. Many choose the second option. They vote for a demagogue who promises that history can be turned back, or they take substances that kill the brain cells for which they have no use. How can the meteoric rise in the level of addiction in a couple of years be called a brain disease? Is there an opioid virus raging through the population the way HIV did? No, the causes are social, cultural and psychological. Throwing money at the problem or building expensive and useless rehab facilities won’t help. Perhaps the transition must run its course. Eventually both Trump voters and opioid users (populations that often overlap) will die out, and a new - hopefully better - society will be born.
9
At the same time Attorney General Jeff Sessions is calling marijuana a “gateway drug.” If we are going to be serious about non opioid pain management, medical marijuana is the obvious path.
17
All talk no action, pen signing photo-op. Ninety deaths per day in a country is a public health emergency requiring money and a multi-level strategic action plan to counter this opioid epidemic. Perhaps he wants to keep his folks addicted and mesmerized so they blindly follow him. Donald the pusher man, pushing his addictive hate filled rhetoric.
12
What else were you expecting?
Sincere interest and action? Really?
28
I'm afraid the root causes that determine who will, and will not, tend to have serious problems with drugs are not within the grasp of this president's thinking.
Until the people crafting policy at the national level (if that's even a thing anymore) understand these causes we don't have much of a chance of PREVENTING all of this damage we see around us.
In the meantime, it certainly is heartening to be hearing so much more talk about "treatment" these days rather than a "war on drugs."
12
Guess you haven't paid much attention to the blithering by Jeff Sessions since he was inexplicably confirmed as Attorney General. This imbecile truly believes marijuana is more dangerous--and a bigger problem--than heroin. Not my words.
22
Could you please, for the love of all that's holy and some of my sanity, tell me about any area where Mr. Trump has actually grasped the problem and has a real solution?
Please?
148
Actions speak louder than words Mr. Trump. Hopefully Yrumo will follow up with some action unless we are to believe that plugging our porous southern border is a start of that action.
4
The opioid epidemic in the United States is a huge problem, and in need of urgent help to prevents deaths. Just don't expect much assistance from incompetent Trump; besides, having no feelings such as compassion towards his fellow men, he seems to be extremely uncaring about other's suffering. So, at least in regards to health care, it would be best to send our demagogue in chief to his golf courses, and get lost. as he'll do much less harm when absent.
9
The problem is one of empathy. He doesn't have any. I can't think of a good reason a narcissist would need any. If your problems are foreign to him, they will remain so. If your story doesn't involve, or revolve around the President, himself, you are just a paper towel toss from becoming irrelevant. "President Trump's brother died an alcoholic, so it's hard to dispute that Mr. Trump understands the horrors of addiction." I beg to differ, just because he knows people in the 99%, doesn't mean he understands the horrors of the poor. At least not so's you'd notice.
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The causes of drug addiction are poverty, hopelessness and availability. When crack cocaine flooded the black urban neighborhoods, the response was to throw everyone in jail. It was all caused by a moral failing of black people.
Now, opiates have flooded into fine upstanding white rural America. The result has been massive increases in addictions. Both epidemics have the same causes. But the white rural epidemic is not a problem with morality. It's just a little education that is required.
So Trump wants to put up some billboards and run some commercials. Big deal.
Why doesn't Trump want to throw all of these people in jail? Because they are his people.
Fixing this problem is going to cost some serious money. I heard on the news today that opioid addiction cost this nation about $75 billion a year. That's less than 1/2 of the annual deficit his new tax cuts will generate. That's real money. So where is it?
Unless we commit substantial resources to this problem, it won't go away. Slashing health care for poor people, especially mental health programs, is only going to make it worse.
But hey, Trump is the great salesman. The greatest. He sold himself as being the greatest. Tell that to dead guy with the needle in his arm.
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If poverty and hopelessness are major factors in drug addiction perhaps you can explain to me why many wealthy people suffer from this disease.
Steve,
Availability. They use it because it is there.
1
Addiction cannot be legislated. Addiction is not illegal. Addiction is addiction.
6
About 10 years ago, physicians in the US were admonished to prescribe opioids because pain was "under-treated." Mass campaigns by professional organizations and government agencies instructed physicians how to prescribe them. Now, 10 years later, we have a "crisis." This is an important issue but one that should NOT be solved by government. Throwing billions of taxpayer dollars at this problem will accomplish nothing--especially when those funds could be put to much better use.
3
Guess you never met anyone afflicted with chronic pain. Lucky you.
The official position of the AMA--until 1979--was that infants don't feel pain. You're just parroting the old Puritanical axiom that anything that makes you feel good must be "bad".
2
This is a distraction from the Trillion Dollar Trump Tax Bill working through Congress. That's why it's only words, and nothing more.
26
On the same day Trump Company decide to add $1.5 trillion to the federal deficit over the next decade, Trump declares there is an opiod crisis but doesn't allocate any money to do anything about it.
Ironic and moronic.
217
What did you expect? With the new tax cuts, they won't be able to afford to add funding to his rant.
1
Ho hum. Another Trump speech, to be followed by ... what? A different direction tomorrow? Some Tweets blaming Obama? Will we ever get tosee you walk the talk Mr. President, and actually DO something?
91
Your column is bizaare. Why are you writing that "one would have hoped that Mr. Trump would be eager to deliver real relief.......
What for? Like he did to the people in Puero Rico. He does not care about other people.
Why are you expecting him to behave in an uncharacteristic way. THIS IS WHO HE IS and always will be.
He talked the way he always does, said essentially nothing and was self referential by talking about his brother. Last time I checked alcohol is not a prescription narcotic. But no matter.
258
Exactly. Why are we still hanging around hoping that Trump will act like a "normal" leader who exhibits empathy and generosity? He has never been this person, NEVER, and there no hope he ever will. So instead of simply decrying his every lying word and phony charade from the sidelines, the opposition should be focused on developing and communicating viable alternatives that can work to address the multiple crises in the country.
1
Amen, Amen and another Amen. You got it Right. Trump is only for Trump
God help us all.
1
Frankly, given what I have seen of Trump, if this issue could be phrased as san opportunity for him and his greedy brood to earn a lot of money... The poor and addicted will find help so fast that it would look like a miracle...
The man is obvious to a fault.. he cares for no one but himself and his immediate associates/family...I mean, we all saw what happened to Puerto Rico..
1
"Just Say No" says Donnie John. Pure theft. When the red states are cleaned out through death the epidemic will be over. The end.
68
He alone can do it.
10
In a world where Trump is President, people are just naturally going to get high.
65
Here what we know - you want drugs- you can order them from China.
You want rehab - we know that rehab fails in two-thirds or more of the cases.
If you honestly want to kill yourself via drug overdose in America - then there is little we can do to prevent you.
The Grey Lady using her bully pulpit to beat up on Trump is not going to change the basic facts on the ground.
3
I will believe it when the poppy fields in Afghanistan get destroyed
19
Ummm-the GOP is on board with Big Pharma. You can thank your vote for why this is a problem.
60