What Does a Trump Presidency Mean for the American Opioid Crisis?

Ian Hamilton argues that by focussing on the illegal supply of Fentanyl and other opioids instead of on harm reduction measures, President-elect Trump is wilfully missing the point.

Protestors in Manhattan demand lawmakers implement harm reduction strategies that will save lives, 28 August 2024. Photo: Erik McGregor/Sipa US/Alamy

One of Donald Trump’s first acts as President-elect has been to appoint Robert F Kennedy Junior as his nominee for Health Secretary. Top of his in-tray will be the opioid crisis that has gripped America in recent years and been responsible for so many premature deaths.

The number of fatalities as a consequence of taking fentanyl and other drugs has risen seven-fold from 2015 to 2022, opioids now claiming over 100,000 lives a year. Although there are signs that the number of deaths is beginning to fall, they remain in the tens of thousands.

Although many view the appointment of Robert F Kennedy Junior as surprising, given his conspiracy-based views on vaccines, he may prove to be an inspired choice to deal with the opioid problem. Not only does he have personal experience of addiction, but he has made some interesting comments about how it could be tackled. He has been scouring America to find examples of good practice in treating opioid addiction. So, he is clearly committed and open minded about how to address this problem.

Sadly, the horrific rise in opioid deaths in America is no accident, most victims are known to have used synthetic opiates such as fentanyl. Fentanyl is up to fifty times stronger than traditional opiates such as morphine, which is already a potent drug.

The scale of these deaths is unprecedented in America or any Western country. There are many families that had no direct experience of drug addiction or of its most serious consequences. Most will have viewed addiction and drug-related deaths as something that happens to ‘others’ rather than to them, or in their communities.

The emergence of synthetic opioids some twenty-five years ago and the accompanying widespread prescribing of these drugs has fundamentally changed this perception.

Little wonder then, that Americans look to their politicians to offer hope and provide interventions that can halt the devastating impact of these drugs. The Biden White House has issued a briefing which suggests there is support for improving access to treatment for those that have developed problems with opiates but there is little in the way of detail about how this will be achieved.