As US opioid crisis deepens and shifts, Trump seeks solutions


The human and economic toll of the U.S.’s opioid crisis has only widened since President Donald Trump swept into the Oval Office promising solutions. Given the epidemic’s momentum, the stakes are high as he lays out a plan to combat it.

Trump could officially declare the opioid epidemic a national emergency during a major speech on Thursday, having said in August that he would. That move could pave the way for a stronger federal response, partly by opening access to extra money.

The need for action has been underlined by a high and possibly climbing death toll, complaints from employers as they struggle to hire a drug-free workforce and concerns from parents as the epidemic tightens its grip on America’s youth.

It’s difficult to get real-time data on opioid overdoses, especially because toxicology screenings take time to process, but the cities and states that release data quickly show that the death toll could be headed for another record year in 2017.

Pennsylvania county data are fairly up-to-date, and the numbers show that overdose deaths are still rolling in, driven increasingly by the powerful synthetic, fentanyl. Heroin deaths persist in Cincinnati, government data show. Massachusetts opioid-related death numbers for the first half of the year are basically in line with those from the same period in 2016, a year when the state hit a new overdose high.

The epidemic is killing 91 Americans each day, based on CDC estimates. It’s hard to tell how many people are actually addicted, though government survey data suggest that 2 million Americans 12 years of age and older were hooked on painkillers and another 591,000 were abusing heroin in 2015.

Those numbers seem small in a nation with a working-age population that tops 205 million, but it’s clearly affecting workforce readiness: Employers are citing it and even Federal Reserve Chair Janet Yellen has said it could be cutting into the supply of active workers.

Princeton economist Alan Krueger found in a 2016 paper that nearly half of prime-age men who are not in the labor force take pain medication daily. In fact, the increase in opioid prescriptions from 1999 to 2015 could account for one-fifth of the decline in men’s labor force participation and one-quarter of the decline in women’s participation, he suggested in more recent research.

Given the social and economic costs of the crisis, it’s no wonder that the Trump administration feels pressure to address it, yet there’s no easy solution. That partly owes to the fact that the epidemic is a moving target. As it deepens, it’s changing.

Amid state and national regulator efforts to crack down, fewer pharmacies and doctors are doling out prescriptions, though the rate stood at 66.5 per 100 people last year.

As pills have become less readily available, more people have made the shift to heroin, which is now often laced with potent fentanyl and other illegal synthetics.

The places hit hardest by the drugs have also changed with time.

As the fallout grows, its epicenter has expanded toward America’s Northeast and away from the center of the country.

What’s more, younger victims have overtaken their older counterparts as the crisis’ key demographic, which matters from a workforce development perspective. Those young people could have had long careers ahead of them, so their loss is not only a human tragedy but also signifies missed economic potential.

It’s unclear what the president’s plan will look like, but he’s promised “a very, very big statement.” The commission that Trump tasked with studying the problem and making recommendations for combating the crisis is set to release its final report on Nov. 1.

“We have a 9/11 every three-and-a-half weeks in America,” New Jersey Gov. Chris Christie, who leads the commission, told David Gura in an interview with Bloomberg Television this week. “We need to step up aggressively to try to go after it, I believe the president is going to do that. I believe he understands this issue.”



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