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State of Addiction Policy: Looking ahead at a Trump presidency

State of Addiction Policy: Looking ahead at a Trump presidency

This article marks the completion of Sovereign’s 10-part State of Addiction Policy editorial series. Over the past year, we have broken open a wide range of controversial political topics and examined their effects on the health of the nation. The series comes to a close with the culmination of the presidential election.

  • See the rest of our State of Addiction Policy articles here.

After a seemingly interminable election season, voters from across the country finally had the chance to visit their local polling stations on Nov. 8 and cast their ballots for president of the United States of America. When the dust had settled, there emerged one victor: Donald Trump, the outspoken political outsider.

But winning the election was only the beginning. Now that the drama and headlines of the election are behind us, we can look forward and consider what Trump’s presidency will hold. Based on his campaign and the analysis of experts, we can draw conclusions on the effect that the Trump administration will have on various aspects of health in America.

Trump on drug addiction

For most of his presidential campaign, Trump’s stance on curbing drug addiction centered almost exclusively on stopping the flow of drugs from entering the country through our southern border with Mexico. On Oct. 28, just 11 days before Election Day, he released a more detailed plan to curb drug abuse, with four main points:

  1. Build the wall along the Mexican border, aggressively prosecute drug dealers and deport illegal immigrant traffickers
  2. Close shipping loopholes with China that have allowed dealers to send the powerful opioid fentanyl through the mail
  3. Fix drug regulations such as increasing access to recovery drugs and limit the number of Schedule II drugs made in the U.S.
  4. Help recovering addicts through means including the Comprehensive Addiction and Recovery Act, drug courts and expanded access to the opioid overdose reversal treatment naloxone

Trump’s focus on attacking the supply, called interdiction, has not been popular with addiction experts. Theodore Cicero, a substance abuse expert and professor of psychiatry at Washington University in St. Louis, said, “All interdiction attempts have failed. It is hard to see how re-emphasizing attempts to reduce supply will make much of dent in an important problem. We need to reduce demand, not simply the supply of these drugs.”

The president-elect’s recent expansion of his drug policy has been noted by pundits, but has been criticized for being undercooked. Kaltheen Ronayne of the Associated Press notes that Trump “has called for expanding enforcement as well as treatment programs, but he has offered no specifics on costs.” Author and editor Phillip Smith called Trump’s prevention, treatment and recovery plan “lip service.” Without details, it is difficult to determine what effect, if any, these measures will have on drug addiction.


State of Addiction Policy: Looking ahead at a Trump presidency  Trump on the Affordable Care Act

Perhaps the most contentious and divisive health care issue during the campaign was the debate over the Affordable Care Act (ACA), colloquially known as Obamacare. While Hillary Clinton promised to double-down on the ACA and expand it, Trump has strenuously argued to repeal and replace the act.

Throughout his campaign, Trump has defined the ACA as a broken and unnecessary economic burden, criticizing the act’s “runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices.” He has promised to restore “free market principles” to create a number of reforms in the ACA’s place, including:

  • Allowing citizens to deduct insurance premiums from their taxes
  • Financing state Medicaid programs with block grants
  • Allowing the sale of insurance across state lines
  • Requiring price transparency on health care providers

These reforms have not been met with enthusiasm by many financial experts, however. The Committee for a Responsible Federal Budget, a nonpartisan think tank, estimates that Trump’s policies “would cost nearly $550 billion over ten years under conventional scoring and about $330 billion with dynamic scoring.” According to a Commonwealth Fund report conducted by Christine Eibner and colleagues at the RAND Corporation, Trump’s plan would also increase out-of-pocket costs to consumers, particularly low- and middle-class families.

Trump on mental health

While Trump’s opponent made mental health a primary part of her campaign, Trump has not provided many details for his plans to tackle the issue. The Star Tribune notes in a comparison of the candidates’ plans that “Trump does not offer anything in specific” and that “his webpage offered very little as to his stances on mental health.”

On Trump’s campaign website, he addresses the subject by saying that “we need to reform our mental health programs and institutions in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support.”

Trump has offered no further information on just what those reforms are or what plans he would create himself, if any, to address the issue. This apparent lack of interest in mental health has received criticism from commentators. Ben Cohen of The Banter describes his plan as “do absolutely nothing other than waiting around for Congress to pass something.”

Trump on gun rights

When Trump does mention the issue of mental health, it is often in the context of defending Second Amendment rights. Proud of his support from the National Rifle Association, Trump has championed the issue of gun rights. With the spate of mass shootings receiving widespread attention, the issues of gun rights and mental health have become inextricably linked.

In contrast to Clinton, Trump has not advocated to prevent the sale of firearms to people who have been involuntarily committed to outpatient mental health care. He states, “Most people with mental health problems are not violent, but just need help.” Instead of changing gun laws, he has proposed, “Fix our broken mental health system. All of the tragic mass murders that occurred in the past several years have something in common – there were red flags that were ignored. We can’t allow that to continue. We must expand treatment programs, and reform the laws to make it easier to take preventive action to save innocent lives.”

As before, Trump has yet to provide any details on how he would fix the mental health care system to curb gun violence, leaving the future uncertain.

State of Addiction Policy: Looking ahead at a Trump presidency

Trump on crime

Billing himself as the “law and order candidate,” Trump has made crime one of his tent pole issues. Promising to get tough on crime, he characterizes America as “at a moment of crisis,” saying, “The attacks on our police, and the terrorism in our cities, threaten our very way of life.” The data, however, shows that both crime and attacks on police have gone down significantly over the past decade.

While Clinton advocated for community policing and called for increased training on deescalating encounters with minorities and the mentally ill, Trump has advocated the federal government to stay out of the issue “unless invited in by appropriate authorities or when verifiable improper behavior is clearly demonstrated.” Instead, Trump would have investigations into police misconduct limited to the state and local level. This leaves open the question of continued police violence against the mentally ill.

While only the future will tell whether Trump’s strategies have a positive effect on behavioral health, the fact that the topic has entered into the public discussion is itself a blessing. With increased attention and community involvement, it is to be hoped that the overall health of our nation will see improvement by the time the next election rolls around.

Take a look at our survey below and weigh in on how you believe America’s health will fare over the next four years. Tell us what you rated and share your thoughts with us at news@sovhealth.com.

Look back at this series

All previous articles in our State of Addiction Policy series are available for review, so you can catch up on any that you might have missed:

  1. The growing shift to treat addiction as a health issue rather than a crime
  2. Overview of the changing attitudes toward addiction and treatment
  3. Reviewing state strategies for reducing addiction costs
  4. The criminalization of addiction
  5. The development of CARA
  6. A closer look at the states with the lowest overdose rates
  7. Behavioral health care challenges in the Hispanic community
  8. A look at competing drug policies in the presidential election
  9. The debate over marijuana legalization

Sovereign will continue to report on relevant topics in future editorial series to keep the public informed. You can track new developments at SovHealth.comFacebook and LinkedIn. You can also follow us on Twitter and join the discussion with the hashtags #StateOfAddictionPolicy and #SovTalk.

About the author

Wade Sands is the content manager for Sovereign Health. Throughout his career, he’s held court on a wide range of topics, from video games and real estate to addiction and behavioral health treatment. Wade takes pride in sharing useful knowledge that can improve the lives of his readers. For more information and other inquiries about this article, contact the author at news@sovhealth.com.


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