WASHINGTON — The Trump administration on Thursday unveiled a strategic planning document two years in the making: the National Drug Control Strategy, traditionally a wide-ranging annual report that outlines the government’s approach to policing illegal drugs, reducing drug demand, and treating addiction.

Though President Trump pledged to make the opioid crisis a top priority after assuming office, the Office of National Drug Control Policy did not release an equivalent document after his first year in office, as is customary.

The 23-page blueprint includes little new policy. Instead, it emphasizes a number of previously outlined Trump administration priorities: reducing the drug supply through stricter law enforcement, lowering first-time opioid prescription rates, and expanding access to addiction treatment.

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“The strategy builds upon our current whole-of-government approach that educates Americans about the dangers of drug abuse, ensures those struggling with addiction get the help they need, and stops the flow of illegal drugs across our borders,” Jim Carroll, the director of the Office of National Drug Control Policy, said Thursday in a statement.

The new document’s release came just hours after Carroll was formally sworn in at a ceremony officiated by Vice President Mike Pence and attended by administration drug policy advisers including Kellyanne Conway, U.S. Surgeon General Jerome Adams, Deputy Attorney General Rod Rosenstein, and assistant health secretary Brett Giroir.

His position — in theory, meant to be a “drug czar” who oversees all federal drug policy initiatives — had been vacant for two years. The ceremony marked the end of an 11-month process during which Carroll had not been confirmed by the Senate but ran ONDCP anyway, in an acting capacity.

The strategy document emphasizes leveraging drug court systems and employment programs to foster long-term recovery. It stresses the necessity of improving insurance coverage for addiction treatment, better utilizing prescription monitoring programs, and increasing access to the overdose-reversal drug naloxone. And despite its emphasis on supply reduction, the report acknowledges the risk of cutting off care for chronic pain patients, a topic that has gained prominence in recent years as governments and health systems have rushed to respond to the crisis.

At 23 pages, the Trump administration’s proposal is roughly one-fifth the size of the Obama administration’s first drug policy strategy. Beyond advocating for controversial but data-driven programs including syringe exchanges, the 2010 document included mandates for federal agencies ranging from the Department of Health and Human Services to the Department of Transportation.

A Trump administration commission did, however, release a lengthy report in November 2017 that included 56 specific policy recommendations to stem addiction deaths. That document helped shape a sweeping bill to address the opioid crisis that Trump signed in October.

While lethal drug combinations — particularly opioids and the anxiety drugs benzodiazepines — are a leading cause of overdose deaths, the Trump administration document makes no mention of that drug category. It also devotes little attention to fast-climbing rates of methamphetamine-related hospitalizations and deaths.

The report included few concrete metrics by which the administration will measure successful policy outcomes. The top listed priority, according to the strategy document: that “the number of Americans dying from a drug overdose is significantly reduced within five years.”

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  • Unfortunately these policies are punishing the sickest Americans. Supposedly they were not meant to affect chronic pain patients, or palliative care, or surgical patients or cancer patients but they most certainly are.
    It’s hard enough fighting a progressive disease and now I am fighting for palliative care. I never thought I’d be affected by this as I have a progressive debilitating disease and I have always been compliant but now I have learned Veterans have been going through this for years… VA policies have caused needless suffering since 2016. It’s outrageous!

    Millions of good law-abiding people are undermedicated; the sick are suffering needlessly as their pain medication has been reduced to ineffective doses or completely taken away.
    We are sick, we are injured, we are in pain, we are responsible, we not addicts so please stop treating us like one! We don’t want to rely on medication but we want to live, we need to live with less pain.

    Unfortunately many doctors and pharmacist are like mine; they misunderstand the 2016 CDC *recommendations*; they are *recommendations* for opioid naive patients, not laws and not directed at my chronic progressive disease, but these doctors and pharmacists openly fear they will lose their license if they continue effective opioid treatment.
    After over a decade of various treatments, I have found opioids to be the most reliable and effective. Well, they were reliable until government began dictating my medical treatment. Opioids are perfectly safe when taken as prescribed. Alternative therapy has limitations and is expensive and they also have risk (paralysis and death included). Like most Chronic Pain Patients, I abide by the contract I have with my doctor as I want to live, and I want to live that life with less pain. My doctor shouldn’t have to fear losing the medical license nor should we the sick be forced to suffer in severe pain 24/7/365 because of it. It’s an unintentional consequence perhaps but it’s gone on too long.
    It’s life changing when medication provides the ability to function again and it’s agonizingly devastating when that medicine is taken away.
    I’m sorry some people abuse drugs but punishing all pain sufferers in the world won’t save them! The fact is, most deaths are from ILLEGAL drugs like heroin, NOT legitimate prescriptions. Crack down on the street drugs, not physicians and patients.

    What about our quality of life? Who is making policy for us? Who cares about the sick?! Government officials aren’t doing anything; they don’t respond to the letters I send. Every news outlet talks about the addict but they never talk about how this is affecting us.
    It’s long overdue as every minute of untreated pain is cruel and inhuman!
    These laws and policies violate our Constitutional Rights, as well as Social Security and Medicare rules. Where is the outrage?
    Unless you are my doctor, unless you have bargained with God in pain, you have no right to decide my medical care.
    Thank you for reading []

    • Sorry to hear about your pain and that ongoing situation.

      One point, the facts show that most deaths/harms related to substance consumption are from alcohol (LEGAL). Illegal drugs definitely create significant harm but don’t add up to the total harm to society that alcohol is creating.

  • First you make up the opioid crisis to cover up the fact that you are failing to do your job at stopping the drugs coming in from other Country’s. You have failed to take care of the drugs being sold on the streets. These drugs contain fentanyl which is the real opioid crisis.

    Than the CDC falsifies their numbers showing more deaths from prescription opioids, blaming everything on people who take their medication for years without any problems.

    The CDC than changes their numbers, but VERY QUIETLY, but the damage
    is done. So the Government continues with their charade for absolutely
    NO reason.

    Chronic Pain Patients do not get High, we do Not Snort, Boil, or Inject our
    Meds. The medication dulls our pain enough for us to function like normal
    Human beings. If you get high from opioids than you should have enough
    Common sense to tell your Doctor, who should prescribe another medication. If you don’t than you are an addict taking them just to get high.

  • A great plan to hasten the death of America’s drug addicts. It took 2 years to concoct? In a nutshell, the administration is pretending to offer help (impotent help) while really hoping that the problem eliminates itself. Horribly cynical. Look at the cast of morons in that sparsely staffed office. Many have no experience in treatment or interdiction. There is a story for you. Unmask the bastids.

  • Acupuncture was introduced in United States in the 1800’s. While France, and Italy have incorporated Acupuncture into their medical system. However, in USA, the medical system did not integrate it not because of its inefficacy, but they knew that acupuncture would make people understand that our system was inadequate.

    Fast forward to 2019, people are finally realize that acupuncture must be implemented. There come integrative medicine!

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