Donald Trump was serving his first term as president when fentanyl began to flood American communities. What do experts say he can he do now to reduce overdose deaths?
LEILA FADEL, HOST:
President-elect Donald Trump is promising to crack down on fentanyl smugglers and drug dealers. Critics say many of his tough policy ideas are unrealistic and could drain support from addiction programs that are saving lives. NPR’s Brian Mann reports.
BRIAN MANN, BYLINE: When Donald Trump talked about street fentanyl and overdose deaths during the campaign, he framed it not as a public health crisis, but as a border problem, a crime problem.
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DONALD TRUMP: Sir, I heard you want the death penalty for drug dealers. Why? Well, you know, I’d like to end the drug epidemic, if that’s OK.
MANN: Fentanyl and other street drugs kill roughly 100,000 people in the U.S. every year. After the election, the man Trump named to serve as border czar, Tom Homan, promised U.S. military action against Mexican drug cartels during an appearance on Fox News.
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TOM HOMAN: President Trump is committed to calling them a terrorist organization and using the full might of the United States special operations to take them out.
MANN: Fentanyl actually spread in the U.S. during Trump’s first term. And most people smuggling the deadly opioid into the U.S. are American citizens, not Mexicans or migrants. But many addiction experts say Trump’s tough talk appealed to voters. Tom Wolf is an activist in California who’s in recovery from opioid addiction. He says Americans want this crisis solved fast.
TOM WOLF: People are tired of the theft. They’re tired of the open drug use. And they want some accountability to be injected back into the process.
MANN: Jonathan Caulkins, a researcher at Carnegie Mellon University, agrees Americans are exhausted by the public disorder and death that come with fentanyl. The question now is whether Trump will follow through on ideas that would tilt the country’s response sharply from treatment and recovery toward more police – and possibly military – action. Caulkins called some of those ideas misguided.
JONATHAN CAULKINS: Even invoking the idea of military action in Mexico against drafters is, like, the worst idea anybody has ever, ever had.
MANN: Caulkins believes a U.S. military strike would do little to slow fentanyl smuggling or save American lives but could shatter diplomatic relations and destabilize Mexico. Brandon del Pozo, a former police chief who studies drug policy at Brown University, also blasted Trump for his death penalty plan.
BRANDON DEL POZO: There are thousands, if not hundreds of thousands, of Americans who our neighbors are doing something that’s illegal, right? They’re definitely dealing drugs, but they might be doing it because they’re addicted to drugs. The idea that we would execute them – that shocks the conscience.
MANN: Even some activists like Tom Wolf, who want tougher drug policies, worry Trump could go too far, deemphasizing drug treatment and recovery while reigniting a full-scale drug war.
WOLF: I would like to see the pendulum stop in the middle. We all know that the war on drugs in the ’80s was over-draconian. As a result, it failed.
MANN: Trump takes over at a moment when there are signs the public health approach may be working. Drug deaths dropped sharply over the last year, a trend that saved about 16,000 lives according to the Centers for Disease Control and Prevention. Many researchers credit the Biden administration for pushing better health insurance, treatment and medications for people with addiction. Keith Humphreys, a drug policy expert at Stanford University says it would be a mistake for Trump to cut programs that appear to be helping.
KEITH HUMPHREYS: My fear would be that he continues chopping away at the Affordable Care Act and Medicaid, which are the financial backbone of the American addiction treatment system.
MANN: Kassandra Frederique, who heads an advocacy group called the Drug Policy Alliance, predicts Trump will shift the country’s fentanyl response away from public health, hoping for a quick fix.
KASSANDRA FREDERIQUE: Someone is saying to you that we will just turn off the faucet, cut the supply chain. We’re just going to arrest all the people. Then we won’t have to deal with this anymore. And while it can be attractive to some people, it’s a mirage.
MANN: Every expert interviewed by NPR agreed Trump’s promise of a swift end to the fentanyl crisis is unrealistic. Despite recent progress, most said the addiction and overdose epidemic will take years, or even decades, to solve.
Brian Mann, NPR News.
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