The Rosenthal Report - June 2019

Rosenthal Reports



In 2017, there were a record 70,000 drug overdose deaths in the United States, two-thirds of which were linked to opioids—and data for both 2018 and this year shows no significant reduction in fatalities. Yet as the 2020 Presidential race kicks into high gear, only two of the 24 Democratic candidates—Senators Elizabeth Warren and Amy Klobuchar—have announced comprehensive strategies to fight the opioid epidemic. Given the Trump administration’s lackluster response to the crisis, the Democrats are missing an opportunity to both raise greater awareness of the drug crisis and build political momentum to find and fund solutions.

Sen. Warren’s proposal is based on the Comprehensive Addiction Resources Emergency (CARE) Act, a bill she and Rep. Elijah Cummings introduced in Congress in 2018. It calls for $100 billion to be spent over 10 years to boost substance-abuse treatment and other anti-drug initiatives—a scale and scope of funding supported by the Rosenthal Center. Money would go to both increase access to drug treatment and the use of overdose-reversal drugs, as well as such measures as research into innovative treatments and training for health care staff, among other measures. To fund the program, Warren proposed instituting a new wealth tax on the super rich. 

Sen. Klobuchar’s plan also allocates $100 billion over a decade to address the opioid epidemic as well as alcohol misuse and mental health services. It includes smart initiatives in prevention, treatment and recovery such as better training for doctors to recognize the early warning signs of addiction, transitional housing for recovering addicts, and treatment instead of incarceration for nonviolent drug offenders. Funding would come from charging opioid manufacturers a fee for every milligram of drugs they sell—similar to a recently approved opioid tax in New York State—and reaching a “master settlement agreement” from the nearly 2,000 lawsuits that have been filed against pharmaceutical companies and distributors.

For the most part, both proposals are thoughtful and incorporate many of the best practices of addiction care. Most importantly, they aim to get more individuals with substance use disorder intro treatment.

Today, only one in five addicts receive specialty treatment and fewer than half of all treatment facilities offer medication assisted treatment (MAT), which combines addiction-withdrawal medications and peer-based counseling. Compared with the Trump administration’s failed attempts at curbing the epidemic, the Democratic proposals would likely have more impact than anything the government has previously attempted.

Whether these strategies are ever enacted, however, is as uncertain as the election itself. The ambitious CARE Act never gained much traction in either the House or Senate. Lacking strong leadership from the White House, Congress opted instead to boost prescription-drug monitoring and law enforcement, allocating overall around $6 billion in short-term funding—a fraction of what would be appropriate.

While it’s still early days in the campaign, I urge other Democratic candidates to take a forceful stand as well. Elevating the opioid epidemic onto the high profile platform of a presidential campaign—and taking the message to areas of the country hardest hit by the opioid epidemic, as Warren has done—will ensure the issue remains at the forefront of public debate and policymaking.


4th June 2019
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