Opioid Crisis: Critics Say Trump Fumbled Response To Another Deadly Epidemic President Trump promised to end America's opioid crisis. On his watch overdose deaths flattened in 2018 then surged again to record levels.
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Opioid Crisis: Critics Say Trump Fumbled Response To Another Deadly Epidemic

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Opioid Crisis: Critics Say Trump Fumbled Response To Another Deadly Epidemic

Opioid Crisis: Critics Say Trump Fumbled Response To Another Deadly Epidemic

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AILSA CHANG, HOST:

The coronavirus is not the first deadly epidemic faced by President Trump. Four years ago, Trump campaigned on a promise to stop America's growing wave of opioid overdoses. Instead, overdose deaths have risen, and critics say the drug fight has been hobbled by mismanagement and lack of planning. NPR addiction correspondent Brian Mann reports.

BRIAN MANN, BYLINE: A week before the last presidential election, candidate Donald Trump gave a speech in Manchester, N.H. The opioid crisis, he said, was destroying lives, shattering families.

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PRESIDENT DONALD TRUMP: We are going to stop the inflow of drugs into New Hampshire and into our country...

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TRUMP: ...One hundred percent.

MANN: During President Obama's last year in office, overdoses were surging, especially in battleground states like New Hampshire, Ohio and Pennsylvania key to the election. This from ABC News.

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UNIDENTIFIED REPORTER: In suburban neighborhoods across America, the calls are coming in...

UNIDENTIFIED PERSON: An overdose.

UNIDENTIFIED REPORTER: ...All of them heroin overdoses.

MANN: The year Trump took office, more than 42,000 Americans died from overdoses linked to heroin, fentanyl and prescription opioids. Before coronavirus hit, this was the health crisis grabbing headlines. In October 2017, Trump declared a national public health emergency.

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TRUMP: No part of our society - not young or old, rich or poor, urban or rural - has been spared this plague, drug addiction.

MANN: Some successes followed. Trump signed legislation boosting federal funds for drug treatment. And during trade talks with China last year, he pushed to slow that country's exports of fentanyl. Those actions have drawn praise from experts like Beau Kilmer, who heads the RAND Corporation's Drug Policy Research Center.

BEAU KILMER: The federal government has taken some important steps to increase access to evidence-based treatment for opioid use disorder and made some progress at pressuring China to better regulate some of its synthetic opioids.

MANN: But critics also point to serious missteps behind the scenes that hobbled federal efforts, including the decision to sideline the Office of National Drug Control Policy, which has orchestrated the country's drug response since the 1980s. Instead, Trump handed leadership of his opioid effort to political appointees, including former New Jersey Governor Chris Christie and White House adviser Kellyanne Conway.

Again, Beau Kilmer.

KILMER: This made it difficult for people to understand, well, you know, who's leading and coordinating the efforts on opioids.

MANN: Still, for a time, there seemed to be some progress, with opioid deaths declining slightly in 2018. Then the number of overdoses surged again last year to record levels. More than 50,000 people died. Researchers say fentanyl continues to spread fast, killing more and more people. Last December, Congress' Government Accountability Office issued a report blasting the administration for failing to come up with a coherent national drug control plan two years in a row, as required by law. Even some members of the administration began voicing alarm.

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BRETT GIROIR: Basically, everything is pointed in the wrong direction. You know, it's just a - it's just a nightmare.

MANN: Admiral Brett Giroir is assistant secretary of health and a senior adviser on opioid policy in the Department of Health and Human Services. He spoke during a panel discussion in July.

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GIROIR: All the progress that we made has now been reversed. And this is even before the pandemic.

MANN: As Trump's first term winds to a close, there's one more issue that alarms many drug policy experts. Trump has fought to dismantle the Affordable Care Act, but that policy subsidized the expansion of state Medicaid programs that now fund roughly 40% of opioid addiction treatment in the U.S. Brendan Saloner is a researcher at Johns Hopkins Bloomberg School of Public Health.

BRENDAN SALONER: In the states that went forward with the Medicaid expansion, we've seen very large increases in the number of individuals actually going to treatment programs.

MANN: Even if Trump loses the election, the Supreme Court he reshaped could strike down the Affordable Care Act. Critics say that would likely leave hundreds of thousands of people suffering opioid addiction without access to care at a time when overdose deaths are surging again.

Brian Mann, NPR News.

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