The least you need to know about Trump’s opioid plan

On Monday, the White House rolled out its plan to address the opioid crisis, including a controversial call for harsher criminal justice policies. President Donald Trump has alluded to supporting an “ultimate penalty” for drug traffickers in recent months, and now the administration is urging the Department of Justice to seek the death penalty for some offenders.

"If we don't get tough on drug dealers, we're wasting our time, and that toughness includes the death penalty," Trump said at the press conference in New Hampshire announcing the initiative.

Most stakeholders wince at the idea of reliving the war on drugs, but the president’s plan isn’t exclusively one of law enforcement. Here’s the least you need to know.

Three strategies

The administration’s plan contains three strategies: One aims to reduce the number of opioid prescriptions by one-third over the next three years; the second aims to stop the flow of illicit drugs into the country—Trump specifically noted that a border wall would “keep the damn drugs out.”

“And the third is compassionate treatment for people—evidence-based, science-based, compassionate treatment that can help people recover and stay away from relapse,” Alex Azar, secretary of the Department of Health and Human Services (HHS), said.

What’s yet to be determined is the cost of the strategies and how they might be funded. The Senate recently passed a bipartisan budget deal that included $6 billion in funding to address addiction and overdose, but many believe it’s nowhere near enough.

"This week in Congress, we are working to secure more money to target effective treatment and education measures to prevent abuse and help more people through recovery," Rep. Hal Rogers (R-Ky.) said in a statement. He launched Operation UNITE in 2003.

Trump on Monday underscored the need for treatment, particularly medication assisted treatment, which he said is becoming more available. He also backed the idea of more first responders being equipped with naloxone. In addition, he revealed the new public awareness campaign website, www.crisisnextdoor.gov, something his White House Commission had recommended creating. The site includes messages from the surgeon general and longtime recovery advocate Darryl Strawberry, a former Major League Baseball pro.

Also under the administration’s plan, states would be incentivized to collaborate on a nationwide prescription drug monitoring program. A number of states already share data, but the task is cumbersome and patchwork to say the least. Incentives could galvanize the tech community to innovate workable solutions.

The president also called for an end to the IMD exclusion—a policy that could have costly implications for state Medicaid programs. In October 2017, Trump instructed HHS to find a way to expedite the state waiver process to sidestep the federal IMD exclusion. At the time, the announcement overshadowed the first declaration of the public health emergency related to the opioid crisis.