No New Money, No New Ideas in Trump’s Opioid Response

This article appeared on on Oct. 30, 2017

BY NATHAN RILEY | Donald Trump’s declaration of a public health emergency to end the epidemic of opioid overdose deaths wraps itself in virtue, but avoids the burning question about the nation’s drug policy: What works?

During the 1990s, Switzerland and Portugal were among the nations that experienced the growth in opioid use seen here in the US as well. In those two nations, however, the response was radically different than in the US.

Switzerland and Portugal asked public health officials to solve the problem and minimized law enforcement activity in response. As a result, there, drug use seldom involves criminal sanctions and services are provided by health and social workers comfortable in working with drug users. The Swiss offered medically-assisted therapy with methadone, and for a smaller group of users medical heroin itself. Programs were geared toward aiding drug users in managing their habit. There were never grand declarations to “end” drug use.

The Swiss program — designed by doctors in tandem with users — conflicts with basic American attitudes toward drug use. A cardinal principle is that the user picks their dose. Overdose levels, of course, bring intervention, but the program design is clear that the user must determine their comfort level. After 20 years without a major backlash, heroin users, over the long run, tend to abandon their habit. And, crucially in the context of the link between drug use and other criminal behavior, most live without relying on illegal activity to pay for their habit.

Drug users have easy access to medically-assisted treatment. Those users permitted access to medical heroin in Switzerland must stop over a three-to-10-year period. The number of Swiss narcotics-related deaths in 1995 was 376; by 2012, it had fallen two-thirds to 121.

These nations have housing and psychological services available to all, one of the key demands of drug reformers. The presidential commission appointed by Trump and headed by New Jersey Governor Chris Christie endorsed that idea, but there is no money in Medicaid for these services.

Donald Trump had two ways to go — finding more money for health services or making bold but empty promises. If he had declared a “national emergency” — as he initially pledged — it would have created claims on a $53 billion federal fund. For the “public health emergency” he declared last week, there is currently $57,000 in the kitty. Hence the Times’ headline: “Trump Declares Opioid Crisis a ‘Health Emergency’ but Requests No Funds.”

A swift warning came from Gay Men’s Health Crisis about the “potential efforts under the Public Health Emergency Declaration to redirect funding from HIV/ AIDS programs.” The Daily News also voiced suspicion that money would be siphoned from AIDS/ HIV services.

But the biggest howl of fury came from the new executive director of the Drug Policy Alliance, who blasted the president’s speech saying it showed “a profound and reckless disregard for the realities about drugs and drug use.” Maria McFarland Sánchez-Moreno, a human rights activist who replaced Ethan Nadelmann, challenged Trump, poopooing his recommendation that drug prevention programs revive the “just say no” evangelizing of Nancy Reagan and his faith that public service announcements would “prevent” drug use.

“He made a big deal” about taking a pharmaceutical opioid off the market, she scoffed, noting that such a strategy is years out of date. “The opioids involved in overdoses are mostly coming from the illicit market” today, McFarland Sánchez-Moreno said. Drug users have gone from the gray market to a wholly criminal underground market of drugs laced with fentanyl — a transformation that is a damning indictment of the prohibition and the criminalizing of drug use. Drug deaths have been rising for years. Last year, there were 64,000 overdose deaths — roughly equal to all Americans killed in the Vietnam, Iraq, and Afghanistan conflicts combined.

Trump also showed his ignorance about how drugs enter the US, when he spoke lovingly of how his Mexican border wall would halt the inflow. McFarland Sánchez-Moreno was unconvinced; the illicit drug trade, she said, “always” finds ways to “get around the walls and barriers the US has put up to block it,” with many drugs smuggled inside freight containers as part of our heavy border commercial traffic with Mexico.

Pointing his finger at immigrants, she added, has a sinister motivation. Trump blames “immigrants for bringing drugs across the border, ignoring that immigrants are overwhelmingly more law-abiding than US citizens,” McFarland Sánchez-Moreno said. The entire presidential declaration, she said, provided yet another excuse for “talking about criminal justice answers to a public health problem, even though the war on drugs is itself a major factor contributing to the overdose crisis.” Trump is still trying to use a hammer to smash the drug problem, with immigrants hit with a special ferocity.

The president’s plan, McFarland Sánchez-Moreno charged, will spread pain and misery, “condemning even more people to death, imprisonment, and deportation in the name of his war on drugs.”

Sadly, as if on cue, Chuck Schumer, the top Democrat in the US Senate, answered Trump’s call, finding $12.5 million to fund a new DEA team to focus on the smuggling of fentanyl at Kennedy Airport. Look for the arrest of black and brown baggage handlers.

Nobody expects this one unit to make a real difference, but it points up drug reformers’ fears that in a nation that refuses to give up its belief that criminal law protects its young from drug addiction, law enforcement will get the bulk of any new funds identified. A public health approach, based on strategies that “work,” remains the low man on the budget totem pole.

Drug Reformers Declare Solutions Must Be Sweeping

This article originally appeared in Gay City News.

Added by paul on October 26, 2017.Saved under Nathan Riley
Tags: Ethan Nadelmann, Jerry Brown, Drug Policy Alliance, medical marijuana, Donald Trump, opioid crisis, “The New Jim Crow”, Michelle Alexander, crack epidemic, mandatory sentences, mass incarceration, drug legalization, Maria McFarland Sánchez-Moreno
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Michelle Alexander delivering the plenary address in Atlanta. | DOUG McVAY/ INTERNATIONAL DRUG POLICY REFORM CONFERENCE

BY NATHAN RILEY | Activists from across the globe gathered in Atlanta October 11-14 to plot strategy for defanging drug prohibition in the United States. The conference, called by the Drug Policy Alliance, scrambled to balance recognition of the limited possibility for gains and the conviction that justice demands sweeping reforms.

Michelle Alexander, whose 2010 book “The New Jim Crow” laid out in damning detail the harsh penalties imposed on black and brown communities under the guise of fighting drugs, gave the plenary address, which took on the puzzle of President Donald Trump’s election.

In a fierce display of racial solidarity, she said, voters in 30 states supported Trump’s “deliberate appeal to white racial resentment and anxieties” while at the same time voters legalized pot in four states and led four more states to enable medical marijuana programs. A greater turnout by black and brown voters would have defeated Trump in states like Florida, North Carolina, and Pennsylvania.


The results don’t represent a paradox, insisted Alexander, but fit the longstanding pattern of Jim Crow justice. Last year, 64,000 Americans died from drug overdoses, she said in a fiery speech, a number greater than the total of all the soldiers killed in Vietnam.

“Yes there is an outcry, but it is relatively muted compared to the crack epidemic,” she said.

Crack “killed just a tiny fraction of those dying of opioid overdoses and yet a literal war was declared on poor people of color — a militaristic war” during the height of crack use, she argued. There were “round-ups of people herded into courtrooms.

“Things are very different this time around. The white face of medical marijuana and the white male face of drug heroes such as those in ‘Breaking Bad’ make it possible for white folk to feel a kind of empathy that was utterly impossible 20 years ago in the midst of the crack epidemic.”

Alexander warned that the contrast between white people’s ability to sympathize with Caucasian users and their indifference to the suffering in black and brown communities is more than a weakness in drug policy. As Trump’s election demonstrates, she said, that disparity in attitudes threatens democratic government.

A racially mixed crowd of 1,500 gathered in Atlanta as Alexander insisted that whites must break out of the cocoon that shields them from appreciating the suffering of other communities.

Citing sentencing reformer Marc Mauer’s book, “Race to Incarcerate,” she explained, “The most punitive nations in the world are the most diverse; the nations with the most compassionate, or the most lenient criminal justice policies, are the most homogenous. You know, we like to say that diversity is our strength when it may actually be our Achilles heel.” Jim Crow justice, Alexander said, threatens civil liberties in the US and it fosters a failed government that could undermine “the future of the globe.”

The argument that whites must check their privilege and make common cause with immigrants, blacks, Latinos, and Native Americans was a constant conference theme. A true interracial majority coalition is a key objective of the Drug Policy Alliance.

There are hopeful signs. Harm reduction programs are spreading in the South, and in California a new law reduced mandatory sentences, with Governor Jerry Brown signing the RISE Act just as the conference convened. The measure ends sentencing enhancements that have added three years to drug convictions for every prior conviction. Long sentences are cruel and cause the pernicious pattern of mass incarceration.

Other good news: in Atlanta, the mayor signed a bill decriminalizing marijuana possession, and there are rumors that communities across New York State are prepared to move toward experimental safe consumption spaces where drug users are in the presence of an overdose prevention worker who can intervene immediately if things go wrong.

This conference was the first hosted by Maria McFarland Sánchez-Moreno, who has replaced Ethan Nadelmann as the Drug Policy Alliance’s executive director. McFarland Sánchez-Moreno has done human right work in drug war battlefields in Peru and Columbia, and during her tenure as co-director of US Programs at Human Rights Watch, her team pushed against racial discrimination in policing, excessive sentencing, and unfair deportation policies that tear families apart.

The Drug Policy Alliance first championed medical marijuana as a first step in unwinding prohibition, but the organization’s program has expanded and now calls for decriminalization of all drugs. Essentially, the group wants the police to arrest no one for drug possession, but instead steer a drug user to a harm reduction program. This is the policy in Portugal and is being tested in Seattle.

The unhappy truth, however, is that this approach would have only a tangential impact on harsh Jim Crow justice.

Possession seldom brings long sentences; these sentences are imposed on sellers. The opioid crisis has brought a new wave of arbitrary penalties. Sellers are seen as murderers because their product includes fentanyl. Yet they don’t make the product, and in the northeast US virtually 100 percent of the street product is fentanyl or laced with it.

Dealers have no control over the ingredients, but they are sentenced as though they created the system.

A sweeping opposition to the criminalization of poverty and drug use forms the radical core of the Drug Policy Alliance, and Atlanta made that ultimate objective abundantly clear.