Dozens of bills, drafted as emergency responses to the opioid scourge, are kicking around Congress.
These measures range from incentives for new research and testing to requiring drugmakers to package these prescriptions only for set time periods.
Moneyed interests are involved.
As the health and medical website Stat reported this month, one of the hardest-fought issues is “how far Congress should go in expanding access to any particular addiction treatment, resurfacing concerns that lawmakers could play favorites.”
Would the legislation favor therapeutic communities? Access to the medication buprenorphine? Methadone? Access to the medication Vivtrol?
How heavily would law enforcement be counted on to stop the spread of fentanyl — and what will the strategy entail?
Ideally, these choices would be made in a disinterested and highly informed way.
While President Donald Trump needs to sign bills to make them law, the debate appears to get little if any visible direction from the White House Office of National Drug Control Policy, which began under President Ronald Reagan.
This week, 24-year-old Taylor Weyeneth went public with his own story of having risen to a top job at the office under Trump only to be fired — a narrative about the haphazard way appointees are selected.
For those running the office now, there are weekly meetings of an “opioids cabinet” chaired by Kellyanne Conway, the Trump public relations guru identified as a “point person” on this highly technical, deep-government issue.
Jim Carroll, a former deputy White House chief of staff, has been serving as acting drug czar since his nomination months ago. His background for the post seems to have come as a Virginia prosecutor who dealt with narcotics-related cases.
The office’s stated mission is “leading and coordinating the development, implementation and assessment of U.S. drug policy.”
Surely there would be much to coordinate.
Proposals that came out of hearings in Congress would call for action from the National Institutes of Health, Drug Enforcement Agency, Centers for Disease Control, the Food and Drug Administration, and the Substance Abuse and Mental Health Services Administration.
But from all appearances, the role of Carroll’s office has been downgraded.
The job was supposed to go to Rep. Tom Marino (R-Pa.). But he withdrew in October after news stories about his efforts to pass a bill backed by Big Pharma, seen as undercutting Drug Enforcement Administration efforts.
Earlier this month, the White House did announce a multimillion-dollar public-service ad campaign.
“We hope these ads will spark conversation to educate teens and young adults to talk to their doctors about alternatives to opioids,” Conway said.
Conway received a dose of taunting in March when she gave a sort of “just-say-no” message at a millennials’ conference on drug use.
“On our college campuses, your folks are reading the labels, won’t put any sugar in their body, they don’t eat carbs anymore, and they’re very, very fastidious about what goes into their body,” The Hill quoted Conway saying.
“And then you buy a street drug for $5 or $10 and it’s laced with fentanyl, and that’s it. My short advice is, as somebody double your age, eat the ice cream, have the French fry, don’t buy the street drug.
“Believe me, it all works out.”
Much of the rest of the ballyhooed new federal battle against opioids appears to be a work-maybe-in-progress.