Presidential candidates remain silent on opioid crisis beyond 'war on drugs' rhetoric: 'It's easier to point the finger' | US elections 2024

Last year, 108,000 people died from overdoses in the U.S., more than from Covid-19 or diabetes, but overdose prevention has received little attention in this election campaign.

On the relatively rare occasions when presidential candidates Donald Trump and Kamala Harris discuss opioids, they resort to “war on drugs” rhetoric — suggesting that tougher border and law enforcement policies are the answer to the problem.

Harris' campaign has promised to spend $160 billion to stop fentanyl from crossing the border.

“As president, I will double the resources of the Department of Justice to pursue these transnational cartels and take action to stop the flow of fentanyl into our country that is destroying entire communities,” she said in a speech in Las Vegas in September.

Trump has used more explicit language to blame migrants crossing the border for the overdose crisis.

“What we actually know, not least from our own law enforcement agencies, is that almost all of the fentanyl that enters the country is introduced by American citizens through legal ports of entry, not by immigrants,” says Ryan Marino, an addiction medicine specialist and professor at Case Western Reserve University School of Medicine. “Not to mention that a not insignificant amount is actually trafficked by members of law enforcement.”

Misleading rhetoric that places blame for the overdose crisis outside U.S. borders is frustrating for medical professionals, activists and family members of opioid users whose primary goal is to prevent preventable overdose deaths.

“Since the 1990s, we have lost over a million loved ones, neighbors and family members to preventable drug overdoses, yet our political candidates continue to offer the same drug war playbook that led to the current crisis we find ourselves in,” said Kassandra Frederique. Managing Director at Drug Policy Action. “Both Harris and Trump have used the overdose crisis as an opportunity to compete to see who can be tougher on immigration and the border, rather than offering a real plan to save lives.”

Frederique suspects that Harris and Trump are avoiding a meaningful confrontation with the reality of the overdose crisis because some of the blame lies with their respective governments.

The Trump administration criminalized all fentanyl-related substances in 2018, leading to more fentanyl seizures. These measures have not reduced the number of overdose deaths – they continued to rise, from fewer than 70,000 in 2018 to nearly 108,000 in 2022.

“It’s easier to point the finger at the border to distract voters from the damage their policies and inaction have caused. While the Biden-Harris administration has taken important steps to minimize harm and expand access [the overdose-reversal drug] Naloxone, their efforts ultimately fell short of the scope and scale that this crisis requires,” says Frederique.

Locally, election candidates are also avoiding the issue, even in cities hit hardest by overdoses, such as Baltimore.

Logan Hullinger, an independent journalist based in Baltimore, has reported on the political silence surrounding the city's overdose crisis.

“I am a recovering addict myself and have overdosed several times in the ten years I was actively addicted,” he says.

Hullinger hoped his reporting could provide a humane, insightful perspective compared to media coverage that exacerbates the stigmatization of people who use opioids. But he was frustrated by how little attention politicians in Baltimore had on the issue. He says they often say they are unable to comment on the crisis because of the city's ongoing lawsuits against pharmaceutical companies and drug distributors.

“Sometimes it feels like the lawsuits were used as an opportunity to avoid talking about a health crisis, which isn't exactly good PR for the city,” Hullinger said.

Local candidates in other overdose hotspots like San Francisco are taking a similar approach to Harris and Trump, promising a crackdown. Nevertheless, raids do not help against addiction.

“Targeting supply without addressing demand actually increases risk and leads to more overdoses,” Marino says. For people addicted to opioids, losing access to reliable care could mean they seek more unknown and dangerous sources.

Frederique points out that since the prescription opioid overdose crisis began, a chain reaction of crackdowns has made the drug supply increasingly dangerous.

Restrictions on prescription opioids didn't stop people from using opioids, but rather “led people to the illegal supply of heroin, which was cheaper,” says Frederique. Heroin crackdowns led to illegal fentanyl, fentanyl crackdowns led to fentanyl analogues. After these were also criminalized, Nitazene, a class of synthetic opioids that can be up to 40 times more potent than fentanyl, is already circulating in the United States, as the Guardian reported has already reported.

Access to overdose reversal medications, such as: B. naloxone; opioid cessation medications such as methadone; and drug testing services have been proven to dramatically reduce the risk of overdose deaths.

Frederique and Marino advise voters to push politicians to put more resources into these proven strategies, but they have different ideas about whether voters care enough to do so. Frederique says voters “absolutely” care about this issue and that they “want and deserve a real plan that puts health and saving lives first.” Most Americans agree that the war on drugs failed.”

Marino, on the other hand, has found that focusing on immigration and drug interdiction is more politically popular. Hullinger is also “unsure where they are [opioid] “The crisis is one of voters' priorities.” He says voters care about the state of Baltimore's drug scene, “but not always for the right reasons.” Many people, for example, view drug users as a public nuisance and demand that they be City is doing more to clean up its neighborhoods.”