It’s unnatural to have to bury a sibling. You grow up side by side in color-coordinated outfits, squinting into the sun in all the same family vacation photos, sharing bedrooms and soccer equipment and secret code languages. But then, after living parallel lives for so long, one of you zigs while the other continues to zag. Suddenly, your world as you knew it is over. It’s a specific, hollow, unjust pain. Like someone took an ice cream scoop to your DNA and scraped out a big important hunk from the middle.
Too many Americans like me have lost loved ones to addiction. But I was surprised to discover that President Donald Trump is among our ranks. Because even though our brothers both died from their substance use issues, the President and I have learned very different lessons from watching it happen.
Fred Trump Jr. struggled with alcoholism for years, dying in 1981 at just 43 years old. My brother Matt misused opioids, benzos, and any other pill or powder that crossed his path for years before dying from an overdose two years ago at age 26. Losing a brother to a disorder that’s so preventable and treatable—it made me feel infuriated. But to hear Donald Trump tell it, it was Fred’s bad choices that led to his demise, and Donald went on to be the successful man he is today because he wisely learned from Fred’s mistakes.
Yet the “bad choices” narrative doesn’t really hold water anymore, as substance use issues claim lives in epidemic proportions. Drug overdoses now surpass both gun violence and car crashes as the number one cause of accidental death in the United States. Almost 60,000 people died of overdoses in 2016. Life expectancy has dipped for the first time in two decades, largely due to overdose deaths killing so many people well before they’re eligible for AARP. A new report from the White House released this week estimates that the epidemic cost over $500 billion in 2015.
What we’re doing isn’t working. We need real action, plans, strategy, funding. But our president is falling into simplistic thought traps that threaten the progress we’ve begun to make towards treating addiction like a medical condition, not a moral failing.
The president often speaks warmly, if vaguely, about his older brother Fred, a charismatic pilot and family black sheep. But reports say the two clashed often, and now President Trump presents his brother as little more than a cautionary tale. Growing up in Queens, New York, Donald says, “my brother always told me: Don’t do drugs. So I didn’t.” But it’s not that simple for most teenagers.
Growing up in Arlington, Massachusetts, my brother’s transition to his teen years brought burgeoning mental health issues and a discovery of his homosexuality—not quite the sort of traits that were welcomed in our small Irish-Catholic community. Our town didn’t offer much for high schoolers to do for fun, beyond swigging from handles of grainy vodka in the woods until the cops came and chased you home. Our drug prevention assemblies at school featured cheezeball videos of C-list athletic celebrities insisting that you be a winner by saying no to dope. Still, most of the kids in my corner of Greater Boston said an enthusiastic yes to Busch Lights, blunts, and beady little pills left over from wisdom teeth surgery. Kids windmill high-fived over the keg while wearing their DARE T-shirts as an ironical joke.
Donald Trump insists that “it’s really, really easy not to take” drugs. Because for him, it always has been. But the desire to self-medicate, the aforementioned mind-numbing social boredom, or even simple teenage rebellion can prompt a kid to try. After the first few uses, risk factors like genetics, family life, and socioeconomic conditions make it a roll of the dice as to whether that kid will be able to gingerly put down the water bong and never use problematically again, or develop an addiction that will eventually kill him.
My brother wanted to not take drugs. He wanted it to be really, really easy. But once he was addicted to opioids, it became impossible to just say no. These drugs reprogram brains in dramatic ways, causing behavior changes, painful withdrawal symptoms, and an overwhelming compulsion to use—not necessarily to feel high, but just to feel normal. After overdoses brought Matt to the ER, doctors would discharge him with a couple pamphlets and a list of Narcotics Anonymous meetings. Even though attempting to quit substances cold turkey can kill you, this is precisely the model that we uphold as good, as aspirational. Choosing to stop, just like you chose to start.
Donald Trump has recently been touting his plans for “really tough, really great, really big advertising,” vowing to spend billions on anti-drug campaigns. Of course, this sounds familiar. Nancy Reagan’s drug prevention effort was not only ineffective (research shows DARE kids were precisely as likely to try drugs as kids who received no anti-drug messaging), it also kicked off years of racist, unscientific fear mongering about crack, crime, and killer dealers. Now, as police broadcast shaming photos of overdose victims on social media, and our news cycle features harebrained stories about overdosing on fentanyl just by touching it, it’s nauseatingly easy to see how simple it would be to slip right back into that unhelpful drug hysteria.
What’s more, these empty prevention ideas don’t do anything to address the problem we have right now: Millions of Americans addicted to drugs, overdosing and dying, without enough trustworthy treatment resources. A fancy ad campaign would not have halted my brother’s drug problems. Medication, behavioral therapy, and a destigmatized social attitude about drug use and addiction might have, though.
Luckily, we’re making baby steps toward progress. Shady rehabs are being exposed and shut down. Innovative local initiatives are seeing success, like the compassionate Angel police program and Vermont’s effective “hub and spoke” treatment model. Even DARE has begun embracing modern prevention research, pivoting to models that encourage kids to make healthy choices rooted in their own self-esteem, rather than force-feeding them drug avoidance tactics rooted in fear.
Still, plenty more Americans will lose their brothers to substance use issues in 2018. Too many. I wish Donald Trump’s personal experience had made him more thoughtful about this misunderstood disease. But without that leadership from the White House, it’s up to regular Americans to to take back control of how we talk and think about addiction. That starts with one simple perspective adjustment: You don’t have to think that all people with drug addictions are perfect angels. You just have to think that they’re people.