InsideSources

There’s a new presidential opioid commission in town, but drug policy experts remain skeptical about its mission and effectiveness. It also appears that New Hampshire does not have a seat at the table, for now at least.

The President’s Commission on Combating Drug Addiction and the Opioid Crisis was announced Wednesday when President Donald Trump signed the executive order laying out its blueprint. It will be chaired by New Jersey Gov. Chris Christie, who has made the opioid crisis a priority as governor, and will study appropriate steps for lawmakers and federal officials to take to combat the epidemic.

“This is an epidemic that knows no boundaries and shows no mercy, and we will show great compassion and resolve as we work together on this important issue,” Trump said.

The panel’s mission would be to identify federal funding streams that could be directed to address the crisis, determine the best practices for prevention and recovery, evaluate federal programs and the U.S. health system to identify regulatory barriers or ineffective initiatives like prescribing practices, and consider changes to the criminal justice system.

More than 52,000 Americans died from a drug overdose in 2015 — up from 47,000 in the previous year — according to the U.S. Centers for Disease Control, and nearly two-thirds of those deaths involved an opioid.

The commission would make interim recommendations within 90 days of its establishment along with a final report in October. The agencies involved would be expected to take actions implementing those policies.

The commission would be composed of Attorney General Jeff Sessions, Health and Human Services (HHS) Secretary Tom Price, Veterans Affairs Secretary David Shulkin, and Defense Secretary James Mattis. Another five members from state governments, law enforcement, and other groups would finish it. Massachusetts Republican Gov. Charlie Baker and North Carolina Democratic Gov. Roy Cooper are reportedly set to sit on the panel.

When the commission was announced, a spokesman for New Hampshire Republican Gov. Chris Sununu told NH1 News that he “doesn’t have a formal role with the commission.”

If that stands, it would be an interesting position from the White House. The Granite State has the second-highest overdose deaths in the country. While Massachusetts has also been devastated by the opioid crisis, Baker did not support Trump in the 2016 presidential election and Governor John Sununu never once wavered from his support for Trump.

There was also no one from New Hampshire taking part in the listening session at the White House when they announced the commission. None of New Hampshire’s Democratic congressional delegation took part in the session.

That’s worth noting because Trump and Christie as presidential candidates often discussed the opioid crisis during their campaign visits in New Hampshire.

“A wall will not only keep out dangerous cartels and criminals, but it will also keep out the drugs and heroin poisoning our youth,” Trump said in a stop in the Granite State in October.

However, drug policy experts are concerned that Trump is focusing on just the criminal justice side of the crisis, and not enough on treatment and prevention.

“We don’t yet fully know what the Trump policy towards the opioid crisis will be,” said Leo Beletsky,a law professor at Northeastern University who specializes in health and drug policy, in an interview with NH Journal.

“During the campaign, he made statements supporting treatment access and focusing on interdiction at the US-Mexico border,” he added. ‘Since the election, we have heard much about the ‘Wall,’ other interdiction efforts, and criminal justice tools to combat the crisis, but not so much about the treatment issue.”

Other advocates are frustrated with actions the Trump administration has already taken that could actually worsen the crisis.

The Office for National Drug Control Policy (ONDCP) would support the commission, and the office’s director — known as the “drug czar” — would represent the president. Yet, the ONDCP post is still unfilled, despite reports that former U.S. Rep. Frank Guinta of New Hampshire was being considered for the job.

A new spending plan reported last week would cut the Substance Abuse and Mental Health Services Administration’s mental health block grant by $100 million in 2017. Trump’s proposed 2018 budget for HHS would cut the agency’s funding by nearly 20 percent.

Beletsky was also concerned about Sessions being involved in the commission due his skepticism about treatment and favoring a punishment system to handle the opioid crisis.

“Further, Jeff Sessions is a long-time adherent to the idea that we can arrest and punish our way out of substance misuse in this country — an idea that has been a demonstrable failure and one that has frankly brought us to where we are today,” he said.

Several experts also question the value of the commission and how its efforts could be duplicative of actions and groups already in existence.

In November, Surgeon General Vivek Murthy released the office’s first-ever report on opioids and addiction, which included tools and recommendations to combat substance abuse.

There’s also the Bipartisan Task Force for Combating the Heroin Epidemic, which was created in 2015 by Guinta and New Hampshire’s other delegate, Democrat U.S. Rep. Annie Kuster. It’s mission has transformed as the crisis evolved from just heroin to include opioids and fentanyl, but it remains a legislative approach to handling the epidemic.

“The Presidential Commission…appears to be weighed heavily towards a more partisan and more criminal justice-focused approach, in a tone set by the AG,” Beletsky said. “As far as I know, there is not one public health expert on the Commission, which is as clear signal as any that Obama Administration’s mantras of ‘public health approach’ and ‘we can’t arrest our way out of this problem’ will not find much support in this group.”

Kuster appeared supportive of Trump’s efforts to tackle the opioid crisis and create a presidential commission, but cautioned against repealing parts of the Affordable Care Act that provide support for individuals seeking substance abuse treatment.

“We also know that there is not enough capacity for those seeking treatment, and I was pleased to see that part of the Commission’s mission will be to assess the availability of substance use treatment and recovery services,” she said in a statement. “I look forward to working with the Commission and discussing how the Bipartisan Heroin Task Force can be a productive partner in the House of Representatives to advance policies to address the opioid addiction crisis.”

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It’s no secret that there is a feud growing between President Donald Trump and the political reporters who cover him, but there’s also a number of citizens who completely distrust the media too. A recent study concludes that political journalists and Americans have opposing views of democracy, which might contribute to a “disconnect” between Americans and the media.

Tim Vos, an associate professor of journalism studies at the University of Missouri, and former doctoral student David Wolfgang, conducted in-depth interviews with political journalists across the country. The study identified a lack of diversity among journalists’ sources as a potential cause for the disconnect between the media and the public.

One of the basic standards of good journalism is gathering diverse viewpoints and covering all sides of an issue, which the political reporters interviewed for the study agreed was important to them. Yet, Vos found that a lack of newsroom resources, quick deadlines, and a lack of time to reflect on articles often prevents reporters from covering issues as fully as they’d like.

This conclusion isn’t necessarily new. It’s been well-documented that due to budget cuts, staff layoffs, the rise of social media, and a constantly changing media landscape, journalists are under a lot of pressure to post a story first, get the exclusive interview with a high-profile public figure, and generate traffic for their media outlet.

“But the changing nature of online publishing has forced some political journalists to adapt by publishing stories with fewer than the ideal number of diverse sources,” the study found. “One newspaper reporter admits he will publish stories online with just one source or viewpoint and then update the story later, once he receives information from other sources.”

With reporters focusing on efficiency rather than a diversity of views, they end up only reaching out to the decision makers who have the ability to enact political change. This is where Vos found an interesting theme emerge in his data. By focusing on the “elite” sources, he saw that political journalists had a different view on democracy, which could also add to the disconnect between the media and the public.

“Ultimately, political viewpoint diversity is constructed through the journalists’ assumptions about democracy,” according to the study. “When the political reporters talk about their jobs, they invoke assumptions about the role of journalism in democracy and about the nature of democracy. All the journalists interviewed talk, in some version or another, about providing audiences with news that will keep them informed about policies and politicians. But, this relationship between journalism and democracy is anchored in competing versions of democracy.”

Most reporters Vos interviewed had an “elitist” view of democracy, meaning American citizens should elect political candidates during elections and then allow those politicians to perform their jobs with little input from the public. Their role in the process is to update the public on the actions of the elected officials, so the public can be well-informed during the next election cycle, according to the study.

“By and large, the political reporters really defined a form of democracy that aligns with how political reporters operate,” Vos told InsideSources. “You are trying to interview sources who are close to the decision-making process and have a say on public policy. It’s focused on that small subset of political actors and their ideas.”

This philosophy, also known as “administrative democracy,” is at odds with the more populist view of democracy that many Americans hold, which states that the public should have influence over elected officials’ decisions on a more regular basis.

“Political reporters see their role as to monitor those who have power and monitor if they are competent or incompetent, or corrupt or not corrupt,” Vos said. “If [journalists] expose a corruptive act, then that’s where the public is supposed to react and vote them out of office.”

He said he found these competing views of democracy often in the 2016 presidential election, especially with the Access Hollywood tapes released in October, which revealed Trump making lewd remarks about women with Billy Bush.

“When reporters descended on the Billy Bush tapes or other controversies related to Trump, they thought they found this disqualifying fact, that Trump is not qualified for office, and then they expected the public to vote accordingly,” he said. “That’s an idealized version of how the public, press, and democracy didn’t work together. Trump certainly proved that it wasn’t that simple. That still explains the press’s confusion of what happened. They thought they were doing their job and something would come of it, but it didn’t.”

For several members of the media, after Trump’s victory in November, they admitted that they dropped the ball on seeing and covering the rise of Trump and Democratic presidential candidate Bernie Sanders. The two “outside” candidates were talking about issues that resonated with people outside the Beltway and some reporters said they didn’t do their due diligence when it came to listening to the people of Middle America.

New York Times columnist David Brooks said he had to do better to understand the American psyche.

“For me, it’s a lesson that I have to change the way I do my job if I’m going to report accurately on this country,” he wrote.

Even though reporters said they needed to change their approach to their job, it can be argued that it’s back to business as usual, at least according to Vos’s research, where the media stopped listening to the public and focused solely on the elites in Washington.

Take the controversy with Attorney General Jeff Sessions, which is currently playing out in the media. He has been accused that he misled Congress by failing to disclose pre-election meetings with Russia’s ambassador to the United States.

“The coverage so far has been insider perspective, with reporters focusing on what is the political norm or if some sort of legal barrier has been broken or crossed,” Vos said. “They’ll stay with the story until there’s a resolution, but there hasn’t really been any explanation of what this is all about. What’s really at stake here, why would this be disqualifying information. That part requires much more engagement with the public, with their understanding of what’s at stake here, and if they care about it.”

A recent Emerson College poll found that the Trump administration is more trusted than the news media among voters. The administration is considered truthful by 49 percent of registered voters and untruthful by 48 percent, but the news media is untruthful by 53 percent and only 39 percent find it honest.

There are many factors that could have led to those results, including incorrectly predicting the presidential election, bias in reporting, and the rise of “fake news,” but Vos suggests there are ways political reporters can reverse the trend.

“Whenever [reporters] can get outside the bubble of those who are already in decision making positions, I think it’s a good idea to do so and to listen for ideas that aren’t being pushed by the major political parties,” he said. “[Ideas] might not be from a well-known national figure, but sometimes interesting perspectives and important facts come from unsuspecting places. If journalists are simply focused on the elite forces, they are going to hear the same thing over and over again, and it might not be what the public cares about.”

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