Addiction experts have mixed reactions to Trump’s opioid plan

President Trump speaking at Manchester Community College in Manchester , N.H.Keith Bedford/Globe staff

Addiction specialists in Massachusetts deplored President Trump’s call for incarceration and execution of certain drug dealers in his address in New Hampshire on Monday, saying that approach merely repeats the errors of the past.

But they praised the White House’s official policy statements and documents that emphasized the importance of expanding access to treatment, programs that divert addicts from jail into treatment, and limits on opioid prescribing.

“The policy position of the administration is a giant step forward. The rhetoric is the rhetoric,” said Arlington Police Chief Frederick Ryan, a leader in promoting the role of police in helping addicted people to treatment rather than jail. “Expanding access to evidence-based treatment is precisely what this crisis needs.”

Ryan said he doesn’t support mandatory sentences or the death penalty for drug dealers, but said those issues didn’t come up in a White House telephone briefing with advocates Sunday night.

“No matter who the president is, when the president says this is one of his top priorities, that brings focus and resources to this issue,” Ryan said.

But others asked whether those resources would materialize.

“What we still don’t have from the administration is a request for Congress to appropriate the funding we need to tackle this issue,” said Dr. Andrew Kolodny, co-director of opioid policy research at Brandeis University’s Heller School for Social Policy and Management. What’s needed, Kolodny said, is a multi-billion-dollar, multi-year commitment to make it easier for addicted people to get into treatment than to get heroin or pain pills.

Massachusetts Attorney General Maura Healey said in a statement, “We have spent years combating this devastating public health crisis with every tool in our arsenal, and I welcome the Trump administration to this fight. .... What our cities and towns need – desperately and immediately – is more federal funding. Unfortunately, we didn’t hear enough about that from the president.”

Governor Charlie Baker, speaking with reporters Monday afternoon, seemed to support the get-tough approach to drug traffickers, saying he filed legislation allowing district attorneys to charge “major traffickers” with manslaughter.

“I certainly think there’s plenty of evidence that a lot of the folks who traffic in these drugs know that they are extremely dangerous and in many cases deadly,” Baker said. “I think we should try to attack that with the full force of the law.”

But Baker demurred on the question of the death penalty, saying he needed more details.

Senator Edward J. Markey sharply criticized the president’s approach in a statement.

“We will not incarcerate or execute our way out of the opioid epidemic,” Markey said. “We are still paying the price for one failed War on Drugs, and now President Trump has drawn up battle plans for another.”

Michael Botticelli, executive director of the Grayken Center for Addiction at Boston Medical Center, noted that there is not a “clear line” between drug users and drug dealers. “There are many people who are dealing drugs in small quantities largely to support their own addiction,” he said, and they will not benefit from jail time.

“The United States has already been down this path of hard criminal penalties and mandatory minimum sentences. This moves us back and ever further away from focusing on this issue as a public health issue,” said Botticelli, who was director of national drug control policy under President Obama.

Although he has frequently criticized the Trump administration’s approach to drug policy, Botticelli praised the president’s proposals to reduce overprescribing of pain medications and to reduce the supply of fentanyl coming into the country.

Mark Libon, vice president of behavioral health services for Dimock, a Boston community health center, was also of two minds about the president’s proposals.

“I felt optimistic in reading his plan to increase education and awareness and expand access, and was very disheartened to and shocked by his including mention of the death penalty,” Libon said.

Dr. Michael F. Bierer, president of the Massachusetts Society of Addiction Medicine, said that history has already shown that reducing the demand for drugs is more effective than trying to cut the supply.