If the opioid crisis isn't a national emergency, nothing is

Please act accordingly, Mr. President

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President Trump has shown himself in his not-quite-seven months in office to be the most surprise-prone chief executive in recent American history. We should by now have learned to expect anything from a man who takes to the pages of his second-least favorite newspaper to heap scorn on his handpicked attorney general and oldest political ally. If Trump announced tomorrow that he was in talks with "my generals" to embark on a six-month-long Instagram golf tour of Saudi Arabia via camel or assembling a White House task force to investigate the constitutionality of making fake news a crime, I would not blink. But I was still astonished to see on Tuesday that in between calls for the nuclear annihilation of the Korean peninsula he decided not to declare a national state of emergency in response to the ongoing crisis of opioid addiction in this country.

If 142 Americans dying of drug overdoses every day is not a "national emergency," then the phrase has no meaning.

Besides, as Trump himself noted in his address Tuesday from a golf course in New Jersey, he was speaking earlier and more loudly about the drug problem in this country than virtually every other candidate in 2016, by the end of which nearly 50,000 more Americans had died of accidental drug overdoses. While it would be a gross oversimplification to follow the president's lead in ascribing his victory to his willingness to discuss the issue on the campaign trail, there is a very real sense in which his words resonated with people in many parts of the country hit hardest by the effects of drug use.

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This was true during both the primaries and the general election. Trump won handily in places like Montgomery County in the Rust Belt portion of Ohio, which had previously gone for Barack Obama by a similar margin in both 2008 and 2012. By June of this year, 349 people in Montgomery County had died of drug abuse, already exceeding last year's total; public officials there expect this year's grim rally to reach as high as 800.

Which is why his response is so mystifyingly inadequate. To say that the "best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place" is a non-starter. Most of us under the age of 35 have attended a DARE program or watched Barbara Bush and Winnie the Pooh and the Ninja Turtles tell us not to smoke reefer. Knowing that taking drugs is wrong is not the problem here.

One thing we're going to need is more money, which would come with formally declaring a state of emergency. We need increased funding for treatment and rehabilitation, especially in parts of the country where empty public purses are leading local governments to contemplate unconscionable steps such as refusing emergency medical services to those who have already been treated twice for overdose. We also need to make sure that if the Republicans in Congress manage to pass a health-care bill, it does not involve cuts to Medicaid that would hurt drug addicts.

But throwing money at the problem will not make it go away. The truth is that we need to wage a war on drugs in this country — and we need to win it. Supply and demand must be interdicted. Lawsuits like the ones pursued by New Hampshire and other states against pharmaceutical companies that have in their greed knowingly abetted the immiseration of millions of Americans should be filed at the national level. Purdue Pharma, the makers of OxyContin, have spent hundred of millions of dollars on deceptive marketing schemes designed to minimize the risks associated with a drug that is hurting more people that it helps.

With federal assistance the states must cooperate in their efforts. Doctors who prescribe patients knowing that there is a likelihood or even potential for abuse should be held to account, and in some cases have their licenses taken from them and imprisoned. Dealers should be subject to severe criminal penalties. Such is the danger that they pose to the common good that I would not shrink from recommending the death penalty. There is no meaningful difference between someone who knowingly sells heroin laced with fentanyl to hundreds of Americans and a madman shooting up a school or a shopping mall — except for the fact that one is a lunatic while the other is a gruesomely rational cold-blooded entrepreneur feasting on the despair of his fellows.

None of this is going to be pleasant or simple. Which is why it's so strange that our self-described tough-guy president, who delights in toughness, tough cookies, tough jobs, tough talk, and anything else you can put the t-word in front of or behind is shying away from it.

Declared or not, we are in the middle of a national emergency, Mr. President.

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