Trump’s Opioid Speech







At least five or six people asked me what I thought about the President’s address in which he declared the opioid crisis a public health emergency. I didn’t watch his address, but I did read a transcript of his speech.

When people insert the comment, “Believe me,” into what they are saying, I tend not to believe them. Perhaps it’s an occupational hazard, but that’s what I consider a “tell.” Just like the phrase, “I’m not gonna lie to you,” my brain assumes there’s a whooper of a lie headed my way.

However, the “believe me” phrase could be just a verbal tic on President Trump’s part, like the word “very” which he said eighteen times in his speech. Yes, I counted. I don’t know why that annoys me so much, except maybe I expect a more diverse vocabulary from the President. It’s very, very, very annoying.

I applaud his effort. He said some good things, and the overall message of his speech was that the U.S. has a problem, we need to do something about it, and here’s what I’m going to do to help. I could nitpick about the accuracy of some of the things he said, but I think he’s sincere in his desire to help people overcome substance use disorders.

But isn’t it disingenuous to tell people you plan to get approvals for treatment at the same time you are ending Obamacare? People need insurance to pay for medical care, so how will the 10 million or so who had insurance under Obamacare pay for treatment?

It was also disingenuous for him to say he’s “directing all executive agencies to use every appropriate emergency authority to fight the opioid crisis,” and that we should expect to see “Approvals that will unlock treatment for people in need and those approvals will come very, very fast…”

Money is being released quickly, from the 21st Century CURES Act, passed by Obama in December of 2016 and made available to states by April of this year. That is fast, for government money. I didn’t like Trump taking credit for legislation passed before he became president.

But those are trivial irritations compared to what’s important. Perhaps President Trump will pass legislation that gives people access to treatment for opioid use disorder. I hope that access will be for evidence-based treatment, and not for a “just don’t start” sort of campaign. We already endured the “Just say no” of Nancy Reagan. It’s not bad as far as it goes, and might prevent people from experimentation with drugs, but it’s of little use once opioid use disorder develops.

After President Trump’s speech, I am cautiously optimistic. I’ll have to see details before I get too excited, though. With so much at stake, I do hope the President allows experts to guide his policies. If we shoot a missile at opioid use disorder, let’s be sure it’s pointing in the right direction.


9 responses to this post.

  1. Posted by Anon on October 31, 2017 at 12:51 am

    I admire your ability to write this post, with such grace. With over 10,000 deaths in less than one year, and continuing to climb daily since he took office, I am less optimistic about lip service and more discouraged with the lack of action of this administration.

    The war has already started and those of us, in the trenches, feel that without a strong plan and the attached resources there is no end in sight. My narcissist radar makes me suspect that until he is directly impacted (as in someone very close to him) by this epidemic, that this is the extent of his intent to launch and missiles and fight in this war.


  2. Posted by Alan Wartenberg MD on October 31, 2017 at 3:37 am

    Perhaps you were just being charitable in not mentioning the absolutely amazing statement about “HIS” idea about just telling kids (never mind that the vast majority of those affected are adults, mostly older adults) NOT TO EVER START, and how easy that is!!! And that he is going to authorize an advertising campaign that will enrich TV and radio and do zero for those who are sick and suffering. I am not optimistic, cautiously or otherwise. He had the chutzpah to mention his brother, whose alcoholism was significantly fed by Donald Trump and his father’s making Fred Trumps life a living hell and cutting him out of his father’s will. In addition, Trump cut off his brother’s family from health insurance, despite a long-term chronic illness in one of Fred Trump Jr’s children (Donald Trump’s nephew), leaving them without money or coverage. This is a man with no heart, and precious little brain. No good will proceed from him or his administration.


  3. I too find the language very, very, very, very annoying especially from someone who reminds us he went to an ivy league college.

    I also wonder why he waited so long and why instead of a national crisis it’s just a public health – a lesser.

    And I worry about how ppl will pay for it. The ACA was one of the major things to help MAT so many patients that were burdened with outrageous payment for treatment. I worry that it will be taken from them and those that need treatment won’t be able to get it.


  4. Posted by Trudy Duffy on October 31, 2017 at 2:28 pm

    Your comments about Trump and his response to opioid crisis are very generous. Ninety days from now, when emergency order requires renewal, please look back on your initial thoughts. The action taken is insufficient, not in line with his own commission and the preponderance of existing recommendations from experts. Once again, he relys upon his own advice to himself…. when he needed to listen to others.

    The best speaker on this issue recently was the fire chief from Huntington, West Virginia. She was factual, heartfelt and realistic about the opioid crisis and much needed resources to turn this around.


  5. Posted by Luke Sampson on October 31, 2017 at 10:11 pm

    Dear Jana , I always look forward to your posts which inspire me to keep going in this work after 8 years of entering a world I did not realize existed, a world of potentially beautiful people and to see the beautiful smiles which for too long had been hidden.I am thankful for people like you who I don’t really know but somehow feel close. I thought your post about Mr. Trump’s speech was true but I have a very sincere question. Why is it that no matter what he says there must be criticism and in this case a bad photo? Is it that it is just not popular to appreciate him without a negative connotation. Not many of us are perfect especially in the words we use and how we use them. Not many of us could stand in the face of constant criticism. I know he has much wealth and may be abrasive but I appreciate him and his desire to make a positive difference in a culture that seems to have lost the way, myself included


    • I’m sorry I offended you, Dr. Sampson, as I hold you in high regard. You are right, I did look for the worst picture I could find. I tried -and failed – to moderate my negative feelings about President Trump. I didn’t want to post about how I felt personally, only about his policies, but it came through on the post, obviously.


  6. Posted by Barbara Peschke on October 31, 2017 at 10:31 pm

    Thank you for your wonderful post Jana. As the above writer I also look forward to your posts and addiction treatment information as I am new to this field. You are always right on in my opinion. I, like some of the others who replied, feel you were very charitable in talking about Trump. I do not put any faith in him helping in this epidemic.
    Please keep up your hard work and great posts. It is very much appreciated.


  7. Posted by DAVE ISRAEL on November 6, 2017 at 3:33 pm

    I’m glad that something is being done with this issue, whether it be something President Trump does or something President Obama did, but one thing that keeps getting looked over are the people who use pain meds for legitimate pain and use them properly. A part of this is from theft rather than the pain patients doing wrong and if we were required to lock the meds in a safe or something at the pharmacy that would go a long way in preventing them from getting to the streets but instead of doing that they are diagnosing them with substance use disorders or lying about stuff to make it seem that the diagnosis was justified and leaving them to suffer unending pain. I’m not saying that nobody who uses pain meds develops a problem but it’s no where near the numbers that some claim, even the FDA, DEA & CDC say that but still the focus is on pain patients when a full 3/4 of those using have never had a prescription for meds.


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