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.
“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.”