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US president Donald Trump has said that his Department of Justice intends to seek the death penalty against drug traffickers ‘where appropriate under current law’. The announcement was one of a range of measures set out as part of his latest initiative to attempt to tackle the country’s ever-worsening opioid crisis. The initiative would address the factors fuelling the crisis, he said, including ‘insufficient access to evidence-based treatment’ as well as both the supply of illicit drugs and over-prescription by medical professionals. The number of opioid overdoses in the US has quadrupled since 1999, as has the level of opioid prescribing (DDN, September 2017, page 5). Trump pledged to launch a ‘nationwide evidence-based campaign’ to raise public awareness of the dangers of prescription and illicit opioid use, and to implement a ‘safer prescribing plan’ to cut opioid prescriptions by a third within three years. He would also ‘crack down on international and domestic drug supply chains devastating American communities’, he said. Alongside the possible death penalty for drug dealers this would include further securing ports and land borders, shutting down illicit online opioid sales and strengthening penalties for selling fentanyl and other substances that are ‘lethal in trace amounts’. The initiative would also work to ensure that ‘first responders are supplied with naloxone’, however, and increase access to evidence-based treatment ‘as an alternative to, or in conjunction with, incarceration’ for people in the criminal justice system. ‘We will work to strengthen vulnerable families and communities, and we will help to build and grow a stronger, healthier, and drug-free society,’ he said. Maria McFarland Sánchez-Moreno: Trump's administration should stop its obsession with killing The US-based Drug Policy Alliance said that while measures such as improving treatment provision and rolling out naloxone would be helpful if there was a focus on putting the latter ‘in the hands of individuals and community groups’, the president had ‘done little to offer a public health response’ to the situation. ‘Rather than helping people at risk of overdose and their families, Trump is cynically using the overdose crisis to appeal to the worst instincts of his base, and pushing for measures that will only make the crisis worse,’ said executive director Maria McFarland Sánchez-Moreno. ‘If this administration wants to save lives, it needs to drop its obsession with killing and locking people up, and instead focus resources on what works: harm reduction strategies and access to evidence-based treatment and prevention.’ Meanwhile, visits to US emergency departments for suspected opioid overdoses increased by 30 per cent in the year to September 2017, according to the Centers for Disease Control and Prevention (CDC). The Midwest saw the largest increases, with Wisconsin recording a 109 per cent rise. ‘Long before we receive data from death certificates, emergency department data can point to alarming increases in opioid overdoses,’ said CDC acting director Anne Schuchat. ‘This fast-moving epidemic affects both men and women, and people of every age. It does not respect state or county lines and is still increasing in every region in the United States.’ Opioid initiative briefing at www.whitehouse.gov Vital signs: opioid overdoses treated in emergency departments at www.cdc.gov

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Trump calls for death penalty for drug dealers