Politics Opioid Crisis: Trump Prescribes Heavy Dose of ‘Alternative Facts’ David Bienenstock December 11, 2017 President-elect Donald Trump, left, and New Jersey Gov. Chris Christie shake hands after a meeting at Trump National Golf Club Bedminster clubhouse, Sunday, Nov. 20, 2016, in Bedminster, N.J., after meeting. (AP Photo/Carolyn Kaster)

Back in August, the president of the United States traveled to Huntington, West Virginia—a town of 48,000 where the mayor estimates one in 10 residents is addicted to opioids.

Opioids are America's big problem. 'And we are going to solve that problem,' said President Trump. So far he's all words, no action.

“You have a big problem,” the president told an adoring public rally, “and we are going to solve that problem.”

He didn’t explain how he would solve the problem. That’s not Trump’s style (“Believe me, believe me, believe me”). But four months later, the plan is now becoming clear. He will let them drop dead.

Millions of Americans, of all ages, and from all walks of life, will either die from an opioid overdose in the next 12 months, or seriously fuck up their lives chasing that dragon. Someone you love or rely on is secretly struggling with opioid abuse right now, or will be soon. Meanwhile, pharmaceutical executives pocket billions by recklessly (and sometimes criminally) pushing deadly and addictive narcotics.

That’s all old news. What you might not know is that those same pharmaceutical executives have now hatched a plot to take cannabis from the people, patent its essence, and pad their profits. And the Trump Administration is helping them do it.

More Deaths Than the Vietnam War

Here’s where we are with the opioid crisis. According to a new study from the Centers for Disease Control and Prevention, more than 64,000 people died of drug overdoses in America in 2016, with heroin and prescription painkillers by far the leading culprits. That’s more fatalities in one year than total US casualties during the entire Vietnam War. And the epidemic continues to escalate—faster than ever. Overdose deaths have quadrupled since 1999, and rose by 21% in the last year.

It’s is important to note that, to an astonishing degree, President Trump did best electorally in the rural, predominantly white, low-income communities most devastated by opioid abuse. People living in this so-called “desperation belt” are also far more likely to commit suicide.

“All addiction is an escape from pain,” Dr. Gabor Maté writes in In the Realm of Hungry Ghosts: Close Encounters with Addiction. “So don’t ask the question ‘why the addiction,’ but ‘why the pain?'”

Pain Killers

Much ink has been spilled since the election exploring the pain of these “forgotten Americans,” who live lives of quiet economic desperation and trust a guy who shits in a golden toilet to stick up for them. But nobody talks much about how they afford to keep feeding the monkey.

Big Pharma rakes in the cash, the cops and DEA look the other way, and American taxpayers foot the bill.

According to a new report by the inspector general of the U.S. Department of Health and Human Services, more than 45% of Medicare beneficiaries in Alabama and Mississippi were prescribed painkillers paid for by “big government.”

While an investigation by the Charleston Gazette-Mail revealed that over a two-year period, out-of-state pharmaceutical companies shipped almost nine million hydrocodone pills to a pharmacy in West Virginia located in a town of just 400 people in the poorest county of one of the poorest US states.

To be clear: That’s one type of opioid shipped to a single pharmacy.

The Opioid Hustle

So here’s how this hustle works: People are desperate, impoverished and in pain—whether physical, emotional or both—and the communities they live in offer little to no real economic opportunity or social services. But the doctor at the local pill mill will write you a script anytime to make you feel better. Big Pharma rakes in cash, the cops and the DEA look the other way, and the American taxpayer foots the bill.

What could go wrong?

Plenty. Consider just one example: Sarah Fuller, from Camden, New Jersey, who was 31 and on disability for back pain from a car accident when, over a 15-month period starting in Jan. 2015, Medicare shelled out $250,544 to cover her prescription for Subsys, a fentanyl-based mouth spray manufactured by Insys Therapeutics (remember that name). The payments to Fuller’s pharmacist finally ended in April 2016, when her fiancé discovered her at home, dead from a fatal fentanyl overdose.

And that’s just one story of literally millions.

The Anti-Cannabis Commission

Traditionally, the government’s response to “drug epidemics” has been to demonize users and launch costly counterproductive enforcement campaigns that rely on street level arrests and “taking out kingpins.” But that approach won’t do at all if the users are predominantly white and the kingpins are pharmaceutical corporations that make huge political contributions every year. So the federal government had to come up with a new game plan.

So far, the White House’s most visible move has been the formation of the president’s Commission on Combating Drug Addiction and the Opioid Crisis. But with outgoing New Jersey governor Chris Christie at the helm, the commission released a final report that could have been written by Big Pharma lobbyists.

Left untouched by Trump's commission: the criminal responsibility of pharma executives who broke the law and begat this crisis.

Even though Christie’s a former federal prosecutor, nothing in the report addressed the criminal responsibility of the pharma executives who broke the law and begat this crisis. This despite massive evidence that the pharmaceutical industry—in the words of an ongoing Senate investigation—“focused on fostering addiction as a central component of its business model.”

These are the same pharma executives who, according to emails obtained by USA Today, were invited to testify before the president’s opioid commission because it offered “a good networking opportunity.”

Not invited to testify before the commission: Anyone who believes cannabis can play a role in alleviating the opioid crisis. This is despite massive evidence showing that the ready availability of legal cannabis in a state significantly lowers overall opioid use and abuse. The commission did acknowledge “that there is an active movement to promote the use of marijuana as an alternative medication for chronic pain and as a treatment for opioid addiction,” but then rejected that idea out of hand.

Cannabis, the report concluded, is just far too dangerous and untested to even research its potential.

No Leaders Available to Lead

The president went down to West Virginia and personally promised to solve the opioid problem, which vastly disproportionately affects his strongest supporters. Then he put together a commission that covered up Big Pharma’s central role in creating and exasperating the crisis, and pointedly ignored the potential of cannabis to treat pain safely and help addicts get off opioids.

So what’s actually in the plan? A strategy that ramps up enforcement against Mexican and Chinese black market dealers (but not the pushers in suits and ties), and increases Medicare funding for addiction recovery (so taxpayers foot the bill to treat the addicts we already paid to create), plus a few toothless measures against “over-prescribing” and “doctor-shopping.”

And who will quarterback this crucial high-profile life-and-death effort?

Sounds like a job for the Drug Czar.

No Drug Czar, No HHS Secretary…

Only problem is, after nearly a year in office, the president has not yet appointed a director of the Office of National Drug Control Policy (a.k.a. “the Drug Czar”).

Tom Marino was twice up for the Drug Czar post, and twice removed himself.

He nominated Tom Marino for the position back in October, but Marino withdrew soon after a 60 Minutes segment exposed how, as a member of Congress, he’d authored the Ensuring Patient Access and Effective Drug Enforcement Act, a gift to Big Pharma that made it extremely difficult for the DEA to investigate pharma executives for criminal activity. When DEA Office of Diversion Control head Joseph Rannazzisi spoke out against the bill, Marino basically got him fired.

How about the Secretary of Health and Human Services? The president’s original nominee, the virulently anti-cannabis Tom Price, sailed through his Senate confirmation despite getting caught red-handed buying up Big Pharma stocks and then pushing those companies’ agendas in Congress.

In September, Price was forced to resign after getting caught sticking taxpayers with the bills for his lavish private jet travel. Last week the president nominated Alex Azar to replace him. And who’s Alex Azar? A former pharmaceutical executive, of course.

No FDA Director…

Let’s see, who’s next? What about asking the head of the Food and Drug Administration (FDA) to spearhead the effort? Sounds good, except Dr. Scott Gottlieb, the president’s pick for that position (who still awaits Senate confirmation), has taken hefty speaking fees from opioid manufacturers.

In 2012, well into the opioid epidemic, he wrote an essay calling out the DEA for—get this—being too tough on Big Pharma and pill mills.

Which brings to mind another campaign promise the president repeatedly made—that he’d “hire the best people” to run the federal government.

Conway! Fix This (or at Least Bury It)

That now includes, apparently, Kellyanne Conway, counselor to the president, who has now been tapped “to coordinate and lead the [opioid] effort from the White House.”

The inventor of 'alternative facts' now is tasked with solving the opioid epidemic.

Best known for coining the phrase “alternative fact” and going on a political talk show to urge Americans to snap up twinsets and accessories from the president’s daughter’s clothing line, Conway is also currently under investigation by a special prosecutor for potentially violating the Hatch Act, which bars executive branch employees from using their government positions to campaign for or against political candidates.

Far more troubling, Conway has zero experience in law enforcement, addiction treatment, or public health. And it’s not like she’s leaving her other job behind. So basically the president’s response to the ongoing and preventable deaths of his strongest supporters is to have a lifetime political hack spend part of her day pretending to give a shit.

Money Talking

Too harsh? All right, let’s follow the money. Because if there’s one golden rule for understanding this president, it’s that money talks and bullshit walks.

And what do you discover when you follow the cash? Turns out, when the president declared the opioid crisis a public health emergency on October 26, that declaration only made available $57,000 in funds to tackle an epidemic the Centers for Disease Control and Prevention estimates costs society $78.5 billion.

Had the president declared it a national disaster instead, that would have unlocked billions of dollars in Federal Emergency Management Agency relief funds. Two words. That’s it. Substitute “national disaster” for “public health emergency,” and billions of dollars would snap into action.

So far, no additional funds have been requested. Like I said, the plan has dropped dead.

Perhaps I’m being unfair. After all, the Billionaire-in-Chief did donate a quarter of his annual salary as president (or $100,000) to fight the epidemic…the same week his party pushed through a tax plan that could save him over a billion dollars.

‘A Death Wish for Our Daughter’

And what about the role of cannabis in all this?

The good news is that the federal government has just made a historic move to acknowledge the medical efficacy and safety of THC by reclassifying cannabis’s best known chemical component from Schedule I (high potential for abuse, no known medical use) to the far less restricted Schedule II category. The bad news is that new status only applies to synthetically-produced THC, in the form of a patented product from a single pharmaceutical company.

Remember when I said not to forget the name Insys Therapeutics?

In the company’s entire history, they’ve only previously brought one product to market, Subsys, the fentanyl spray that Sarah Fuller was taking when she fatally overdosed.

According to Fuller’s mother, Insys not only bribed doctors and defrauded Medicare as a standard business practice, they went so far as to call her daughter’s health insurer “pretending to be calling from her doctor’s office and the like, [falsely] telling the insurance company that Sarah needed Subsys because she had cancer and was suffering from breakthrough cancer pain.” That call, Fuller’s mother said, “was Insys’ death wish for our daughter in exchange for profit.”

Insys: Four Indicted, Including Ex-CEO

In October, Insys’s billionaire founder and former CEO John Kapoor was arrested for his role in the company’s alleged schemes to illegally move units of Subsys. Six additional Insys Therapeutics executives have also been arrested by the FBI. The severity and brazenness of their crimes can be best understood by how scarce such enforcement is in the rarified world of pedigreed dope peddlers.

Insys is the same company that spent $500K to defeat cannabis legalization in Arizona.

But still, despite their one-and-only product being a deadly, addictive opioid 50 times stronger than heroin, which they allegedly engaged in a massive criminal conspiracy to push onto vulnerable people, last July the FDA and DEA allowed Insys to launch Syndros—their new 100% synthetic THC drug—as a treatment for nausea and vomiting in chemotherapy patients.

Which must mean it’s finally cool with the feds if cancer patients smoke a joint or two to get through chemo, right? Especially since prescribed Syndros costs up to $2,000 per month.

Ah, not so fast.

FDA to Insys: You’re A-Okay

“The DEA notes that FDA-approved products of oral solutions containing dronabinol [THC] have an approved medical use,” DEA officials wrote in the filing that approved moving Syndros to Schedule II, “whereas marijuana does not have an approved medical use and therefore remains in Schedule I.”

Meaning, basically, that Big Pharma’s dirtiest dealers can charge you exorbitant prices for lab-made THC, while the feds contemplate cracking down on cannabis—even in states where it’s legal. No wonder Insys Therapeutics donated $500,000 to anti-legalization efforts in the last election cycle. Gotta squash the competition.

Keep Fighting for the Safer Cannabis Option

Now where does that leave us?

Remember those desperate people in the heartland, and really all over the country. They’re going to keep dying. And unlike a lot of other political issues, this one hits them very close to home. There’s no way to hide the bodies. They are our friends, neighbors, and loved ones.

As a cannabis community, we must continue to lead the way in advocating for this plant as a lifesaving alternative pain treatment and gateway out of addiction. And not let the Trump Administration and its Big Pharma friends continue to profit from addiction, arrest, and misery.

David Bienenstock Veteran cannabis journalist David Bienenstock is the author of "How to Smoke Pot (Properly): A Highbrow Guide to Getting High" (2016 - Penguin/Random House), and the co-host and co-creator of the podcast "Great Moments in Weed History with Abdullah and Bean." Follow him on Twitter @pot_handbook. View David Bienenstock's articles