It now appears that the Trump administration is advancing their plan to impose stricter penalties in order to address the opioid epidemic, and may make it public as early as next Monday, when the President is scheduled to appear in New Hampshire. Among other things, the plan calls for a mandatory minimum death penalty for drug traffickers who are involved in the distribution of illegal opioids such as fentanyl, which is incredibly lethal.

According to the Politico report, the language used in the plan proposed by the Trump administration would provide options for the death penalty to be used in “certain cases where opioid, including Fentanyl-related, drug dealing and trafficking are directly responsible for death.”

President Trump’s recent statements regarding imposing stricter penalties for drug traffickers have caused strong reactions. Trump indicated that he wanted to seek the death penalty for drug dealers, similar to sanctions imposed in places like Singapore, which has had a high rate of drug-related executions for years.

Kellyanne Conway, who leads President Trump’s anti-drug efforts, in an attempt to clarify the President’s comments after his appearance at the opioid summit last month, indicated that the President feels strongly about drug dealers who bring the powerful drug fentanyl into communities, which often leads to multiple overdose deaths within a short period of time.

Trump’s stance on punishments for drug dealers stands at odds with what many see as an addiction issue currently sweeping the nation. Many people feel that mandatory minimums and other harsh punishments do nothing to mitigate drug crimes, and rather, unfairly punish people in poverty and other circumstances, highlighting the divided approach to assessing and combating the opioid and prescription drug epidemic.

Even though the Trump administration declared the opioid crisis a national emergency in October of 2017, the administration did not allocate additional resources to fighting it or to assist local agencies with any efforts to combat the problem. Former Democratic congressman Patrick Kennedy, said, “When we get a message like the president gave and his actions speak louder than words when he doesn’t appropriate the resources, it makes a farce out of his speech.” 

Last fall, the President’s Commission on Combating Drug Addiction and the Opioid Crisis released a report with recommendations for how to approach the crisis, and many of those are in the Trump administration’s proposed plan, including recommendations for drug monitoring databases that could be accessed nationwide in an attempt to flag patients who are seeking prescriptions in multiple states as well as increasing the availability and access to the powerful anti-overdose drug naloxone. Recommendations also included massive media campaigns to address the issues of addiction, and to reclassify addiction as a “chronic brain disease,” and provide additional education to students about the effects of opioid abuse.

The plan proposes to limit access to opioids by changing how the government pays for prescriptions; seeks changes to Medicaid approval for treatments that would help addicts obtain the necessary treatment for their addictions; and would form a new DOJ task for that would help monitor internet sales. Currently, there is an outdated, antiquated rule that bars Medicaid from paying for inpatient treatment for addiction; the plan asks Congress to repeal that rule so that residential treatment would be covered. (Under both the Obama and Trump administrations, certain states have obtained federal go ahead to waive that Medicaid rule barring inpatient treatment.)

Additional ideas, such as the implementation of mandated prescription issuance adhering to “best practices” by Medicare and Medicaid would also be scaled from 75% in three years to 95% in five.

It also appears that the current proposed plan would cost significant more than Trump had initially budgeted – potentially billions more, which would most likely not be approved by Congress. If Congress does go ahead and reverse the current rule banning Medicaid coverage of inpatient treatment, that additional cost could be a significant burden to the states affected.

United States Attorney General Jeff Sessions announced a new task force aimed at targeting the pharmaceutical companies, who, according to Sessions, have contributed to the epidemic by continuing to sell and push the opioids and other addictive pain killers. The task force, called the Prescription Interdiction and Litigation Task Force (PIL), will “examine existing state and local government lawsuits against opioid manufacturers to determine if we can be of assistance,” according to Sessions. Sessions also mentioned the impact of deceptive marketing tactics used to push painkillers and opioid drugs, making them more attractive to consumers while hiding the dangerous side effects and addictive nature of those drugs. The PIL task force would also allow for increased prosecutions of criminally negligent doctors, pharmacies, and other healthcare providers.

In the announcement on February 27, Sessions said, “The Justice Department will primarily argue that the federal government — through various federal health programs and law enforcement efforts — has borne substantial costs from the opioid epidemic and seeks reimbursement.”

The plan would also approach the epidemic from the enforcement side, seeking tougher punishments as a means of deterring the sale and consumption of opioids and other painkillers, as well as other illegal substances. However, this approach is not supported by many, including a significant number of public health advocates who argue that the opioid epidemic is a disease, and should be treated as such. Human rights groups have long objected to sweeping mandatory death sentences, especially as they relate to drug crimes, citing a number of mitigating factors that may play into those cases. Often, drug dealers are users themselves, and their addictions feed their criminal activities.

Many have argued that an increase in punishments for drug crimes would disproportionately affect people of color and the poor. According to The Sentencing Project, one half of people currently incarcerated in the US are incarcerated due to drug crimes, and the number of inmates in the US due to drug crimes is currently 10 times greater than it was in 1980. Tougher punishments for drug use and sales, as implemented in the infamous “War on Drugs,” have not resulted in lower rates of illicit drug use, and in fact, reports suggest that drug use has increased. 

While he did not reference a specific country in statements provided at an opioid summit last month, Trump did say, “If you shoot one person, they give you life, they give you the death penalty. These people can kill 2,000, 3,000 people and nothing happens to them … Some countries have a very, very tough penalty, the ultimate penalty. And, by the way, they have much less of a drug problem than we do. So we’re going to have to be very strong on penalties.”

These statements are in line with similar directives issued by the Trump administration, including those issued by US Attorney General Jeff Sessions, who urged prosecutors to “pursue the most severe penalties possible” earlier in 2017.

Under the Obama administration, then-Attorney General Eric Holder had directed prosecutors to avoid charging defendants with crimes that would automatically mandate lifelong sentences or long mandatory minimums. Sessions, in 2017, issued a two-page memo rescinding Holder’s guidance, and asked that prosecutors charge defendants with more serious crimes that carry longer sentences.

New York Representative Chris Collins supports the plan, telling Politico, “I’m all in on the capital punishment side for those offenses that would warrant that. Including drug cases. Yep.”

Other lawmakers have expressed a less optimistic view of the idea to call for the death penalty, including Senator Shelley Moore Capito (Republican, West Virginia), who said, “I mean, I get the message he’s delivering: We’ve got to treat it seriously. I don’t see that that’s going to solve the problem.” West Virginia has been hit particularly hard by the opioid epidemic.

Representative Jared Polis (Democrat, Colorado) told Rolling Stone, “President Trump has long admired dictators and strongmen, so it shouldn’t surprise us that he espouses the rhetoric of somebody like the Philippine dictator [Rodrigo] Duterte. I wish that he had the same tenacity in attacking the practices of multi-national pharmaceutical companies that have pushed prescription opioids, which have led to the vast majority of abuse cases.”

Also quoted in the Rolling Stone article were other lawmakers, including Representative Dana Rohrabacher (Republican, California), who said: “I would hope however that we would try to focus more on treatment than we do on the murder of drug salesman who are peddling hard drugs. The war on drugs has been totally unsuccessful. What we should be trying to do is refocus those efforts on people who are addicted to hard drugs to help them and try to give them an avenue out, rather than simply trying to beef up the police force and buy more guns and battering rams.”

President Trump is planning on going to New Hampshire next week accompanied by Heath and Human Services Secretary Alex Azar. It seems likely that his plan for addressing the opioid crisis will be unveiled during his speech at Manchester Community College.

 

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