New report details the scale of the U.S. opioid crisis and its link to drug trafficking

The opioid overdose crisis that killed more than 100,000 Americans in a year is being called one of the most pressing national security and public health challenges facing the U.S. A majority of the overdoses are driven by the potent synthetic opioid fentanyl. Maryland Rep. David Trone, co-chair of the federal Commission on Combating Synthetic Opioid Trafficking, joins William Brangham to discuss.

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  • Judy Woodruff:

    The opioid overdose crisis killed more than 100,000 Americans for the most recent year on record, the most ever.

    It's being called one of the most pressing national security and public health challenges facing the U.S. And these overdoses are costing the nation an estimated $1 trillion a year.

    William Brangham talks with one of the chairs of the national commission that's looking for solutions.

  • William Brangham:

    Judy, a majority of those overdoses are being driven by the highly potent synthetic opioid fentanyl. Manufactured abroad and trafficked into the U.S., it is then sold by itself or mixed into various street drugs or counterfeit pharmaceuticals, where its potency often turns deadly.

    Overdoses now kill more people than car crashes, firearms, suicide, or homicide.

    So, how do we address this?

    Representative David Trone, Democrat from Maryland, is co-chair of the National Commission on Combating Synthetic Opioid Trafficking.

    Congressman Trone, great to have you on the "NewsHour."

    Your report lays out ways to address the supply of these drugs and the demand for these drugs. I want to talk about the supply issue first. As your report points out, Mexican cartels are largely manufacturing this fentanyl and shipping it into the U.S., but they are relying on a steady stream of precursor chemicals to make those drugs from China.

    What do you think we ought to be doing vis-a-vis China to try to stop that flow?

  • Rep David Trone (D-MD):

    Well, we certainly can disrupt the flow, and we need to get China to enforce Know Your Customer laws.

    They have a huge petrochemical industry. They got a handful of middlemen that are buying these drugs and then shipping them to the two major cartels in Mexico. So, we can put pressure on China to know where this product is going.

    But, unfortunately, these precursors and pre-precursors can be readily found elsewhere once we do slow down from China. It's kind of Whac-A-Mole. If we stop it there, it could easily move to India, which has a major chemical industry also, or elsewhere.

    So, we end up back in Mexico, who has vertically integrated this whole business, the cartels.

  • William Brangham:

    As you mentioned, the cartels in Mexico have enormous political power. They are an incredibly intimidating force in Mexican society.

    Do you think the Mexican government itself is doing enough to address this?

  • Rep David Trone:

    Well, the Mexican government has had a very difficult time with corruption.

    It's a major issue. It's a $100 billion business, the drug business there. It's — over a third of the Mexican gross domestic product is controlled by the cartels. So, Mexico, unfortunately, has adopted, for survival of the individuals, a hugs, not bullets approach.

    They are not going after the cartels because they don't want a civil war. The cartels are armed to the teeth. And there were 36,000 murders last year, in Mexico. Less than 1 percent were solved.

  • William Brangham:

    Let's turn to the demand side, which your report addresses very specifically, that there — these drugs are coming because there is some appetite for them here in the United States.

    And your report talks about the need to beef up and to ramp up proven medically assisted treatment for people suffering from addiction. But we have been making this argument as a society for years. I wonder why you think it is — we have been so slow to ramp up that treatment that we know can work.

  • Rep David Trone:

    Yes, a lot of folks are concerned about giving a drug to stop the craving for another drug.

    But MAT, medically assisted treatment, it works. We have to empower more doctors and even nurses to sort of prescribe these MAT drugs. They can be a big win. And now, as COVID begins to recede, we have got to turn our attention to this, or it'll be another million deaths by 2029, according to latest poll — latest research effort from Stanford.

    That's kind of scary.

  • William Brangham:

    Like many of us, I know that this issue is deeply personal for you. Your nephew Ian struggled for many years with addiction and eventually died of an overdose.

    And, as you have commented publicly, this touches so many people in this country, Republicans, Democrats and everybody else. Do you think that the bipartisan nature of addiction will help us finally start to address this for real?

  • Rep David Trone:

    I think you have hit the nail on the head.

    I come out of the business world. In the business world, we never ask Republican, Democrat independent. Who cares? It's how we get the job done, how we have a laser focus on the mission. And this commission was formed to be bipartisan. We had Senator Tom Cotton, a conservative Republican, and myself, a progressive Democrat. And we have been clear-eyed and great partners.

    And Senator Cotton has been there every step of the way, 76 recommendations on supply, but mostly demand, because I don't think we can stop the supply. That's what we came to. It's demand. And we have been right there with the senator.

    And now we have got to give this report life, not let it sit on the shelf, take it out and move actions through Congress, and also executive actions.

  • William Brangham:

    I don't mean to sound pessimistic about this, but these kinds of ideas have been circulating for a very long time.

    And one of the recommendations you make is to elevate the drug czar to a Cabinet-level position to give that position more muscle. Why do you think it has taken us so long and so slowly to get really starting to address this issue?

  • Rep David Trone:

    I think you hit the nail on the head.

    We just can't seem to get the consistent focus to keep our eye on the prize, as John Lewis talked about. And it was a Cabinet-level position until 2008; '93 to '08, it was in the Cabinet; '09, President Obama took it out. I don't understand why.

    And, since then, it's been an L-shaped increase on deaths across our country. So, it's shouting. And Senator Biden, when he was in the Senate, was on record supporting it to be a Cabinet-level position. And that's an important recommendation to organize all-of-government response. And that's what our commission was, an all-of-government response, executive, outside experts, Republican, Democrat.

    And you know what? We're better than what we have shown so far. We cannot just let this continue and continue, have another million deaths by 2029. That's not who we are. And we owe it to each other to really step up, and take action, and put the talk to the side and work as a team, as a country.

  • William Brangham:

    All right, Representative David Trone of Maryland, thank you very much for being here.

  • Rep David Trone:

    Thank you very much. Appreciate it.

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