Trump needs more than fire and fury to defeat US opioid addiction

He may have been going off-script about North Korea, but Donald Trump’s declaration of war on opioids this week came with the foreknowledge of his advisers. Instead of threatening “fire and fury”, as he did on North Korea, Mr Trump proclaimed a national emergency to defeat America’s galloping drug epidemic.

Last year an estimated 60,000 Americans died from drug overdoses — more than the total US death toll in the Vietnam war, which lasted more than a decade. Opioids are now the leading cause of death for Americans under the age of 50. This year’s toll looks set to be higher.

Can Mr Trump reverse the trend? It would be in his interests to do so. The US counties with the highest drugs mortality rates were far likelier to vote for Mr Trump than for Hillary Clinton. Mr Trump has even attributed part of his success to the opioid epidemic. In a leaked transcript of a phone call with his Mexican counterpart earlier this year, Mr Trump said he had won the state of New Hampshire because it was a “drug-infested den”. Part of his pitch to build a wall with Mexico was to keep out the drugs dealers who are “poisoning our communities”. The surprise is how long it has taken Mr Trump to declare his war.

Yet his administration betrays few signs of having devised a strategy to win it. Chris Christie, the Trump ally and governor of New Jersey, who authored a report on the epidemic this week, has urged Mr Trump to treat the epidemic as a public health crisis rather than a war. This would involve using medical substitutes to treat opioid addicts — an avenue disallowed under the strict abstinence regime imposed on drug users. It would also mean lifting restrictions on Medicaid funding of drug treatment centres.

An image released by the Drug Enforcement Administration of 20mg tablets of OxyContin © AFP

In both cases, Mr Trump has been heading in the opposite direction. Medicaid…

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