Drug control challenges for the next ‘drug czar’

 In National News, Regulation

By Robert MacCoun, senior fellow at the Freeman Spogli Institute and professor of law at Stanford

In this series, FSI experts share their recommendations for President-elect Trump.

Coordinating all the departments and agencies involved in federal drug control policy wouldn’t be possible without the Office of National Drug Control Policy (ONDCP), which plays a crucial role in keeping everyone on the same page. At the helm of the ONDCP is the “drug czar” — the director — who also commands an important bully pulpit in shaping the way people understand and respond to drug problems.

On Jan. 20, one of the challenges that President-elect Trump will face is steering the Office of National Drug Control. Here are three broad suggestions for how he should approach that challenge:

1. Manage the opioid crisis.

If the Office of National Drug Control Policy tackles nothing else in the next four years, tackling the opioid crisis should be priority number one. By a wide margin, the most pressing agenda for national drug control policy is to get the opioid crisis under control. A decade or so ago, it looked like the opioids — a class that includes poppy-based opiates like heroin as well as synthetics like oxycodone and fentanyl — were becoming a minor footnote in drug policy, as there were relatively few new initiates replacing the addicts of the Vietnam era’s heroin epidemic. Now, astonishingly, heroin-related deaths have just surpassed firearm deaths in America; all drug overdoses combined kill more Americans each year than AIDS did at its peak. We have a variety of treatment options for opioid dependence, but they are only effective if they are deployed where they are needed. Encouragingly, the recently enacted 21st Century Cures Act has earmarked significant new funding to combat the opioid crisis, Even so, if the Affordable Care Act is repealed, the treatment gap could grow larger, not smaller.

2. Provide federal leadership for marijuana regulation.

Even with a vastly larger user base, marijuana is less consequential than the opioids for public health. On the other hand, we are at a historically important moment in the emergence of a major new industry. The new administration has three paths available. First, it can try to roll back state changes in marijuana law. But with 1 in 5 Americans residing in a state that’s legalized marijuana, with over half of the states legalizing some form of medical marijuana, and with a majority of all Americans favoring legalization in various recent polls, that would be a deeply unpopular and distracting fight.

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