Presidential Administrations and the Opioid Crisis

Mar 10

Whatever one’s personal views on who is to blame for the overdose deaths in the United States, there is no denying there has been a steady increase in the number of overdose deaths in the past two decades and it’s far more complicated than who sits in the oval office. A Forbes article in 2023 declared that “Synthetic Opioid Overdose Deaths Soared While Trump Was President.” A New York Post article focused on a GOP eruption during the 2023 State of the Union address in “which many blamed [Biden’s] administration for letting [drugs] slip through the southern border.”

A review of information from the National Center for Health Statistics reveals that overdose deaths have increased during every presidential term and may have more to do with cartels to develop robust supply chains and technological innovations (synthetic opioids) than anything else.

If one looks at illegal drugs as a business, the drug crisis seems a function of marketplace reactions with surges, lower increases, and more surges as supply chains and innovative changes make drugs cheaper, more potent, and more accessible.

The only decrease in the number of overdose deaths in any one given year since 2001 happened in 2018 during the Trump administration, when overall overdose deaths decreased by nearly 2,900. There was a 4.3% decrease in all overdose deaths and 1.7% decrease in opioid deaths. The trend did not continue and 2019 outcomes mirrored those in 2017. In the final year of Trump’s presidency, there was a 23% increase in all overdose deaths and opioids accounted for 75% of those deaths.

Forbes Stuart Anderson asserts that the “Trump administration’s decision to close U.S. ports of entry to nonessential traffic during the Covid-19 pandemic in March 2020 had the consequence of accelerating drug traffickers’ shift to fentanyl, a more potent drug than heroin, which helped lead to an increase in drug overdose deaths.” Another possible explanation is the ability of cartels to produce a cheaper and more robust (potent) fentanyl product and nuanced supply chain efforts on which cartels have relied, developed, and perfected over decades. Anderson’s explanation tends to discount the historically innovative trends by drug cartels that seem to plague one administration to the next.

Although drug deaths increased at a lesser rate during Obama’s first term, that was not the case in his second term in 2014 as fentanyl hit the marketplace. There was a 41% increase in opioid deaths and a 31% increase in overall overdose deaths during the start of Obama’s second term, where opioids accounted for 61% of non-opioid and opioid overdose deaths combined. By the end of his term in 2016, opioids accounted for 66% of overdose deaths.

The supply chain apparatus and product change to fentanyl was well under way prior to the Trump administration and took a few years to take hold in the marketplace. (A similar analogy would be the crack-cocaine epidemic in the 1980s and the Oxycontin epidemic in the 1990s that fueled other opioids.)

As the table above shows, overdose deaths increased 29.3% from the start to the end of Bush’s first term (2001 to 2004) and 18.2% from the start to the end of his second term (2005 to 2008). Although overdose deaths were on the rise, the percent of increase was on the decline. Overdose deaths during the Obama administration showed something similar. In Obama’s first term, there was an increase in the number of opioid deaths but the percent of increase was on the decline compared to his predecessor’s last term in office, 18.2% to 10.8% respectively. That would change with Obama’s second term, when overdose deaths increased 30.9% from the start to the end of his second term (2013 to 2016).

Surges may have less to do with who is in charge and more to do with the ability of cartels to adapt and presidential administrations inability to form sustained and cohesive actions that see the war on drugs as a permanent endeavor that must carry over from one administration to the next. Drug surges seem to have a cyclical element that increases steadily with episodic surges every 8 years no matter who is in charge. However, there is no denying every administration has seen an increase in overdose deaths.

Although the Biden Administration is likely to see a decrease in the percent-of-increase deaths from the start of its term to the end of its term compared to the administration’s predecessors, it is likely to see an unprecedented number of deaths that will exceed 420,000, of which 320,000 are likely to come from opioids. These deaths would mark the highest of any administration.

The chart below shows the increase in the share of overdose deaths from opioids, with fentanyl as a leading cause of these overdoses. The opioid crisis is not new; it’s evolving.

The Drug Enforcement Agency Laboratory has found that, of the fentanyl-laced fake prescription pills analyzed in 2022, six out of ten now contain a potentially lethal dose of fentanyl. This is an increase from DEA’s previous announcement in 2021 that four out of ten fentanyl-laced fake prescription pills were found to contain a potentially lethal dose.

Although numbers have increased for both males and females, males still account for the overwhelming majority (70%) of all overdose deaths. The last several years, however, have shown an unprecedented increase in overdose deaths for males and females.

Human drug trafficking across the border and other ports of drug entry plays a role in the problem, and the effort to minimize it requires more aggressive and cooperative action and less finger pointing.

The U.S. needs to engage in at least five major efforts that are sustained and carry over from one administration to the next.

An unprecedented military commitment to dramatically expanding the scope, personnel, and operations that lead to ending drug cartels, drug dealing, and illegal drug production. (Yes, cartels and drug trafficking as terrorism.)
Eradicate homelessness and open-air drug use by providing shelters.
Expand mental health services.
Unprecedented commitment to educating children, parents, and the public
A comprehensive and well trained police force

In 2001, there were just under 20,000 overdose deaths. By 2022, that number has increased more than 5-fold to over 107,000. Until the U.S. begins to see sustained declines in the actual number of overdose deaths year after year, no president can claim success, and it’s the reason a more bi-partisan long-term commitment is essential more than ever.

The border certainly plays a role in drug trafficking, as do other ports of entry, and social media, where young people purchase Percocet or other pills they believe are legitimate drugs, only to later learn they are laced with fentanyl, a synthetic opioid that is creating devastating consequences in cities across America and causing the spike in opioid deaths. Unsuspecting teenagers and young adults are dying from such encounters when purchasing drugs, often on social media sites such as SnapChat.

It’s reflexive to assume overdoses are happening to drug addicted people only, but that is not the case in thousands of incidents. Many are happening to young people who are experimenting with drugs for the first time or others who simply want a prescription for a common ailment, like back pain, and look for a self-prescriptive outlet. Today’s young people are more apt to self-medicate than previous generations and social media has only made it easier for them to purchase pills on-line that lead to fatal fentanyl overdoses.

The non-profit Song for Charlie is one of the most important and upcoming entities working to address the fentanyl crisis, with its No Random Pills Pledge. I strongly encourage you to watch their video and share it with your network.