By now it is well known that opioid drugs such as OxyContin (oxycodone) and Percocet are ravaging North American society. Opioids are now responsible in the United States for causing about 37,000 deaths per year. Since the year 2,000 opioid deaths in the U.S. have quadrupled. That is without counting deaths from overdoes of heroin or fentanyl and other drugs. Some people overdose on these drugs after getting addicted to opioids.

How did this happen? In part the problem is that for decades medical doctors have been prescribing prescription opioids for all kinds of ailments, including fairly minor ones. This included things like toothaches, back pain, and the like. Their patients asked the doctors for help and the doctors gave it, even when it was probably not wise for many of these patients to get such prescriptions. We shouldn’t always get what we want. Of course, once people were addicted, Big Pharma was happy to oblige.

In the U.S, the Drug Enforcement Administration (‘DEA’) saw some astonishing efforts to fill prescriptions. In some cases, they were sending out thousands of suspicious orders for pharmaceuticals. In one case, one pharmacy in Kermit West Virginian—in the heart of Trumpland—a town of just 396 people ordered 9 million opioid pills in 2 years!

One would think this would be an easy problem to resolve. One would think wrong. The DEA should be able to investigate and shutdown such commercial trafficking without getting indigestion. But in 2016 the American Congress unanimously passed a law that drastically curtailed the power of their DEA to go after drug distribution. And they did this in the midst of a drug epidemic. And they did it unanimously when ordinarily they cannot agree unanimously what day it is. How did that happen?

It is interesting how that happened. According to Trevor Noah on the Daily Show (Of course I get most of my news from Comedy News ) “that is because of the thing that they are addicted to—Money.” [1] Political commentators have long understood a fundamental principle of political analysis—follow the money. In 2016 the Pharmaceutical Industry (‘Big Pharma’) spent $246 million on lobbying the American Congress. In the decade from 2007 to 2017 they spent a cumulated total of $2.4 billion. That money was well spent.

Big Pharma consistently ranks at the top or near the top of big spenders on lobbying Congress. They do that because it works. That money buys them a lot. The insurance industry another big spender is cheap in comparison. Even though they were second in 2016, they spent a paltry $152.9 million. The gun lobby spent a puny $10.5 million. That is about 4% of what Big Pharma spent. Big Pharma spend money like river boat gamblers and it paid off BIGLEY. It paid off with unanimous legislation that they like. Like the law that crippled the ability of the DEA to investigate commercial drug traffickers.

As a result of such big spending Big Pharma has big influence with Congress. Big spending and big influence go together like love and marriage. Big Pharma wanted to get rid of regulations they did not like. These are more of those regulations that Trump keeps saying hobble American industry. In fact it bought them the right to basically write the laws that emasculated the DEA in the middle of a drug crisis that they helped to create and from which they were the primary financial beneficiaries. As the Washington Post said,

“In April 2016, at the height of the deadliest drug epidemic in U.S. history, Congress effectively stripped the Drug Enforcement Administration of its most potent weapon against large drug companies suspected of spilling prescription narcotics onto the nation’s streets.

By then, the opioid war had claimed 200,000 lives, more than three times the number of U.S. military deaths in the Vietnam War. Overdose deaths continue to rise. There is no end in sight.

A handful of members of Congress, allied with the nation’s major drug distributors, prevailed upon the DEA and the Justice Department to agree to a more industry-friendly law, undermining efforts to stanch the flow of pain pills, according to an investigation by The i and “60 Minutes.” The DEA had opposed the effort for years.” [2]

Bob Dylan was right again—“money doesn’t talk it swears.” It is not surprising either that the chief designer of the of the law that hobbled the DEA was Rep. Tom Marino, who is now reputed to be Donald Trump’s next drug czar. Funny how that happens. In fact according to the Washington Post, Drug Industry executive Linden Barber played a key role in crafting an earlier version of the legislation that eventually curtailed the DEA’s power.” As Trevor Noah said, “for $250 million you can write your own laws.” [3]

Of course Donald Trump understood how serious the drug crisis was. In August of 2017 he declared the opioid crisis an “official national emergency.” That was very significant because it made available many millions of dollars to tackle the crisis. He said specifically, this means the country is committed to spending a lot of time, effort and a lot of money on this crisis. This was a big deal. No doubt about it. Trump should have been applauded for that declaration. Yet there was a hitch. Like there usually is with Trump’s dealings.

The problem is that Trump is a snake oil salesman. They know that in New York. They are used to him there. That is why they did not vote for Trump in the election of 2016. When Trump made the formal announcement on October 26, 2017 he did not do exactly what he had promised. It sounded the same. It looked the same. But it was not the same. Sometimes it can look like a duck, quack like a duck, yet not be duck. He said instead, “my administration is officially declaring the opioid crisis a “national public health emergency under federal law.” That is not quite the same. As a recovering lawyer, I know it is important, very important when dealing with charlatans to read the contract over very slowly and very carefully word for word. Nothing else will do. This is not the time and place for shortcuts. Politics is the time for short cuts. When listening to Trump extreme care is needed.

As a result of this “slight” change in wording, instead of many millions of dollars being available to deal with the “official national emergency” for a “national public health emergency under federal law” there was only $57,000 available. Of course he did not tell us this. He kept mum. Trump had played the old shell game. The American public were the suckers. They bought snake oil.

[1] Trevor Noah, The Daily Show, Comedy News Network, (Oct. 26, 2017)

[2] Scott Higham and Lenny Bernstein, “The Drug Industry’s Triumph over the Dea,” Washington Post, October 15, 2017

[3] Trevor Noah, The Daily Show, Comedy News Network, (Oct. 26, 2017)