Ethical Predicaments Weigh Down Opioids Effort

Key agencies involved in combatting the epidemic have been mired in the ethical problems of their leaders.

Brenda Fitzgerald, shown with then-Georgia Gov. Nathan Deal in this 2014 photo, resigned as Centers for Disease Control and Prevention director on Jan. 30.
AP Photo/David Tulis
Erin Durkin
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Erin Durkin
Feb. 5, 2018, 8 p.m.

Agencies critical to the fight against the opioid epidemic have been plagued by the ethical predicaments of Trump administration appointees—and this could be taking a toll on major policy initiatives.

The most recent blow came last week when Centers for Disease Control and Prevention Director Brenda Fitzgerald resigned after a Politico report revealed that she bought shares in a tobacco company while in her position. But even before this revelation, there had been concerns that preexisting conflicts of interest limited her ability to act on issues related to the opioid epidemic.

Fitzgerald’s departure comes as the Office of National Drug Control Policy remains without political leadership. President Trump nominated Rep. Tom Marino to head the office in the fall, but he withdrew from consideration after a Washington Post/60 Minutes investigation found that he had advocated legislation weakening the Drug Enforcement Administration’s ability to go after drug distributors.

The president’s commission on the opioid crisis had pegged ONDCP as important to coordinating and tracking federal initiatives.

“Without political leadership at ONDCP, that mixing, that action, can’t happen,” said Regina LaBelle, the office’s chief of staff during the Obama administration. “The necessary combination of agency skills and perspectives—that can’t be done without ONDCP.”

The office also made headlines recently when the Post detailed the rapid rise, and subsequent departure, of Taylor Weyeneth, a former Trump campaign worker who shot up the ranks of the president’s drug-policy office. Weyeneth became a White House liaison and then served as deputy chief of staff at ONDCP—which has had significant staff turnover—until a wide range of inaccuracies and falsehoods on his résumé were revealed.

When asked whether these departures were weighing down the opioid effort, a White House spokesperson referred to a statement from a senior official made late last year blaming Democrats for the lack of leadership. “I would just add that at a number of these agencies, including [at the Health and Human Services Department], we’ve had historic opposition and obstruction by Democrats in the Senate that have taken forever to confirm much of the kind of sub-Cabinet, particularly those that are charged with actually administering many of these problems,” the official had stated on a press call following Marino’s withdrawn nomination.

The department said turnover has not affected its ability to fight the epidemic. “HHS is focused like a laser on the administration’s response to the nation’s opioid crisis and has not missed a beat. In fact, in his first week on the job, Secretary [Alex] Azar travelled to Indiana Friday to announce a continuation of Indiana’s Medicaid waiver that includes expanded access to substance-abuse treatment, including opioids,” said HHS spokesperson Matt Lloyd.

Both the White House and HHS provided a list of actions taken by the administration to address the crisis, including HHS-awarded grants to states to shore up their efforts. However, governors have said more is needed and are calling for improved coordination among federal agencies.

Ethical experts say the host of problems that Trump appointees have faced may reflect a breakdown in the vetting process.

“What is a little different with the Trump administration is how many appointees have actually been named, and even taken their positions, where major ethics dilemmas still exist,” said Scott Amey, general counsel at the Project on Government Oversight, a nonprofit watchdog group. “I think in a lot of other administrations some of these people would have never been named. If you have appropriate vetting even before names come out, then some of these people may not have made the short list and certainly wouldn’t have been appointed to the position.”

The CDC director’s resignation comes soon after Congress approved Azar as the new head of HHS. Tom Price resigned from the position in September soon after it was revealed he had racked up travel expenses from using private chartered flights.

Given the spate of resignations within HHS, it seems “there may not be a culture of taking ethics seriously,” said Chris Lu, former executive director for the Obama-Biden Transition Project and former deputy chief counsel on the House Oversight and Government Reform Committee.

Lu added that a number of the problems the Trump administration has faced in the first year could be linked to the transition process. “This was a campaign that frankly never thought they were going to win, so didn’t do the proper preparation for that. … Personnel is policy, and they didn’t identify the personnel that would take these positions,” he said.

He noted that former New Jersey Gov. Chris Christie had been in charge of the transition process and “by all accounts put together a good plan,” but was dumped soon after Election Day in 2016.

Christie said at a recent press conference that the administration is learning a painful lesson: Experience matters. “You cannot run a transition as an outsider. You have to be able to understand what needs to be done,” he said in December.

And the White House had a smaller group of Republicans to pull from to fill the administration, said Lu. “The combination of lack of preparation and having a smaller pool of potential candidates has meant that they are probably going to people that in a normal, typical Republican administration never would have been given the opportunity to serve,” he said.

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