White House opioid summit failed to deliver any real solution

On March 1, there was a well-choreographed display of senior administrator’s thoughts about the opioid crisis. The event was designed to share the Trump administration’s proposed policies for handling the opioid problem with the public.

In some ways, the White House opioid summit provided hope that we could make progress in alleviating the opioid crisis. Some of the people who took a leadership role seemed to understand what we need to do in order to solve the problem. However, the summit fell short of reaching its full potential because of the unhelpful attitudes some of the key players projected.

{mosads}Poignantly, the summit illustrated the devastating impact the disease has had on people’s lives. Participants unabashedly shared their personal stories. Those who confessed to their addictions demonstrated courage, because such naked exposure invites humiliating judgment from outsiders.

The meeting showcased a range of topics and various speakers. Perhaps the most enlightening of these voices belonged to three cabinet secretaries — Health and Human Services Secretary Alex Azar, Housing and Urban Development Secretary Ben Carson, and Veterans Affairs Secretary David Shulkin — who expressed their determination to curb the crisis.

The secretaries acknowledged the need to treat addiction as a disease rather than as a crime. They contended that people with addiction must have better access to treatment and emphasized that we must decrease the stigma associated with addiction.

Achieving these goals will be necessary if we are to right the ship of opioid addiction. For far too long, people with addictions have been labeled with such pejoratives as “junkies,” “dopeheads,” and “low-lives,” and they have been treated accordingly. The administration’s stated policies for addressing the opioid crisis focus on prevention, treatment, and recovery.

However, the collective attitudes of the people at the meeting who have been directly affected by the disease stood in stark contrast to what we have been hearing from Attorney General Jeff Sessions. He didn’t wait for the Opioid Summit to tout drug policy reform as the best way to address the opioid epidemic.

To him, this means escalating the war on drugs. He has made the point that drug dealers should face tough penalties. However, he wants to extend those consequences to nonviolent drug offenders, and that’s where we run into problems.

Prosecuting everyone who is involved in the opioid crisis is unhelpful. People with addiction need treatment, not incarceration. Arresting people for the illegal use and distribution of drugs tends to criminalize the disease of addiction. While the summit participants wanted their loved ones to have access to treatment, none of them seemed to favor incarceration as a means to get them that treatment.

Importantly, those who seek drugs often steal, or otherwise obtain, them from those they love. It is not clear whether Sessions intends to charge those who allow it to happen with criminal conduct.

If so, the number of people Sessions might catch in his net would be huge, since more than half of all prescription medications used for non-medical purposes have been diverted by a family member or friend.

Sessions may want to go after only the dealers who sell illicit drugs. Yet that is not clear, because Sessions has also advocated for more legal action against marijuana use. Marijuana offenders are generally not the same people who are involved in cartels with sophisticated distribution networks for hard drugs such as heroin and fentanyl.

Therefore, it seems that Sessions wants to turn as many people over to the criminal justice system as he can, regardless of how they’re involved with drugs.

In addition, Sessions has denigrated people who need drugs for pain. As an example, he has made it sound as if people who use opioids for pain are weak and, if they had sufficient strength of character, they could just tough it out and get on with their lives.

He apparently believes that needing pain medication is a character flaw, and suffering from debilitating pain is simply a bad choice. His attitude and words reinforce the stigma that people in pain and addiction long have had to endure.

President Trump takes it a step further. During the Opioid Summit, he declared that drug dealers should be executed. If it were up to him, we would impose capital punishment on people who illegally sell drugs.

We all know that drug cartel members could be categorized as drug dealers, but what about the delivery people who carry small pouches of heroin or the inner city child who sells his grandmother’s unused pain medicine that was prescribed after her knee replacement operation? Should they be subject to the same legal consequences imposed upon drug kingpins? Maybe the term “drug dealer” also refers to the doctor who prescribes more medication to the grandmother than she used following surgery or the pharmacist who filled the script.

Sessions had little to say at the meeting itself. However, his demonstrated regressive attitude and President Trump’s tough talk greatly detracted from the noble intent of the summit.

That said, there were many positive aspects to the meeting. The cabinet secretaries’ proposals to address the opioid crisis seem to contradict Sessions’ and Trump’s approach. Listening to what they had to say conveyed hope that we all might be able to come together to solve the opioid crisis.

Perhaps the most encouraging comment came when Alex Azar, Secretary of Health and Human Services, expressed a desire to treat the opioid epidemic as a medical challenge rather than as a moral failing or a criminal matter. He spoke of encouraging people with addiction to seek treatment and of increasing funds to develop pain treatments that could replace opioids as the de facto tools for pain management.

He seems to understand that a key component of preventing addiction is to replace opioids with non-addictive, but just as powerful, pain relievers. Following Azar’s suggestions could go a long way toward solving the dual crisis of opioid addiction and chronic pain.

Lynn R. Webster, M.D. is the vice president of scientific affairs for PRA Health Sciences. He is a former president of the American Academy of Pain Medicine. Webster is the author of “The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us.” You can find him on Twitter: @LynnRWebsterMD.