State of Addiction Policy

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State of Addiction Policy: A look at competing drug policies in the presidential election

Sovereign Health’s eighth installment in its State of Addiction Policy series focuses on how the two major presidential nominees plan to fix America’s drug problem. Since 1971, when the Nixon Administration ushered in this country’s war on drugs, America has spent over $1 trillion fighting what most experts agree is a losing battle on substance abuse and addiction. While the two candidates have adopted polar opposite plans to fixing the problem, both approaches entail the expenditure of billions of dollars.

Clinton’s initiative

On her website, Hillary Clinton outlines her $10 billion “Initiative to Combat America’s Deadly Epidemic of Drug and Alcohol Addiction.” In addition to greater funding, the initiative calls for drug prescribers to have a minimum amount of training and to consult the state’s prescription drug monitoring program (PDMP) before writing a prescription for a controlled substance. The initiative calls for rehabilitation instead of incarceration for low-level and nonviolent drug offenses.

Another Clinton proposal is a $7.5 billion fund to support federal-state addiction prevention partnerships over 10 years. To qualify for funding, a state must propose a plan that advances national goals at the state level. If the state’s plan is accepted, the state receives $4 of federal support for every $1 of state money spent.

At the federal level, Clinton would increase the Substance and Abuse Prevention and Treatment Block Grant by 15 percent. This would increase access to treatment. Clinton’s administration would ensure the Mental Health Parity and Addiction Equity Act (MHPAEA) is enforced. Clinton’s other addiction prevention platforms include improving best practices for insurance coverage for substance abuse and promoting more efficient prescriber practices for Medicare and the Veterans Administration.

Clinton expands on her platform in a fact sheet. Her plan would fix gaps in treatment by building out existing recovery infrastructure at the community level. This expansion would include community-based health centers and community behavioral health centers. On the legal front, Clinton’s initiative increases investment in existing drug diversion programs. The onus is on judges and courts to focus not only on rehabilitation but also on reintegration into communities. Studies prove recidivism decreases when offenders successfully reintegrate into society.

Trump’s statements

Republican candidate Donald Trump has not been as forthcoming with details of his views on addiction. On his website, he includes a 43-second video for his drug policy plans, in which he proposes building a wall along the U.S.-Mexico border to keep out drugs and drug smugglers. As for those already addicted, he says only, “We’ll get them the help they need.”

Some of Trump’s other stated positions could also affect drug policy and addiction in this country. Most prominently, Trump wants to completely dismantle the Affordable Care Act. In its place, his administration would eliminate the law that prevents insurance companies from selling plans across state lines. Trump encourages the private sector and the free market to grapple with national insurance solutions, with consumers emerging as the ultimate victor. Trump would block Medicaid grants at the state level, as each state has enough resources at its disposal to deal with its respective populace.

Trump’s administration would also open prescription drug production to foreign companies. He says this would create competitive but safe and reliable products and break the monopoly big pharmacological companies have on manufacturing.

Beyond these assertions, however, Trump has yet to present a clear national plan to address addiction.

What the critics say

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According to the Huffington Post, the Obama Administration requested over $25 billion in its 2013 budget for federal spending on the drug war. Of that amount, $15 billion was earmarked for law enforcement interdiction efforts. In spite of all this money spent on the War on Drugs, the White House noted that opioids were involved in over 28,000 deaths in 2014.

While Clinton’s plan has drawn some support for shifting the emphasis from incarceration to treatment, other commentators criticize her plan for falling too closely in line with the ineffective policies of the past. Mike Ludwig, a news analyst for Truth Out, says that Clinton would “take a similar path” as her predecessor President Obama and complains that “she has said nothing about defanging drug war institutions like the scandal-ridden U.S. Drug Enforcement Administration.”

On the other side of the ballot, Trump’s plan to keep drugs out of America with a wall has also sparked controversy, with many critics stating that a wall between Mexico and America will do nothing to keep drugs out. Mike Vigil, a retired DEA agent, said, “Trump’s wall would not have any impact on the movement of drugs through the U.S.-Mexico border.” He notes that drug traffickers could easily circumvent the wall with various low-tech solutions and keep the drugs flowing in unabated.

Furthermore, even if the wall were effective in blocking drugs from Mexico, critics state that the underlying issues of drug abuse and addiction will not simply go away. Andrew Kolodny, the chief medical officer for the addiction nonprofit Phoenix House, says, “We need to prevent people from getting addicted and be more cautious prescribing [opioids]. Heroin will just keep flooding in. If it’s not coming in through Mexico, you’ll have more Fentanyl labs popping up in the U.S.”

Many political pundits have characterized the November election as a choice between the lesser of two evils. Likewise, the future of our drug policy could be described as a gamble between two imperfect strategies. No matter which side wins out in the end, Sovereign Health will continue to focus on what we do best: treating behavioral health issues, including substance use disorders, using the most effective modalities available.

Follow this series

Check back regularly for updates on the State of Addiction Policy editorial series at SovHealth.comFacebook or LinkedIn. You can also follow us on Twitter and track the discussion by searching for #StateOfAddictionPolicy and #SovTalk. All articles in the series are available here.

Stay tuned for the next installment of the series on the first Sunday of October, which will take an in-depth look at the growing movement to legalize recreational marijuana in America.

About the authors:

Darren Fraser is a content writer for Sovereign Health. He worked two and half years as reporter and researcher for The Yomiuri Shimbun until they realized he did not read, speak or write Japanese and fired him. Undeterred, he channels his love of research into unearthing stories that provide hope to those dealing with addiction and mental illness. Darren loves the Montreal Canadiens hockey club and horror films and would prefer to enjoy these from the comforts of his family’s farm in Quebec. For more information about this media, contact the author at news@sovhealth.com.

Wade Sands is a writer and editor for Sovereign Health. Throughout his storied career, he’s held court on a dizzying range of topics, from video games and real estate to addiction and behavioral health treatment. For more information and other inquiries about this article, contact the author at news@sovhealth.com.