John Giordano, Doctor of Humane Letters, MAC, CAP

Medicine with Plastic bottle on map of United States

Recently, the President rolled out his three pronged approach that he believes will curb our raging opioid epidemic, parts of which sound remarkably close to those of Philippine President Duterte’s; a person our president has openly praised.

Looking into his past, it becomes clear how, with a little encouragement, President Duterte’s declaration of a “War on Drugs” came to be. Duterte has always presented himself as a ‘tough on crime’ politician. He speaks openly of personally killing suspected criminals as Mayor of Davao to set an example for local police. His detractors claim Duterte, nicknamed “The Punisher” by Time magazine, is using the violent and deadly “War on Drugs” as a political tool intended to rally his base.

It’s a sad commentary on humanity when the weakest of us, the down-trodden and often mentally ill, are imprisoned and summarily executed for a disease they didn’t ask for and played no part in getting. We see this all too often in third-world countries; but recent comments from the White House amid their new opioid policy makes me wonder if this great country of ours might start turning a blind eye to humanity like the Philippines did while being steered in that direction.

Everyone agrees we have a raging opioid epidemic growing exponentially, yet there is no one consensus on how to end it. Some experts believe Medication-Assisted Treatment (MAT) is the way to go; while other experts who are proponents of abstinence believe MAT only moves addicts from one opioid to another, doing little to ease the suffering. There are other arguments and considerations as well.

However, if I had to speculate, I think nearly all addiction professionals would agree that the policy shift being set forth by the administration is an abomination that completely ignores facts and will perpetuate this epidemic into eternity. Albeit the president was elected as someone with fresh new ideas on how to approach the major issues we face today, I don’t think anyone touched by addiction, either professionally or personally, quite expected this.

I want to draw your attention to a speech the president made on March 2018 in New Hampshire – one of the states hardest hit by opioid addiction and overdose deaths – revealing his administration’s three prong opioid response plan. You can find the speech in its entirety online; but the short version is: build a wall – ostensibly to prevent the importation of illicit drugs from Mexico – a ‘just say no’ advertising campaign and death penalty for some drug dealers.

To be frank, I was taken aback watching the President’s rollout of new policies on TV. It was a moment of déjà vu. Never in my wildest dreams did I ever imagine reverting back to what most addiction experts believe to be the biggest abject failure of the 80’s, known as “The War On Drugs,” as being the ‘new’ direction for our opioid policy. What I found particularly interesting while watching the president on TV was just how little this administration understands about addiction and this epidemic, let alone what to do about it.

I suppose the most logical place to start is at the beginning, or in this case, the wall. The administration believes, or at the very least postulates, that their iconic proposed multi-billion dollar wall will prevent the importation of illicit drugs from our southern border. I have a lot to say on this, but for now let us look at the facts. The Mexican drug lords have proven just how resourceful they are when it comes to smuggling drugs into the US. They use mules that swallow condoms containing drugs and cross the border. They have submarines and fleets of their own aircraft. Last year, customs agents found drugs in the tires of brand new ford cars built in Mexico and being shipped by rail road to US destinations.

Illicit drugs are coming into this country through every point of entry you can imagine and a few that you can’t. The administration wants to focus on the southern border while untold amounts of fentanyl are being smuggled in from the north. Just last month Canadian officials shut down a fentanyl lab in Calgary, Alberta; their third major bust – just in Alberta – in less than a year. The Royal Canadian Mounted Police Clandestine Lab Enforcement and Response (CLEAR) Team discovered 18 kilos of suspected fentanyl in two different locations.

To give you an idea just how deadly fentanyl is, an amount approximately equal to the size of the head of a pin can kill you if you just touch it!

Many of the Canadian smugglers barter fentanyl with US traffickers for cocaine and other illicit drugs more popular in Canada. Perhaps Canada should build a wall to keep illicit drugs from creeping into their country from their southern border?

Canada is just the tip of the iceberg. The DEA and United Nations narcotics monitors have identified China as the primary source of most of the fentanyl in U.S. street drugs. In a one year study conducted by Senate’s permanent subcommittee on investigations, looking at only six online sellers (five based in China) offering fentanyl, all of which can be found through a simple Google search, investigators identified $230,000 in payments in 500 financial transactions with U.S.-based individuals or businesses – an amount that would translate into $766 million worth of fentanyl, based on its U.S. street value.

So just how did the fentanyl find its way from China into the US; hundreds of packages were sent to more than 300 U.S. based individuals’ doorsteps via United States Postal Service, FedEx, and other private shipping companies.

Bear in mind, this is merely one congressional study of just 6 vendors selling fentanyl online. Who knows how much is coming into this country through our postal system and other private shipping companies. It is also important to note that because this was a congressional study, the administration does have access to it. Suffice it to say that it’s going to take far more than a wall to curb illicit drug trade into the US.

For reasons unbeknownst to me, this administration appears to be enamored with the nearly forty-year-old “Just Say No” campaign. Both the President and the Attorney General have spoken fondly of it on numerous occasions and incorporate it into their prevention plan. Perhaps it is because of its affiliation with the Reagan administration or because it was promoted by Nancy Reagan; then again it may be they find it fondly reminiscent of an earlier era of a president appearing ‘tough on crime;’ it’s anybody’s guess really. For whatever their reason, the sentiment seems misplaced.

The 80’s was a time when cocaine and crack cocaine use exploded in the US. President Reagan vowed to crack down on substance abuse and reprioritize the War on Drugs when he came into office. He signed the Anti-Drug Abuse Act in 1986, allotting $1.7 billion to continue fighting the War on Drugs; just one year after the cocaine centric Miami Vice TV show was nominated for 15 Emmy Awards. President Reagan also instituted mandatory minimum prison sentences for specific drug offenses; not all that different from what the president and Attorney general are proposing with their death penalty for some drug traffickers.

Throughout the 80’s “Just Say No” TV commercials aired across the country. Ads appeared in newspapers and popular magazines. There really is no matrix that could indicate whether it was a success or failure as a deterrent to drug use. But what we do know is that drug use exploded during this period and nonviolent drug offenses increased over 8 fold, from 50,000 in 1980 to more than 400,000 by 1997.

Kellyanne Conway, the President’s counselor and de facto drug czar, seems to have her own version of “Just Say No” that she revealed at a youth forum hosted by the White House last month. Her slogan “Eat the ice cream, have the french fry, don’t buy the street drug.” You can’t make this stuff up; I wish I was, but I’m not.

Talking to a group of millennials, Conway offered up this little nugget of advice; “On our college campuses, your folks are reading the labels, they won’t put any sugar in their body, they don’t eat carbs anymore, and they’re very, very fastidious about what goes into their body, and then you buy a street drug for $5 or $10, it’s laced with fentanyl, and that’s it. So I guess my short advice is, as somebody double your age: eat the ice cream, have the french fry, don’t buy the street drug. Believe me, it all works out.”

I don’t have the benefit of knowing Conway personally, so I don’t know if her comment was intended to be serious, or a failed attempt at humor. Regardless, taken on its own merits, this is a glaring flashing airport size red light warning us of just how little this administration knows in relation to addiction.

I referred to Conway as the de facto drug czar because, well,she is. She leads a White House group of politicos with no health or addiction bone fides that advises the President much in the way former heads of the Office of National Drug Control Policy(ONDCP). This is probably because we haven’t had an acting head of the ONDCP, a/k/a Drug Czar, since January 2017. The current seat warmer is Jim Carroll – the third of this administration’s – who at this time last year was Washington counsel for the Ford Motor Company. Carroll may be a terrific attorney, I don’t know, but he also has no health or addiction education or work history.

It is as if people with extensive addiction expertise critical to ending the opioid epidemic have become an endangered species in White House agencies and are being supplanted by blind loyalists to the administration.

In fact, many of the top level executives at the ONDCP with extensive health and addiction education and work history vital to effective drug policy have resigned or been replaced by this administration’s loyalist with backgrounds similar to Carr oll’s. I’m sure these new staffers are nice people, but they’re just in way over their heads.

At the risk of hearing the answer, I have to ask, “What kind of leadership and support can we in the addiction treatment field expect from the ONDCP in the coming months?” We need to know this because with these policies in place, most experts I’ve spoken to believe we will be seeing more addicts and overdose deaths.

There is far more to this story, but you are going to have to wait until the next issue of The Sober World Magazine.

John Giordano, Doctor of Humane Letters, MAC, CAP, is the founder of ‘Life Enhancement Aftercare Recovery Center,’ an Addiction Treatment Consultant, President and Founder of the National Institute for Holistic Addiction Studies, Chaplain of the North Miami Police Department and is the Second Vice President of the Greater North Miami Beach Chamber of Commerce. He is on the editorial board of the highly respected scientific Journal of Reward Deficiency Syndrome (JRDS) and has contributed to over 65 papers published in peer-reviewed scientific and medical journals. For the latest development in cutting-edge addiction treatment, check out his websites: