One of the lesser reported stories has been the extraordinary push by the White House to respond to the opioid crisis.
When President Trump took office in 2016, opioid overdoses accounted for over 42,000 deaths, out of a total of 64,000 who died from all forms of drug overdoses. In that year, two million Americans had an addiction to prescription and illegal opioids. Deaths from synthetic opioids increased by 72% from 2014 to 2016, caused a daily death total of 175 per day. It has been estimated that over two million Americans suffered from related addiction. Over 300,000 overdose deaths have occurred since 2000.
In 2015, the Drug Enforcement Administration and CDC issued nationwide alerts identifying illicitly manufactured fentanyl (IMF) as a threat. Beginning in 2013, the distribution of IMF increased to unprecedented levels. Individual states have reported increases in fentanyl-involved overdose deaths (fentanyl deaths). During 2013–2014, the number of drug products obtained by law enforcement that tested positive for fentanyl (fentanyl submissions) increased by 426%, and synthetic opioid–involved overdose deaths (excluding methadone) increased by 79% in the United States. Changes in synthetic opioid–involved overdose deaths among 27 states were highly correlated with fentanyl submissions but not correlated with fentanyl prescribing. Eight high-burden states were identified, and complementary data indicate increases in these states are primarily attributable to fentanyl, supporting the argument that IMF is driving increases in fentanyl deaths.
A Heritage Foundation study describes the allure and danger of fentanyl:
“The amount of fentanyl necessary to produce its painkilling effect is so small that manufacturers can ship it in ordinary packages such as envelopes used for ordinary letters. Cheap production isn’t the only economic benefit suppliers have on their side. Fentanyl is said to produce a better high and be more addictive and potent than heroin (50 to 100 times more powerful). This poison isn’t affecting only addicts. In some cases, first responders have inhaled airborne fentanyl, resulting in a contact overdose.”
The Washington Post called this dilemma the “Obama Fentanyl Failure. “The fentanyl crisis represents an extraordinary public health challenge — and requires an extraordinary public health response… experts wrote to six [Obama] administration officials, including the nation’s ‘drug czar’ and the chief of the Centers for Disease Control and Prevention. The administration considered the request but did not act on it. The decision was one in a series of missed opportunities, oversights and half-measures by federal officials who failed to grasp how quickly fentanyl was creating another — and far more fatal — wave of the opioid epidemic. In the span of a few short years, fentanyl, a synthetic painkiller 50 times more powerful than heroin, became the drug scourge of our time. Fentanyl has played a key role in reducing the overall life expectancy for Americans.”
Who, or what, caused this troubling situation, which seems to have expanded so rapidly?
Testifying before the United States Senate Caucus on International Narcotics Control Caucus last year, U.S. Customs and Immigration Enforcement (ICE) Assistant Director Mathew C. Allen stated:
“Illicit Fentanyl, Fentanyl analogies, and their chemical precursors are most often produced in China. From China, these substances are shipped primarily through mail carriers directly to the U.S., or through TCOs in Mexico, Canada, and the Caribbean. Once in the Western Hemisphere, fentanyl or its analogues are prepared and then mixed into heroin supply, pr pressed into pill form, then moved to the illicit U.S. market where dependency on prescription opioids ad heroin remains at epidemic proportions. In some cases, traffickers have shipped industrial pill pressed from China to the United States to operate fentanyl pill press mills domestically. Mexican TCOs also receive shipments of fentanyl, fentanyl analogues and their precursors directly from China. There is strong evidence that large shipments of fentanyl move from China to Mexico and the shipments are not opened until they are within the United States. Mexican cartels have seized upon this business opportunity because the profit potential of synthetic opiods and have invested in growing their share of the market. Because of its low dosage range and potency, one kilogram of fentanyl purchased in China for $3,000-$5,000 can generate upwards of $1.5 million in revenue on the illicit market…”
In October of 2017, the new White House declared the opioid crisis a “public health emergency.” The declaration was designed to expand access to telemedicine services; appoint specialists; and shift some resources from HIV/AIDS programs to those dealing with substance abuse
In 2018, President Trump unveiled an “Initiative to Stop Opioid Abuse.” The measure involved:
- As of October 2018, securing $6 billion in new funding over a two-year window to fight opioid abuse.
- To curb over-prescription, implementing a Safer Prescribing Plan designed to cut opioid prescription fills by one-third within three years.
- Increasing security at land borders, ports of entry, and waterways.
- Passing the SUPPORT Act, the largest legislative package addressing a single drug crisis in history.
The White House notes that the number of first-time heroin users ages 12 and older fell by more than 50 percent in July 2017. Between President Trump’s Inauguration and October 2018, high-dose opioid prescriptions fell by 16 percent. In July 2017, the Department of Justice shut down the country’s biggest Darknet distributor of drugs. That same Fiscal Year, U.S. Immigration and Customs Enforcement took more than 2,300 pounds of fentanyl off the streets. In terms of helping those struggling with addiction, there has been a 20 percent increase in young adults receiving outpatient treatment. And in 2017, America had an increase in the number of patients age 12 and older with illicit drug-use disorders being treated at specialty facilities and private provider offices.
On January 10, 2018, President Trump signed into law the “Interdict Bill,”
The measure authorizes $9 million to purchase enhanced tools and hire more personnel to deal with the crisis; provides additional chemical screening devices available to detect opioid traffic; and requires analysis and data interpretation of relevant data.
Illustration: Pixabay