Fighting opioids: Give insanity a chance

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It’s insane.

Trump’s proposed war on opioids, that is.

If insanity can be characterized as doing the same thing over and over and expecting different results, the plan Trump unveiled last Monday to end the nation’s opioid epidemic is as exquisitely perfect an example of this as you could hope to find.

In a speech in New Hampshire and broadcast on the White House website, Trump promised to reduce the supply of opioids by “getting tough” on drug dealers, including increasing the use of mandatory minimum sentences and using the death penalty, by building the wall along the southern border to reduce drug smuggling, and by suing drug companies.

He promised to reduce demand by getting doctors to write one-third fewer prescriptions for opioids over the next three years; by getting states to join a national database to monitor opioid prescriptions; by developing new, non-addictive pain relievers as substitutes for opioids; and by mounting major media and advertising campaigns to keep people from getting addicted in the first place.

He promised to vastly expand access to treatment for addicts.

And, of course, he promised to throw more money at the problem, including $10 billion over the next two years (it’s not clear if that is in addition to the $6 billion Congress has already voted to throw at the problem).

What Trump’s speech didn’t include was any plausible reason to believe that any of this would make a dime’s worth of difference.

The federal government has been trying to rid the U.S. of opioids for more than a century (for 103 years and three months, to be precise, ever since the passage of the Harrison Narcotics Tax Act on December 17, 1914).

During that time, everything that Trump has proposed for stamping out opioid addiction (with the possible exception of suing pharmaceutical companies) has been tried repeatedly — and failed repeatedly.

Getting tough? As I’ve mentioned often in this space, since 1965 the war on marijuana has resulted in 25 million arrests. The rest of the story is that during that time there have been an additional 25 million arrests for other illegal drugs — mostly heroin, cocaine and methamphetamines.

The result of “getting tough” was perfectly summed up by Senator Dick Durban (D-Illinois), in a single sentence: “We cannot arrest our way out of the opioid epidemic — we tried that and ended up with an even bigger addiction problem and the world’s largest prison population.” And more than 40,000 fatal overdoses a year.

Securing the border? The feds have been trying to stop drug shipments into the country by land, air and sea — the term of art is “interdiction” — for decades. Estimates of the percentage of opioids seized vary, but anything above 20 percent is optimistic.

It’s hard to see how the wall will improve that percentage, since, unlike marijuana, opioids can easily be hidden in shipping containers, more than 26 million of which enter the country annually.

Reducing demand with media and advertising campaigns and anti-drug education? The Partnership for a Drug Free America ran $2 billion worth of ads (including the iconic “This is your brain on drugs,” with a fried egg starring as your brain), and the feds spent billions on the Drug Abuse Resistance Education (D.A.R.E.) program. Drug use went up. Why, it was almost like the anti-drug campaigns were creating interest in drug use where none had existed before. 

Develop non-addictive anti-pain medications? That one is particularly rich, considering that most of the synthetic opioids, whose over-prescription lies at the root of the current opioid epidemic, were originally touted as “non-addictive” alternatives to heroin.

And so on.

So why would Trump propose a new war on drugs that’s defined by the failures of past wars on drugs?

Probably because he promised to end the opioid epidemic. Bluster, boorishness and hyperbola aside, the thing that sets Trump apart from other presidents is that he tries really hard to keep his campaign promises — and when it comes to the opioid problem he hasn’t any ideas about what to do it, except the old ones that have historically failed.

But as George Santayana observed, those who can’t remember the past are condemned to repeat it.

And then there’s this thought from Marx: History repeats two times, the first as tragedy, the second as farce.

Chances are the drug war is about to enter the farce phase.