New Hampshire can be safely added to the encyclopedia of people, places, and things that the 45th president of the United States has publically insulted or, in the case of the Granite State, denigrated on the phone with foreign leaders. In his continuing desire to remind the world that Americans elected him and not Hillary Clinton to put his business acumen to work on drug abuse and trafficking across the southern border, he told Mexican President Enrique Peña Nieto in late January, “I won New Hampshire because New Hampshire is a drug-infested den.” (As usual, Trump has a tenuous acquaintance with verifiable facts. He did win the first-in-the-nation Republican presidential primary but Clinton inched to victory in New Hampshire in November 2016.)
No topic is safe from Trump’s loose lips and poor judgment. It’s not the first time that he has trivialized New Hampshire’s drug abuse epidemic. “You know what really amazed me when I came here and I got to know so many people?” he said at a campaign rally in the state last fall. “They said the biggest single problem they have up here is heroin. … And I said how does heroin work with these beautiful lakes and trees?” The president’s effortless way of getting in his own way on New Hampshire’s most serious health problem by riling up people on both sides of the partisan divide, underscoring the Republican Party’s health-care debacle and renewed commitment to losing the war on drugs, and undercutting the work of his much-vaunted opioid commission takes uncommon skill.
Democratic Senator Maggie Hassan vented her outrage on Twitter:
To date, @POTUS has proposed policies that would severely set back our efforts to combat this devastating epidemic 2/
— Sen. Maggie Hassan (@SenatorHassan) August 3, 2017
New Hampshire Governor Chris Sununu, a conservative Republican who signed a bill establishing needle exchange programs in June, labeled Trump’s comments “disappointing.” “The president is wrong,” Sununu said in a statement. “Our administration inherited one of the worst health crises this state has ever experienced, but we are facing this challenge head on. We have doubled our resources to support prevention, treatment, and recovery; dedicated millions to law enforcements efforts to keep drugs out of our state; increased the availability of naloxone; and are rebuilding our prevention programs for our kids.”
If Trump and his White House communications gurus took a respite from their full-frontal assault on the First Amendment and an unhealthy preoccupation with the mainstream media, they might better focus not only on the epidemic but on the innovative effort that one New Hampshire town has taken to address the drug abuse.
Last month, The New York Times Magazine delivered a compelling profile of Eric Adams, a pioneering Laconia, New Hampshire, police department prevention, enforcement, and treatment coordinator who, single-handedly, takes an intensive, 24/7 approach to dealing with the epidemic that includes everything from finding housing for addicts, to handling relatives’ pleas for interventions and buttonholing skeptical public officials. New Hampshire has the second highest rate of death from drug overdoses in the United States, according to the Centers for Disease Control and Prevention. Only West Virginia has a higher overdose mortality rate.
The writer, Benjamin Rachlin, a New Hampshire native, explored Davis’s Sisyphean work with addicts and people in recovery and continues to ponder how that effort could be scaled up from small rural communities to larger towns and cities. “What is important about what’s happening in Laconia is not simply that you have one officer, social worker, or nonprofit doing this particular thing but that there has been a community-wide reckoning with the situation that the region has found itself in,” Rachlin told The American Prospect.
Not surprisingly, Trump has offered inconsistent views on drug abuse. Most of the Republican Senate’s forays into repealing and replacing Obamacare had Trump’s full-throated support even though the proposals would have decimated the already scarce treatment options in New Hampshire and elsewhere. The Better Health Care Reconciliation Act framework proposed a paltry $2 billion in 2018 alone to cover substance abuse and treatment. Republicans also were posed to slash Medicaid, the largest insurer for addiction treatment services. At the same time, various Republican versions of repeal-and-replaced had modest increases in sums for dealing with opiate addition, to provide window-dressing for legislators from heavily afflicted states.
On the enforcement side of the drug policy ledger, Attorney General Jeff Sessions has turned national drug enforcement back to the 1980s with his revival of the war on drugs, a fight that many local enforcement agencies no longer want to wage, given the failure of current efforts and the new prevalence of deadly and powerful (and easily manufactured) synthetic drugs. Sessions’s interest in criminalizing medical marijuana will also set him on a collision course with more than half of U.S. states, along with almost dozen others that have legalized recreational marijuana. Medical research is also stacking up against the attorney general. Marijuana has been demonstrated to be a viable remedy for chronic pain management, one that even the National Football League is ready to embrace, and could preclude prescribing the opioids that have spawned widespread abuse.
The New Hampshire dustup has even overshadowed the interim report from President’s Commission on Combating Drug Addiction and the Opioid Crisis, which already suffered ignominy by being released on the same day that White House Chief of Staff John Kelly fired communications director Anthony Scaramucci. The commission has called for a national public health declaration of emergency under either the Public Health Service Act or the Stafford Act and for the elimination of certain existing restrictions on Medicaid drug treatment programs. With more than 140 deaths every day, “America is enduring a death toll equal to September 11 every three weeks,” the report said.
Treating opioid-driven substance abuse as a public health crisis is not new. Six states, Alaska, Arizona, Florida, Maryland, Massachusetts, and Virginia, have already declared states of emergency. Four of these have Republican governors. What would be new is a serious or at least scripted commitment by President Trump to address a problem that has killed tens of thousands of Americans with the seriousness it merits rather than as a detail in his obsession with campaigning instead of governing.
This post has been updated.