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Sunday, September 25, 2016

Walls and Bridges: Trump's and Clinton's Vastly Different Plans About Fighting Substance Abuse


We Americans face a presidential election. How important is an issue that threatens every citizen? In 2014, deaths from overdoses reached a new high of 47,055 according to a report from the U.S. Centers for Disease Control and Prevention. That figure represents more than the number of people killed in car crashes or from gun violence.

Now, synthetic opioids — such as fentanyl and carfentanil, 50 and 5,000 times more powerful than heroin, respectively — have become increasingly popular. The resulting flood of overdoes have overtaken Ohio, Indiana, West Virginia, and Kentucky.

According to the National Institute on Drug Abuse, in 2013, an estimated 22.7 million Americans (8.6 percent) needed treatment for a problem related to drugs or alcohol.
The substance abuse epidemic must be a major concern for both Donald Trump and Hillary Clinton. Let's see where both candidates stand on the issue.

Donald Trump

If elected, Donald Trump says he will battle the addiction crisis on two fronts. “First, we have to support locally based and locally run clinics, and we gotta close up the border. That's where the drugs are coming in.”

Trump claims this will “cut off the source of heroin” and it will “stop the inflow of opioids into the U.S.” And, of course, he says he will make Mexico pay for a wall between the two countries. Those are pretty much all the details of his policy.

(Kelly Burch. “Donald Trump’s Solution to Opioid Epidemic: Build A Wall. The Fix. August 05, 2016.)

Trump added, “In the meantime, people are getting hooked, and we're going to take care of those people,” he said. “Many of them got hooked unknowingly.” Pretty unspecific?

Concerning the need for treatment, Trump says, “It’s very hard to get out of the addiction of heroin. We’re going to work with them, we’re going to spend the money, we’re going to get that habit broken.” He has not outlined a plan on where or how money would be spent in treatment, nor has he addressed issues related to prescribing or treatment in healthcare.

(David Solomon. “Trump takes on opioid crisis, eminent domain at 'Politics & Eggs' in Manchester.”New Hampshire Union Leader. November 11, 2015.)

Hillary Clinton

In contrast to Trump, Hillary Clinton calls for approaching the substance-abuse issue from a public-health perspective, rather than from a criminal-justice one.

Clinton's plan, called the Initiative to Combat America's Deadly Epidemic of Drug and Alcohol Addiction, would allocate $10 billion over the course of 10 years to combat the issue from multiple points. That figure would be divided between a $7.5 billion fund to help states create programs tailored to the issues specific to their area and $2.5 billion allocated to the Substance Abuse Prevention and Treatment Block Grant, which directly funds substance-abuse treatment and prevention programs.

(Harrison Jacobs. “Where Hillary Clinton and Donald Trump stand on the opioid epidemic.” Business Insider. September 24, 2016.)

The plan looks to boost treatment and recovery programs, ensure that first responders have drugs needed to stop opioid overdoses from becoming fatal and urges states to focus more on treatment than incarceration. Clinton specifically calls for creating a state fund to help police, fire departments, and EMTs purchase the drug, and to create naloxone training programs for first responders.

Clinton's plan would also direct state Attorneys General to prioritize "treatment over incarceration for nonviolent and low-level federal drug offenders." Clinton's campaign argues that the savings to the criminal justice system would be used -- in part -- to pay for the plan.

(Dan Merica. “Hillary Clinton proposes $10 billion plan to combat drug and alcohol addiction. CNN. September 02, 2015.)

Also, Clinton specifically mentions LifeSkills Training, a three-year program for middle-school students targeting substance abuse and violence, as a type of successful program that can prevent substance abuse later in life.

Clinton on the wall? In the past, she has supported some physical barriers to prevent illegal immigrants from coming into the country, specifically The Secure Fence Act of 2006. Nothing nearly as expansive as Trump's wall. And, she supports controlling the borders. Clinto believes border security involves a combination of “technology and physical barriers.”

Battle Lines Being Drawn

We all must consider substance abuse – dependence, addiction, and overdose – one of the most important issues facing the nation. Every family, in one way or another is negatively affected by abuse. It is clear how both candidates plan to solve the problem. It is not difficult to see that one has many more specifics in her plan than her opponent.

I believe Donald Trump's wall is not enough to stop heroin and other opioids from entering America. In fact, a wall would come at great expense. No, I don't believe Mexico is going to pay for a border wall. And, a wall is only effective where it can be patrolled. Surely, cameras would be required also. In the long run, it would be a tremendous waste of money.

The U.S. border with Mexico is roughly a massive 2,000 miles long. The Berlin Wall spanned just 96 miles comparatively, and it cost about $25 million to build in 1961, or around $200 million with inflation.

The best estimates of total construction for a wall like like Trump proposes range from $15 billion to $25 billion. In addition the U.S. government would have to pay to maintain the wall, which could cost as much as $750 million a year, according to an analysis conducted by Politico.

Consider that the tremendous amount of money for such a wall could be better spent to utilize other technology to help create a secure border.

Most important, research-based strategies to combat substance abuse support a comprehensive plan of prevention, treatment, and recovery. Donald Trump offers no real plans for a research-based solution. Like many plans Trump promotes, his drug policy lacks thorough consideration and offers a simplistic view of a very complex problem. Hillary Clinton, on the other hand, grasps the need for a comprehensive effort that supplies aid to all fronts.

I cannot be more committed to electing someone who understands the gravity of the situation of substance abuse. America is ill. I will be casting my ballot for Hillary Clinton. How about you?

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