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To End the Opioid Epidemic, We Must Expand Substance Abuse Treatment

'A comprehensive public health response to the crisis must include greater access to substance abuse treatment – especially long-term residential treatment for the most vulnerable.'

President Trump went to New Hampshire to unveil his long-awaited anti-opioid strategy, but much of what he said was disappointing, even troubling.

Trump talked tough about law enforcement, advocating harsher sentences for drug crimes, building a wall on the southern border to block immigrants and drug traffickers, and executing drug dealers. He obviously believes that punitive law enforcement measures will end our national opioid epidemic.

But he’s wrong.

We learned from the failed 1980s “war on drugs” that such policies did not curtail the supply or use of drugs, and there’s no indication they would work today in a crisis of even greater magnitude.

Being tough on crime is important, to be sure, but only as part of a broad and balanced solution. We must also be demanding – and more thoughtful – about expanding drug treatment, education and prevention.

A comprehensive public health response to the crisis must include greater access to substance abuse treatment – especially long-term residential treatment for the most vulnerable. We need a wide range of treatment options and funding to ensure that the growing population of addicts gets the help they so desperately need.

Speaking in New Hampshire, a state with the third highest rate of overdose deaths in the nation, the president touched on some of these policies. Promote wider use of overdose reversal drugs. Advance medication-assisted treatment (MAT) to reduce addicts’ drug craving in combination with behavioral therapy. Reduce opioid painkiller prescriptions. Bolster efforts to help vets and prisoners access programs to stay off drugs.

All are very good approaches. Yet Trump was vague on the details. He didn’t propose any new programs along these lines or promise more funding, saying it’s up to Congress – which recently allocated $6 billion for the opioid epidemic – to figure it out.

How much money do we need? Six billion is a drop in the bucket for a public health crisis that is destroying families and communities, disrupting the workplace and lowering the life expectancy of Americans (175 die every day from a drug overdose).

The target should be at least $100 billion, itself a drop in the bucket considering the trillions of dollars in tax cuts the Trump administration doled out to corporations.

But it’s enough to kick start a national anti-opioid effort focused on the states. First, we can double federal block grants to $3.8 billion annually so states on the front line of the crisis have the resources they need.

Then add tens of billions more to strengthen the addiction care workforce, enhance education and prevention programs, and increase Medicaid funding for lower income Americans to receive treatment (Trump has proposed Medicaid cutbacks).

Slowly, we will make progress. There is hope. Treatment works, but only if we have strong leadership and a commitment to proven strategies.

Mitchell S. Rosenthal is a psychiatrist who founded Phoenix House, the national substance abuse treatment organization, and is now president of The Rosenthal Center for Addiction Studies.

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