Donald Trump’s inviting Rodrigo Duterte to the White House adds to the growing list of victimized, marginalized groups endangered by the incoming administration. Amongst the many targets of his bigoted, xenophobic, racist, ableist, and misogynist assaults, drug addicts, too, may now find a place.
The President-elect’s alleged endorsement of the brutal anti-drug campaign in the Philippines is dangerous and unacceptable. Since June, Duterte, the democratically elected President of the small island nation, has likened himself to Hitler, and by targeting a specific group of individuals and calling for their murder — veiled under the guise of cleaning the streets of violent dealers involved in the drug trade — the shoe seems to fit. There are vigilantes that are acting as de facto gestapo where the government’s military cannot, with what the media are labeling “extra judicial killings.” Thousands of people with substance use disorders have been killed, and many more have been imprisoned and have had their families’ lives threatened.
What is happening in the Philippines is state-sponsored genocide, and is a consequence of the prevailing legacy from an outdated and archaic view: the Moral Theory of Addiction. This theory, common in the 18th and 19th centuries, holds that addiction is a function of weak character and lack of will power, and is the result of poor personal choices around drug use. This line of belief regards the person who cannot, for instance, control their alcohol use, as flawed and corrupt, with a deficient capacity to approach life without the desire to escape pain, seek pleasure through instant gratification, and compensate for feelings inadequacy.
As with most of the verbiage from Mr. Trump, only time will tell what, if any, correlation his volatile, unpredictable public persona may have to an actual policy agenda. But with his presidency masquerading under Republican control of the White House, legislation has the potential of sailing through the Republican controlled Congress. Given the intersection of drug control and enforcement, public health and policy, and healthcare access that sits at the nexus of substance-related issues, including addiction, there is indeed a lot at stake.
So, what are the policy signals made evident by Mr. Trump’s rhetoric? STAT News published a series of articles reporting on the Trump campaign’s take on what to do in response to the ongoing so-called “opiate epidemic.” Of course, as with everything else that would follow the genesis of his meteoric rise in political relevance and voter support, the answer was the wall. In a town hall meeting in Ohio back in August, he said plainly, “cut off the source [of drugs], build a wall. If I win, I’m going to stop it.” Right, the wall. The symbol of Trump’s demonization of the other. Illegal immigration from Mexico is not just a bane on the economy, the cause of the increase in crime, and the favorite scapegoat for the “working class Americans,” but is now also the reason for the rise in addiction. As if the decades long, trillions of dollars, losing campaign known as the war on drugs weren’t obviously racist enough.
Trump’s attempt to elaborate on his position following the election, also known as a complete reversal of his original base-pandering, promised to increase access to naloxone, the life-saving opiate overdose reversal drug, encourage in-patient treatment (i.e. rehab), and call for governmental mandate for addiction treatment. Which is basically a stick-to-the-script attempt at covering up what Trump actually believes to be the “right approach” to addiction, the ongoing murderous cleansing of society happening in the Philippines. And now that he’s at the helm of the most powerful political post in the world, many advocates of recovery and addiction treatment, like almost everyone else, are wary of what will take shape after January.
I am a staunch supporter of treating substance use disorders through embracing a harm reduction approach, which prioritizes reducing fatal overdose and disease transmission, instead of requiring abstinence. I don’t need to “wait and see” what policies Trump actually puts forth, since his lauding of what is arguably the most abhorrent and draconian drug control campaigns in the world is further enflamed by a call for our government to mandate or coerce abstinence-only treatment.
As a graduate student in clinical psychology, with a concentration in mental health and substance abuse counseling, I am dedicating my career to understanding how to better treat people with substance use disorders. I am deeply hurt by our President-elect’s alleged endorsement of this campaign, but it bothers me that somehow it has taken until this point for me to have the visceral reaction that just about every other marginalized group has experienced in the past eighteen months. What I have observed others experiencing but not quite felt myself, suddenly and precisely played out in my own experience from these current events. Since there are many others in majority demographic groups that have yet to react this way, I’ll end my post with this famous poem many are likely familiar with, which is engraved on a stone at the New England Holocaust Memorial in Boston, a place I called home for many years:
“They came first for the Communists, and I didn’t speak up because I wasn’t a Communist.
Then they came for the Jews, and I didn’t speak up because I wasn’t a Jew.
Then they came for the trade unionists, and I didn’t speak up because I wasn’t a trade unionist.
Then they came for the Catholics, and I didn’t speak up because I was Protestant.
Then they came for me, and by that time no one was left to speak up.”