Trump’s Opioid Commission Doesn’t Address the Main Causes of Addiction

Worse, Trump’s broader domestic policy agenda could actually worsen the opioid crisis.

By Katherine Gallagher Robbins and Eliza Schultz

On March 29, President Donald Trump announced a new commission to tackle opioid addiction. The stakes could not be higher — public health officials have deemed the opioid crisis the “worst drug crisis” in U.S. history. In 2015 alone, opioid overdoses claimed the lives of an estimated 33,000 Americans.

But considered in the context of his broader domestic policy agenda, President Trump’s commission provides cold comfort for the families and communities that have been ravaged by the opioid crisis.

That’s in part because the commission’s work will begin at a time when health insurance programs like the Affordable Care Act and Medicaid — both of which ensure that millions of Americans have access to essential substance abuse treatment services — are under attack. In addition, the commission doesn’t aim to address key risk factors for opioid addiction: childhood trauma, mental illness, and unemployment. Even worse, other aspects of Trump’s agenda may worsen exposure to these risk factors.

Childhood trauma

The opioid crisis has put significant strain on state foster care systems, which were underfunded even before the epidemic. Many states are unable to cope with the numerous instances of child abuse and neglect that arise from opioid use and addiction. One Ohio county, for example, has seen a 20 percent surge in the number of children who have been removed from their parents’ custody this year, largely due to the region’s opioid epidemic. Now, the county has resorted to putting up billboards and distributing fliers in an effort to recruit more foster parents.

These instances of childhood trauma — exacerbated by states’ inability to cope with the increase of children in the foster care system — perpetuate a cycle of substance abuse, as childhood trauma is correlated with opioid addiction later in life.

In addition to fully funding the foster care system, fighting the opioid epidemic requires reducing childhood trauma across various contexts. Unfortunately, under President Trump’s recent budget proposal, instances of trauma are poised to increase. Trump’s budget eliminates the Legal Services Corporation, which will keep victims of domestic violence within reach of their abusers and expose them to further incidents of it. It also cuts funding for the Department of Justice, which houses essential programs aimed at helping victims of childhood sexual assault.

Mental illness

People with mental illness are substantially more likely to misuse opioids compared to those who do not experience mental illness. Some researchers estimate that close to half of people suffering from opioid addiction have either a mental illness or a personality disorder.

This correlation suggests that efforts to fight the opioid epidemic should be directed towards individuals with mental illness in particular. But many of President Trump’s policy proposals inflict disproportionate harm on people with mental illness, reducing their access to health care. Not only is President Trump advocating for severe cuts to Medicaid and attempting to dismantle the Affordable Care Act — actions that would cost millions of Americans their health insurance and access to substance abuse treatment and mental health care — he has also proposed $100 million in cuts to the Mental Health Block Grant. To add insult to injury, Trump will reportedly use such cuts to help fund his Mexican border wall and ramp-up in military spending.


Individuals often turn to opioids to numb not only physical pain, but also economic woes. Economic anxiety — and unemployment in particular — have been linked to opioid usage. Research has shown that reduced upward mobility and material hardship are also related to the rise in nonmedical prescription opioid misuse.

Despite his campaign promises to relieve economic anxiety, President Trump is poised to do far more harm than good in this area. As outlined in his recent budget, Trump’s plan to eliminate the Manufacturing Extension Partnership is estimated to result in 41,000 fewer jobs across the country — including many jobs in some of the states hardest hit by the opioid crisis, such as Ohio, Pennsylvania, and Michigan. Also on the chopping block are the Community Development Block Grant, the Appalachian Regional Commission, and the Delta Regional Commission, which support economic development in the country’s rural regions — again, areas that have been hit hard by the opioid crisis. What’s more, President Trump’s relentless attempts to deport immigrants would cost the national economy trillions. Should his healthcare proposal come to fruition, it would also be a job killer.


It’s within President Trump’s power to slow the opioid crisis. But doing so would require him to abandon his reckless policy agenda, and instead work to mitigate childhood trauma, mental illness, and unemployment. Until then, his commission — which does little to get at the root causes of the opioid crisis — pays only lip service to a crisis that continues to ravage the country.

Katherine Gallagher Robbins (@kfgrobbins) is the Director of Family Policy at the Center for American Progress (CAP). Eliza Schultz is the Research Assistant for the Poverty to Prosperity Program at CAP.

American Progress (CAP)

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