If the opioid epidemic was simply a problem of supply – people being able to access drugs too easily – then a targeted new effort in Appalachia announced by Attorney General Jeff Sessions this week would be a huge stride toward combating the crisis.
The problem with this approach, however, is that experts agree the opioid epidemic is all about demand. Far too many Americans rely on opioid painkillers, creating a huge customer base for illicitly gained prescription drugs and more serious street drugs, such as heroin and fentanyl.
Sessions’s new plan involves sending more Drug Enforcement Administration agents to the areas where opioid abuse is most rampant. But those fighting the epidemic on the ground say the law enforcement strategy must be coupled with medical help for those suffering from addiction, or the Trump administration won’t get very far in its efforts.
Related: Sessions says DOJ just talked “at some length” about marijuana enforcement
“This is a demand-driven problem and we are trying to apply supply-restricting solutions,” Michael Brumage, executive director of the Kanawha-Charleston Health Department in Charleston, West Virginia, told me (West Virginia is the state hit hardest by the crisis). “That’s what we tried on the war on drugs, and that failed.”
Sessions is creating an entirely new DEA division overseeing the Appalachian region to help local law enforcement combat drug abuse, especially of prescription opioids, The Washington Post’s Sari Horwitz and Matt Zapotosky report. He also announced $12 million in new grants and the designation of an opioid coordinator to work with prosecutors to better manage prosecutions.
“Today, we are facing the deadliest drug crisis in American history,” Sessions said at a news conference Wednesday. “Based on preliminary data, at least 64,000 Americans lost their lives to drug overdoses last year. That would be the highest drug overdose death toll and the fastest increase in that death toll in American history.”
Separately, Sessions also mentioned recent DOJ discussions on marijuana enforcement.
The new Louisville Field Division will unify drug trafficking investigations in Kentucky, Tennessee and West Virginia, with a focus on the Appalachian Mountains, officials said. It will include about 90 special agents and 130 task force officers.
Washington Examiner’s Kelly Cohen tweeted “sessions also directs all US attorneys to designate an ‘opioid coordinator’ by 12/15 to facilitate cases in each district. each coordinator must also revise each district’s opioid epidemic strategy by february 2018.”
sessions also directs all US attorneys to designate an “opioid coordinator” by 12/15 to facilitate cases in each district.
each coordinator must also revise each district’s opioid epidemic strategy by february 2018.
— kelly cohen (@politiCOHEN_) November 29, 2017
At least in terms of geography, Sessions is spot on. A few weeks ago, I wrote about the prevalence of opioid abuse in the Appalachian region – and how it gets worse and worse the closer in you get to West Virginia (which is basically the epicenter of the crisis).
If you look at what researchers call “diseases of despair” (drug and alcohol overdose, suicide and alcoholic liver disease), they have a stronger foothold in the center of Appalachia than on the fringes. In central Appalachia, those maladies led to 94.4 deaths per 100,000 people, but the rate is 52.3 deaths per 100,000 in southern Appalachia.
But law enforcement officers will tell you that keeping an area free of drug dealers for any length of time is a steep task. Brumage called the new DEA forces a “step in the right direction,” but his enthusiasm is tempered.
“Once you bust everybody in a particular area, you have a temporary lull but it lasts only a few days,” Brumage said. “There are always people and supply willing to fill the void.”
Activists who watched the uphill and international “war on drugs” of the past several decades also fear the Trump administration will halt its efforts with beefing up law enforcement, instead of also pouring more resources into helping Americans break free of their drug addictions.
“The emphasis continues to be punishment, so I think it’s very concerning,” said Gabrielle de la Gueronniere, director of policy for the Legal Action Center, a nonprofit organization that fights discrimination against people with a history of addiction. “We’re not really treating this as an illness. There’s a huge treatment gap.”
Sessions also announced that White House counselor Kellyanne Conway will continue to help lead the opioid effort.
Several reporters clarified that the Trump administration isn’t creating a new “drug czar,” as some reports suggested. Politico’s Brianna Ehley tweeted “Sessions was just describing her current role/what she has been doing for months. Nothing new and ‘opioid czar’ is not a real title ”
Sessions was just describing her current role/what she has been doing for months. Nothing new and "opioid czar" is not a real title https://t.co/W1EExoCBr3
— Brianna Ehley (@Briannaehley) November 29, 2017
Politico’s Sarah Karlin-Smith tweeted “White House tells Politico’s @Briannaehley Buzzfeed story incorrect. Sessions just reiterating Conway’s current role. WH has no plan to name an opioid czar. ”
— Sarah Karlin-Smith (@SarahKarlin) November 29, 2017
On a related topic, Sessions said he’s “dubious” of a law restricting DEA’s enforcement powers, which The Post detailed in a recent investigation. The Post’s Sari Horwitz tweeted “Sessions says he was “dubious” of law gutting DEA enforcement abilities in #OpiodCrisis. AG says he’ll support new leg to give DEA enforcement tools back. This was in response @mattzap ? regarding WaPo investigation by @ScottHigham1 & @LennyMBernstein”
Sessions says he was "dubious" of law gutting DEA enforcement abilities in #OpiodCrisis. AG says he'll support new leg to give DEA enforcement tools back. This was in response @mattzap ? regarding WaPo investigation by @ScottHigham1 & @LennyMBernstein https://t.co/JmzTWVcUMT
— Sari Horwitz (@SariHorwitz) November 29, 2017