Here's the Deal, page 35
But could the federal government really dispense love and compassion? I had to think about that. Could the Golden Rule apply to our work in the White House? Or was I just being naïve? We’d just have to find out.
The commission held public hearings that brought together stakeholders from across the country. In my many conversations with people much more expert in this than me, I quickly identified three areas to focus on: Prevention and education. Treatment and recovery. Law enforcement and interdiction.
I specifically avoided making this the Kellyanne Show. But with the steady leadership of my chief of staff, Renee Hudson, we shepherded this whole-of-government approach. I convened an Opioids Cabinet, which met weekly and included people from fifteen different departments and agencies. These experts were grateful to finally have their voice be heard directly in the White House.
Our travels around the country brought the drug crisis into sharp relief and took me to at least a dozen states with the president, the First Lady, cabinet secretaries, and the nation’s leading experts. We demonstrated both urgency and agency as we went from state to state, from big cities to small towns, from factory floors to hospitals, receiving input and delivering resources. On one trip to Cleveland with Governor Christie and former congressman Patrick Kennedy, who spoke openly about his own recovery, we visited veterans and were blown away by the new nondrug treatments for non-combat-related pain. Take a pill wasn’t the only way anymore. The veterans I met that day were proud to demonstrate the alternative therapies that had reduced substance abuse and suicides.
In Maine, New Hampshire, Michigan, and Pennsylvania, we witnessed the conversion of fire departments into “safe havens.” We talked to coroners overwhelmed by opioid deaths. We met with men and women who had worked in faith-based charities, the health system, and the public sector, helping drug addicts and their families. I also got to speak with many people in recovery. A single mom of two named Liza shared her story of survival and then hugged me. The photo of us embracing was carried by local newspapers the next day and is still etched in my mind. It was devastating to learn shortly after our visit that she’d been killed in a freak car accident. But her young children were strapped and safe in their car seats. I called Paul LePage, the governor of Maine.
“We’re going to do this for Liza,” I vowed. “And I want her children to know one day what motivated us. She overcame so much only to leave the world that way. They need to know their mom loved them enough to work hard at getting better.”
I met Barbara Goldner, a nurse and social worker, whose husband, Brian, was the CEO of Hasbro Toys. They had lost their twenty-three-year-old son to a heroin addiction. He’d kept it hidden from his parents, as did the authorities. In the two months preceding his accidental overdose, Brandon had been revived seven times. I listened carefully, remembering my own friend’s sibling, with a heart full of questions. Why is survival a crapshoot for so many? This one dies. This one lives. Addiction is a disease. We know that. Why can’t we save more of these suffering people? Three of Brandon’s ODs happened in a six-day period. Each time, he was discharged without substance-abuse or psychiatric screening, without any assessment of being a danger to himself or others, without referral to detox and recovery programs. Though he had provided his mother’s name and phone number as an emergency contact, Barbara Goldner never received a call about any of her son’s seven overdoses. The call she finally got was from a friend of Brandon’s, who was at his apartment with police and the coroner. In their grief and anger at a system that failed their son, the Goldners became activists, pushing for vital changes in law and hospital protocols.
If a fifty-year-old businessman suffers a heart attack, his family gets a phone call. Why shouldn’t the family of an inner-city young addict who overdoses? HIPAA privacy rules seemed to be counterproductive in cases like that. Soon the U.S. Department of Health and Human Services (HHS) issued a clarification that meant more families would be clued in before it was too late.
The opioids and poly-drug crisis was the most prominent public policy issue that Donald and Melania Trump worked on together. I’d go on to lend my staffer Catharine Cypher to help the First Lady build out her policy shop and solidify her “Be Best” initiative. In October 2017, the First Lady and I visited Lily’s Place in Huntington, West Virginia, which does incredible work for neonatal abstinence syndrome (NAS), babies born chemically dependent. Melania cradled and comforted the newborns, while holding forth on the importance of keeping moms out of jail and their babies in facilities like Lily’s Place. That same month, the Trump administration declared the drug crisis a public health emergency.
The evening before that announcement, the president and First Lady sat with senior staff in the Roosevelt Room as we previewed the run of show for the next day’s event. “I never touched a drug in my life… never!” Trump told us. “And no alcohol, either. No cigarettes. I never touch the stuff. I know myself, and I would want more. I lost my brother Fred, more handsome, smarter, supposed to take over the family business. Lost him to alcohol at forty-two.”
We’d heard this story before. But sitting in the relative quiet of this small room in the White House and knowing how we were taking on the nation’s opioid crisis, I think all of us were struck by how deeply, personally moving his words were.
* * *
WE ROUTINELY REACHED out to people whose stories both informed and inspired us and invited them to the White House, often to meet with the president. Ryan Holets, a police officer from Albuquerque, New Mexico, showed what miracles can happen when people step out of their comfort zones and learn to see addicts as human beings in pain rather than nameless statistics or just a public nuisance.
Holets, we learned, had been responding to a call on September 23, 2017, about someone trying to steal beer from a gas station convenience store. That’s where he spotted a couple sitting on a grassy slope out back. He could see a syringe and a spoon, too, which the pair tried to hide as he approached. The officer’s body camera captured what unfolded next:
“I’m not gonna lie to you, it looks like you guys are ready to shoot up,” Holets said. Then he noticed that the woman, thirty-five-year-old Crystal Champ, was pregnant.
“How far along are you?” he asked.
“Like, seven or eight months,” Crystal answered, clearly agitated.
“Oh, my gosh,” Holets said, his voice shifting from that of a cop about to arrest a couple of addicts to that of an alarmed father of four.
“Why are you doing that stuff?” he admonished. “You’re going to ruin your baby. You’re going to kill your baby!”
Crystal buried her head in her hands and sobbed. Holets had already decided against arresting the expectant parents, but he wasn’t ready to simply walk away.
“What do you think is going to happen when your child is born?” he asked.
Through her tears, Crystal said she wanted to put the baby up for adoption.
“Do you know who’s going to adopt your baby?” Holets asked.
“No. No, I’m so sorry,” Crystal cried.
Sitting with the president, the Albuquerque police officer picked up the story there. “Two worlds collided as I knelt down beside her, a police officer and a homeless drug addict brought together by forces outside of our control.”
Certain that his wife, Rebecca, would feel the same need to make a difference, the Holetses offered to adopt the baby. After going into labor five weeks early, Crystal gave birth. Ryan Holets was present in the delivery room. Sadly, the baby girl was born addicted to heroin and meth and was forced to endure two painful weeks of withdrawal. Ryan and Rebecca took turns at the hospital to comfort the underweight infant around the clock. This was their child now. But they still hadn’t decided what to call her.
“We have so much hope for you,” Ryan murmured to his daughter as he gently rocked her one night.
Hope Crystal Holets was named for the family who gave her a fighting chance, the mother who ultimately chose life, and the single word that was the common goal behind every piece of legislation passed, every cent of the $6 billion in new federal funding we secured to help Americans fight opioid abuse, and every effort across party lines to turn the tide on addiction.
Unknown to almost everyone, Holets’s name had been added to the secret guest list that had been assembled for the upcoming 2018 State of the Union address. He and his wife, Rebecca, along with their new baby daughter, would sit next to Melania Trump in the First Lady’s box. There weren’t many dry eyes when Trump asked the Holets family to stand, eliciting a rare, bipartisan standing ovation.
* * *
THIS NATIONAL CRISIS needed a national team effort.
We pulled in big names from the private sector, like Amazon, Google, Microsoft, Apple, Facebook, Leidos, Walmart, CVS, and Walgreens. Professional sports teams also joined in the effort. The Baltimore Ravens donated money toward drug packets for every tackle made and the Washington Wizards and Washington Capitals hosted an opioid awareness night. Opioids, all of them recognized, were a problem for their customers, their communities, and their employees. They all expressed a willingness to help generate creative ideas. Amazon programmed Alexa to answer questions about opioids and addiction. Emergent BioSolutions offered free NARCAN nasal spray (the drug that can reverse overdoses) to every public library and YMCA in the country. Walmart furnished a product that allows for safe drug disposal. Google invested heavily to expand the reach and success of “Take Back Day.” Governors looked for ways to get their state medical schools to change the curriculum on safely prescribing drugs. Many companies turned their efforts inward, creating better systems of communication and treatment options for their own employees and their employees’ families.
I liked what Belden Inc. did at its cable manufacturing plant in Richmond, Indiana, where business was booming and one-third of the workforce was expected to retire within five years. Now, when a qualified job applicant failed the pre-employment drug test, that person was sent for drug rehab on the company’s dime, instead of just being shown to the sidewalk. And a job would be waiting on the other end. One forklift operator told me he owed his life to the company. Another employee confided that he was almost relieved to have failed the drug screen because he never would have entered treatment otherwise. I started telling the Belden story to employers in other communities. Great ideas are meant to be shared and duplicated.
Our cause got a major boost when the Ad Council voted unanimously to work with us, donating a massive amount of advertising time. “It’s a big get,” I told the president, reminding him that the Council was behind major public service campaigns like Smokey the Bear, Friends Don’t Let Friends Drive Drunk, and A Mind Is a Terrible Thing to Waste. “We’re going to reach so many people!”
One especially effective ad, “Treatment Box: Rebekah’s Story,” featured an addict going through withdrawal and recovery. It was a six-minute film that played around the clock on specially built cubed screens in New York and other major cities. No matter the time of day, people were drawn to watch, standing in one spot, taking precious moments out of their busy day. That one won an Emmy. Other ads in The Truth About Opioids series told the real stories of Americans, many who were desperately dealing with addiction and an overwhelming need to get more pills at any cost. One young man smashed his hand with a hammer. Another sped her car into a wall.
Given all the attention and goodwill we had generated, this was an issue, I was convinced, where we might find bipartisan agreement, even in thoroughly divided Washington. I got busy assembling a legislative package we called the SUPPORT for Patients and Communities Act. SUPPORT stands for Substance Use-disorder Prevention that Promotes Opioid Recovery and Treatment.
I was on Capitol Hill quite a bit in the summer and fall of 2018. Normally when Congress begins adding bills together, you lose support. But incredibly, the opposite was true this time, in part because every member had seen the need back home. One day, as I was delivering a briefing in the Capitol for eighteen senators—more Democrats than Republicans—liberal Massachusetts senator Elizabeth Warren came barreling in, ready, I was sure, to challenge whatever I had to say. But she stopped when she noticed I was surrounded by doctors in lab coats and admirals in uniform. We had a civil conversation. I happily listened to her ideas and answered her questions. Then, seeing she was invested and noncombative, I asked Senator Warren if we could count on her help.
That legislative package passed nearly unanimously. The votes were 98–1 in the Senate, including yea votes from Michael Bennet, Corey Booker, Kirsten Gillibrand, Amy Klobuchar, Kamala Harris, Bernie Sanders, and Elizabeth Warren, all Democrats already angling to run against Trump in 2020—and every single Democrat in the House. The package included a combined fifty bills and yielded $6 billion in new money for state and federal addiction prevention and treatment programs, stopping doctors from overprescribing addictive narcotics and intercepting shipments of fentanyl and other deadly drugs at U.S. borders. It also provided for intensified federal research into new pain management therapies. These changes, I was convinced, would truly save lives. And we proved something a lot of people doubted: In a bitterly partisan era, we could all work together for the greater good of all Americans.
“Together we are going to end the scourge of drug addiction,” President Trump said in the bill-signing ceremony on October 24 at the White House. “Or at least make an extremely big dent in this terrible, terrible problem.”
Over the next few years, progress on the issue continued. We tried to make fentanyl a part of the everyday lexicon, since it was fast becoming a lethal killer. Enough illicit drugs to kill the entire U.S. population many times over were seized through the mail, at our ports, and at our southern border. We launched an enhanced narcotics operation led by the U.S. Southern Command. Just as important, we launched FindTreatment.gov, which had sat dormant for more than a decade. This interactive website provides an easier, customizable way for people seeking addiction treatment to find providers near them. After years of work, we made it possible for those seeking treatment to customize their search as you would with most web searches, including specific treatment, inpatient/outpatient, age, private or public insurance, veteran, LGBTQ. Months later, I suggested it would be applicable for finding testing during a global pandemic.
We began to see the first decline in overdose deaths in nearly thirty years.
Part VI
House Divided
Chapter 29
Poison Keyboard
As 2018 gave way to 2019 and the second half of Donald Trump’s presidency began, the nation was divided in many ways.
Nancy Pelosi was sworn in as Speaker, giving Democrats control of the House of Representatives, while Republicans maintained control of the Senate and the White House. The fruitless hunt to find conspiracy and election-shaping collusion between Russia and the 2016 Trump campaign, otherwise known as the Mueller investigation, seeped into its third calendar year. The federal government was shut down. The contentious debate over whether our southern border should be fortified was roiling Washington again and playing out in cities and towns across the nation. Brett Kavanaugh joined Neil Gorsuch as Trump-appointed associate justices of the U.S. Supreme Court, but the battle scars suffered by people on both sides of the divide during his confirmation hearings remained glaring. You could see it on people’s faces and smell it in the air. A fractured White House was welcoming its third chief of staff in two years. The Democrats were also divided as fresh(man) faces like Congresswoman Alexandria Ocasio-Cortez, an overnight sensation for upsetting a Democrat stalwart in a primary, tried to move the party to the far left, while a large, disparate group of Democrats made clear they were getting serious about running to replace Trump in the White House.
My house was also divided.
George ramped up his presence on Twitter and amped up his criticism of President Trump. A thirsty press corps and a rabid anti-Trump, never-Trump, oddly-obsessed-with-Trump contingent that seems to live on social media could not get enough. Regularly furnishing fresh though often redundant content, and most days well surpassing the number of tweets and retweets sent by the tweeter in chief himself, George did not disappoint his growing fan base of Trump haters.
George, however, did disappoint me, skipping the kinds of confidential, civil conversations spouses typically have when one has a change of heart or both agree to disagree about something big. Instead of that, he chose to take his feelings public. Friends of ours watched in horror, including those who had done something George himself had not done—voted against Donald Trump. It had been a constant theme throughout my complicated life: Even if I could not understand something, I could still grow to accept it. Whatever George’s rationale, it was a complete about-face from his earlier, enthusiastic support of President Trump and his partner of twenty years.
It was just so out of character for George. One of his most admirable qualities, I had always thought, was how he kept his own counsel. Weighing in smartly yet sparingly. Retaining and then repeating details from conversations that I wasn’t even sure he’d been listening to. When my mouth was in mile-a-minute overdrive, George would remind me and my female-centric family in South Jersey (that is also his family) that the famous “Mars versus Venus” gender divide could be scored in daily spoken-word count. Perhaps there is no greater gender gap than this one—with our differing loves of chocolate and our heat-versus-air-conditioning debate vying for second. As his wife and closest confidante, I knew exactly what he thought about various people, places, or things, but neither he nor I would ever have divulged any of that. Clients and colleagues valued his discretion. He saved his verbosity for the sharp legal briefs and sage client advice that he was known for. Family and friends accepted and at times admired that George was quiet but present. He could surprise people with his sense of humor, impersonations, and hearty laugh, yet his natural resting place was knowledgeable but reserved. As wise in what he didn’t say as in what he did say.
