Mr. Trump, please declare war on opioids, not addicts
On Tuesday, President Trump outlined some of his plans for dealing with our opiate epidemic, which took the lives of more than 50,000 Americans during 2015 and will likely cost many more lives this year. On Thursday, the president declared the epidemic a national emergency.
The president has emphasized sealing our southern border and punishing drug offenses more severely. Those measures will never, however, end the opiate epidemic.
The opiate epidemic is fueled as much by demand, as it is by supply. And the demand for opiates is a result of many and complex forces, including people dispirited by unemployment as well as misguided, liberal social policies that reward those who elect to stay out of the labor force.
If these addicts don't obliterate themselves with opioids, they will with marijuana, or alcohol, or cocaine, or crystal methamphetamine.
Drug users need real help – not the revolving door of detox, "rehab" and release that passes for treatment at 99 percent of the substance abuse facilities in the United States.
As a forensic psychiatrist who has testified in dozens of drug-related criminal cases, I say good riddance to the days in which decades-long jail terms were handed out like candy to users who bought drugs in quantities potentially consistent with distribution.
Countless lives were ruined and countless families torn apart by judges who added up grams of cocaine or heroin, ran their fingers across a chart and came to numbers like 11 or 17 or 22 years in prison.
Those draconian sentences should be a source of national disgrace.
Obviously, true drug dealers need to pay significant penalties. But drug users need real help – not the revolving door of detox, "rehab" and release that passes for treatment at 99 percent of the substance abuse facilities in the United States.
And we are ignoring data that suggests that alternative medications such as ayahuasca and ibogaine could provide lasting abstinence for millions of our fellow citizens.
This is no time to be coy or overly cautious in green-lighting and studying treatments like these that show incredible promise to rid people of addiction.
Tens of thousands are dying every year.
This is one of the reasons I took the step of joining The Holistic Sanctuary in Mexico as a psychiatric adviser. Having sent three patients to that facility and seen all three return off all drugs of abuse – and having stayed off – I have anecdotal evidence that miraculous healing can occur when these ancient plant-based medicines are harnessed for good purpose.
I was also among the first psychiatrists in the United States to offer patients ketamine to defeat depression.
I have a rule: Seek to do for patients what you would do for your own child who was at risk of death from addiction.
Would you wait for years of studies to be reviewed by the U.S. Food and Drug Administration to see if that organization ever approves such medications?
Or would you take your child where those medications are offered and also advocate that they be offered, under proper supervision, in the United States?
I am guessing (and it is a guess) that President Trump and New Jersey Gov. Chris Christie might well opt to access ayahuasca or ibogaine were one of their children at death's door from opiates or cocaine or crystal methamphetamine.
And what would be good enough for their sons or daughters should be good enough for anyone's.