Trump's Drug Czar Is Protecting Big Pharma's Opioid Epidemic

Tom Marino wants to jail pot smokers, yet has a soft spot for the nation's biggest drug pushers.

A cascade of pills.
Photo Credit: Pixabay

Update: Tom Marino has since withdrawn from consideration for drug czar following the Washington Post/60 Minutes report. 

President Trump's nominee to head the White House Office of National Drug Control Policy (ONDCP, the drug czar's office) appears more concerned with helping Big Pharma sell tons of opioid pain pills than helping the DEA battle the crisis that saw more than 60,000 Americans die of drug overdoses last year.

That's according to a major investigative report from the Washington Post and CBS News' 60 Minutes Sunday. The report identified Trump's pick, Pennsylvania Republican Rep. Tom Marino, as the primary architect of a bill passed last year that made it harder for DEA agents to go after opioid pain pill manufacturers who in recent years have dumped unprecedented amounts of the addictive drugs on the market.

The bill, the Ensuring Patient Access and Effective Drug Enforcement Act, made it more difficult for the DEA to immediately stop shipments of opioids to or from companies suspected of dealing excessive amounts of the powerful pain-relieving medications. Marino championed it at the behest of a pharmaceutical industry-funded group, the Healthcare Distribution Management Association, which argued that the DEA was too heavy-handed in going after pharmacy and drug companies over what it described as minor paperwork errors.

According to the report, companies including CVS, Rite Aid and McKesson spent more than $100 million pushing the bill. It passed a complacent and compliant Congress last year only after Marino spent years trying to get it through.

"The drug industry, the manufacturers, wholesalers, distributors and chain drugstores, have an influence over Congress that has never been seen before," former DEA official Joseph Rannazzisi told the Washington Post. "I mean, to get Congress to pass a bill to protect their interests in the height of an opioid epidemic just shows me how much influence they have."

Marino and the industry portrayed the bill as a means of protecting legitimate patient access to the drugs—what happens to chronic pain patients in the midst of a crackdown on opioid prescribing is a real issue—but DEA chief administrative law judge John Mulrooney disagreed.

"At a time when, by all accounts, opioid abuse, addiction and deaths were increasing markedly" the new law "imposed a dramatic diminution of the agency’s authority," he wrote in a draft article the Marquette Law Review editorial board provided to the Washington Post.

Marino, who Trump nominated last month for the drug czar post, is on record supporting the increased criminalization of drug use, which would run counter to efforts to treat it as a public health issue, as well as opposing both medical marijuana and marijuana legalization. But he's got a soft spot for the nation's biggest drug pushers—and that could jeopardize his nomination.

"This is a very serious question," said Senate Minority Leader Charles Schumer (D-NY)). "I’m going to meet with Mr. Marino. And I hope to ask him about this because it’s very troubling," he told the New York Daily News.

West Virginia Sen. Joe Manchin (D), whose state has been the epicenter of the opioid crisis, said Monday he didn't need to meet with Marino. Instead, Manchin called on the White House to pull Marino's nomination. He was "horrified" by the report, he told the Washington Post, adding that "there's no way that in having the title of drug czar you'll be taken seriously or effectively by anyone in West Virginia and the communities that have been affected by this knowing that you were involved in something that had this type of effect."

On Monday, Trump acknowledged the report in response to questions from reporters. "He was a very early supporter of mine from the great state of Pennsylvania. He’s a great guy, I did see the report, we're going to look into the report," he said when asked whether he still supports Marino as drug czar.

If Trump doesn't withdraw the nomination, Marino is guaranteed to face a rocky confirmation fight in the Senate—a man who wants to jail pot smokers, but paves the way for Big Pharma to earn billions from addictive prescription drugs deserves some tough scrutiny on the Hill. 

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Phillip Smith has been a drug policy journalist for the past two decades. Smith is currently a senior writing fellow at the Independent Media Institute