A failure by the Obama administration to react to numerous warnings by state officials and its own drug investigators about the rising peril of illicit fentanyl allowed the problem to fester over the years and claim tens of thousands of lives, according to The Washington Post.

And while states were seeing a growing number of fentanyl-related overdoses, Obama-era Attorney General Eric Holder announced a new policy to ease prosecutions of low-level nonviolent drug offenses, which he said would address overly harsh mandatory-minimum sentences for first-time offenders. The move, law enforcement officials told The Post, led to fewer arrests and affected investigators' ability to reach criminals high up in the drug-trafficking chain through deals offered to lower-level offenders.

That, the newspaper said in its report on Wednesday, slowed law enforcement efforts to get to the sources and understand the networks behind the flourishing fentanyl trade.

From 2013 to 2017, nearly 70,000 people died of synthetic opioid-related overdoses, most tied to fentanyl, which is commonly obtained through the black market. In 2017, The Post noted, fentanyl became the leading causes of fatal overdoses.

“Everybody was slow to recognize the severity of the problem, even though a lot of the warning signs were there,” The Post quoted New Hampshire Gov. Chris Sununu, a Republican, as saying.

The appeals to the Obama administration were numerous and came from myriad sources.

A group of national public health experts sent a letter to senior Obama administration officials in 2016 begging for immediate action because, they stressed, thousands of people had been dying from fentanyl overdoses since at least 2013.

“The fentanyl crisis represents an extraordinary public health challenge —and requires an extraordinary public health response,” the group said in the letter, which was sent to officials of the Centers for Disease Control and Prevention (CDC) and to the drug czar.

The administration, it said, acknowledged the letter but took no action.

AS DOCTORS TAPER OR END OPIOID PRESCRIPTIONS, MANY PATIENTS DRIVEN TO DESPAIR, SUICIDE

One significant move that the CDC took in response to increasing public attention on overdoses due to opioids – which included largely illicit opioids such as heroin and illicit fentanyl – was to issue guidelines for general practitioners on prescribing opioids to people with chronic pain.

But many pain specialists and public health experts say those guidelines, while well-intentioned, made sweeping dose recommendations that remain debatable among medical professionals and have since been used to deny pain patients the doses they need. The guidelines also unleashed a wave of policies and laws around the country restricting doses and in some cases discouraging the prescribing of opioids, even to patients who long have relied on them and use them responsibly.

Meanwhile, painkiller prescription rates have declined, and many doctors are either forcing patients to taper off – against the recommendation of the CDC guidelines – or abandoning those pain patients altogether.

A Fox News series in December reported that while many pain patients in the United States have been left undertreated, creating a new public health crisis, overdose deaths due to illicit fentanyl continued to climb.

Political leaders and police from areas hard hit by fentanyl overdoses told The Post that when the Obama administration did address the overdose crisis, it focused on prescription painkillers and heroin, not the greater threat of fentanyl.

“Fentanyl was killing people like we’d never seen before,” said Derek Maltz, the former agent in charge for the Drug Enforcement Administration (DEA) Special Operations Division in Washington. “A red light was going off, ding, ding, ding. ... We needed a serious sense of urgency.”

TOUGH NEW OPIOID POLICIES LEAVE SOME CANCER AND POST-SURGERY PATIENTS WITHOUT PAINKILLERS

But with no loud alarm coming from President Barack Obama or his senior officials, Congress did not move to provide the funding needed, U.S. Customs and Border Protection did not have the manpower or the equipment to detect fentanyl shipments entering from Mexico and China, and the U.S. Postal Service did not use electronic tools that would allow for detecting packages containing fentanyl that had been ordered through the Internet, The Post said.

Manchester [New Hampshire] Fire Chief Dan Goonan said he got tired of going to the numerous roundtable discussions that first responders, politicians and policymakers were having about fentanyl because nothing ever got done.

In 2014, the DEA started to alert local law enforcement agencies around the country about fentanyl, but it got little to no attention at the national level, the Post said.

After actor Philip Seymour Hoffman died of a heroin overdose, attracting broad media attention to the problem, Holder appeared in a video calling heroin an “urgent and growing public health crisis.” But, just like others in the administration who saw the overdose crisis only in terms of heroin and prescription pills, Holder did not mention the bigger threat – fentanyl.

Holder’s former spokesman, Matthew Miller, defended him in an interview with The Post. “It says something that the people pointing fingers at the attorney general can’t point to a single action they recommended that he declined to take,” Miller said. “Eric Holder made fighting the opioid crisis a major focus, he strongly supported the DEA’s work in this area, and if the officials trying to now lay the blame at someone else’s feet had asked for more assistance, he would have given it.”

By the time Holder left his job, federal drug prosecutions had dropped, while fentanyl overdoses were spreading around the country.

Later, Congress asked for the creation of a National Heroin Task Force to look at the overdose epidemic. But again, the focus was heroin and prescription painkillers, which account for a minority of overdoses.

The Post noted that the task force produced a 23-page report on the OD crisis for Congress – within those pages, though, a mere five sentences mentioned fentanyl.

Michael Botticelli, the White House drug czar in the Obama administration, said, “In retrospect, it should have been a focus of the report.”

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Tom Frieden, who was the CDC head during the Obama administration, said he tried to impress upon officials the dangers of fentanyl and how it was becoming a major killer in many communities.

“I felt like I was a bit of a voice in the wilderness,” Frieden said. “I didn’t have the sense that people got this as a really serious problem.”

In an interview with CNN after the new report was published, one of the Post reporters, Sari Horwitz, said: “The Trump administration has done some things. They've talked about it more than the Obama administration. They've ramped up prosecutions. The Justice Department is going after fentanyl and drug trafficking.”



“But," she added, "people are telling us you cannot arrest your way out of this problem. There needs to be a three-pronged approach that involves prevention which is, as I said, a public service campaign to let people know how incredibly dangerous fentanyl is.”