Presidential commission reveals multi-pronged strategy to fight opioid epidemic
“It completely depends on how it’s rolled out,” said Carrie Wade, harm reduction policy director for the R Street Institute. “Some campaigns, there’s a lot of controversy that they actually work. The [D.A.R.E.] campaign was completely ineffective. … But the truth initiatives campaign for nicotine, there’s evidence that show those actually work.”
“As an overall thing, it’s probably putting a lot of money and funding into something that is not going to be very effective, but it totally depends on how it’s rolled out,” she said.
Drug courts are also central to the commission’s vision. These so-called “alternative-to-incarceration courts” address minor drug-associated crimes through suspended sentences and mandatory treatment, rather than shuffling addicts through the prison system. A report from the U.S. Sentencing Commission notes that they are the “longest running and most prevalent of all state problem-solving courts,” with at least 2,000 at the state level.
The commission called for drug courts to be established in all 93 federal district courts, and for state and local courts to apply for funding grants. They note “44% of U.S. Counties do not have an adult drug court.”
Dr. Sally Satel, a practicing physician and resident scholar at the American Enterprise Institute, told the Free Beacon she “strongly supports drug courts.”
“One of the biggest problem with treatment is that dropout rates are very high, up to 60 percent in 6 months,” Satel said. “People need at least one year of serious treatment with supervision. If they have committed a crime … then they are eligible for drug courts and that option is a boon for them.”
Another proponent of drug courts is David Murray, co-director of the Center for Substance Abuse Policy Research. Murray explained to the Free Beacon that drug courts allow for the intersection of criminal and health concerns in one space.
“They’re in principle the right thing. This is both a criminal justice and a public health urgency. So use the full scope of tools that criminal justice and public health can be brought to bear here,” he said.
Drug enforcement also plays a role in the commission’s plan. The opioid epidemic has in the past several years been substantially exacerbated by fentanyl, a highly potent opioid 50 times strongerthan heroin. Fentanyl and its analogues are responsible for 40 percent of opioid overdose deaths in 2016. While many prescription opioid overdoses are due to domestic criminal behavior, fentanyl is often trafficked internationally, especially by the Chinese.
In response, the commission called for “enhanced penalties for trafficking of fentanyl and fentanyl analogues,” as well as “additional technologies and drug detection methods to expand efforts to intercept fentanyl before entering the country.”
Although the commission does encourage seeking opioid alternatives for chronic pain treatment, it stops short of endorsing one prominent but controversial solution: marijuana. It “acknowledges that there is an active movement to promote the use of marijuana as an alternative medication for chronic pain and as a treatment for opioid addiction,” but insists that there is a “lack of sophisticated outcome data on dose, potency, and abuse potential,” pointing to an NIH study which indicated that marijuana use led to a 2.5 times greater chance that the user would subsequently use or abuse opioids.
Wade, for her part, was cautiously optimistic about the use of marijuana for pain treatment, but very clear that it was hard to be sure either way.
“I think it has great potential to be,” said Wade, when asked if marijuana could be a supplement or alternative to opioids for pain treatment.