Florida Drug Deaths Rose Dramatically as Pam Bondi Did Her 'Incredible Job' of Reducing Them

President-elect Donald Trump's spin on his nomination of Pam Bondi as attorney general is notably different from the way he presented the nominee she replaced. Trump portrayed former Florida Rep. Matt Gaetz, who withdrew his name from consideration after just eight days when it became clear that his confirmation was highly unlikely, as a radical reformer who would "end Weaponized Government" and "restore Americans' badly-shattered Faith and Confidence in the Justice Department." Trump's announcement of Bondi's nomination, by contrast, emphasized her extensive experience as a prosecutor (an area where Gaetz was notably lacking) and her bona fides as a crime fighter.

The following day, the Trump transition team touted "wide acclaim" for Bondi, quoting Republican senators who were decidedly less enthusiastic about the Gaetz pick. A press release emailed on Wednesday highlights "bipartisan praise for Pam Bondi," quoting a Fox News story that describes her "commitment to solving problems and working across the aisle on top priorities."

It would have been hard to back up any assertion of "wide acclaim" or "bipartisan praise" for Gaetz, whose nomination dismayed Republicans as well as Democrats because of his numerous scandals, scant legal experience, and reputation as an obnoxious showboat in the House. Bondi, who worked as a local prosecutor for more than 18 years and served as Florida's attorney general for two terms, is indisputably much better qualified to run the Justice Department than Gaetz, and she is unburdened by the ethical charges that helped sink his nomination. Still, her supposedly inspiring work as a drug warrior—a prominent part of Trump's case for her—is much less impressive than he thinks, coinciding with a dramatic increase in Florida drug deaths.

Fox News cites the assessment of Dave Aronberg, a Democrat who sought the nomination to run against Bondi for attorney general in 2010. She subsequently picked Aronberg as her "drug czar," a move he thinks "really said a lot about her because she got a lot of criticism, withering criticism, from some members of her own party" for appointing a Democrat to that post. Bondi "was not seen as a very partisan person" in Florida, Aronberg adds. He says she had a "strong working relationship with Democrats" and "would support legislation regardless of whether it was supported by Democrats or Republicans."

In addition to highlighting Bondi's reputation for bipartisanship, Trump says she did "an incredible job" in "work[ing] to stop the trafficking of deadly drugs and reduce the tragedy of Fentanyl Overdose Deaths." Fox News likewise notes that when Bondi took office as attorney general in 2011, she "quickly earned a reputation for cracking down on opioids and the many 'pill mills' operating in the Sunshine State." It quotes state prosecutor Nicholas Cox, who notes that Florida "was the epicenter of the opioid crisis" at the time. Aronberg "credits his former boss as being the person 'most responsible for ridding the state of Florida of destructive pill mills.'"

The implication that Bondi's anti-drug efforts succeeded in reducing overdose deaths does not find much support in data reported by the Florida Department of Health. The age-adjusted rate of "deaths from drug poisoning" did fall a bit after she took office, from 13.7 per 100,000 residents in 2011 to 12.1 in 2013. But then it resumed its upward trajectory, reaching 25.1—nearly double the 2011 rate—by the time Bondi left office in 2019. The death rate rose sharply in 2020 (as it did across the country), rose again in 2021, and declined slightly in 2022, when it was 34.9 per 100,000.

In 2019, according to data from the Centers for Disease Control and Prevention (CDC), Florida ranked 20th on the list of states with the highest drug death rates, down from 15th in 2011. But despite that relative improvement, Florida's rate as reported by the CDC rose by 66 percent during that period. In absolute terms, the number of drug deaths rose by more than 80 percent.

Trump, in short, is right that Bondi did an "incredible job" of reducing drug-related deaths—but not in the way he means. It would indeed be incredible to credit Bondi with reducing a problem that exploded on her watch.

The correlation of aggressive drug law enforcement with escalating drug-related deaths is by no means limited to Florida. But Bondi's approach epitomizes what went wrong across the country.

Bondi's fans praise her for cracking down on "pill mills," which may indeed have made it harder for nonmedical drug consumers (as well as bona fide patients) to obtain prescription opioids such as hydrocodone and oxycodone. But the result was increased consumption of black-market alternatives, which are much more dangerous because their quality and potency is highly variable and unpredictable. That hazard was magnified by the simultaneous proliferation of illicit fentanyl as a heroin booster and substitute—a development that likewise was driven by prohibition, which favors more potent drugs that are easier to conceal and smuggle.

Nationally, the crackdown on pain medication was successful at reducing opioid prescriptions, which fell by more than half from 2010 to 2022. But that reduction did not slow, let alone reverse, the upward trend in opioid-related deaths, which instead accelerated. Given the predictably perverse effects of trying to enforce drug prohibition, that was no mere coincidence.

Drug-related deaths may finally be declining. According to the CDC's provisional estimates, the nationwide death toll during the 12 months ending in June 2024 was 14 percent lower than the number during the previous 12 months, which is the biggest such drop ever recorded.

According to an analysis by Nabarun Dasgupta and two other drug researchers at the University of North Carolina, it is "plausible" that wider distribution of the opioid antagonist naloxone, which quickly reverses heroin and fentanyl overdoses, contributed to that apparent turnaround. But they think it is "unlikely" that anti-drug operations along the U.S.-Mexico border played a significant role.

Dasgupta et al. note that recent border seizures have mainly involved marijuana and methamphetamine rather than illicit fentanyl, which is implicated in around 90 percent of opioid-related deaths and more than two-thirds of all drug-related deaths. Instead of reducing those deaths, methamphetamine seizures may have had the opposite effect. "We detected a sudden increase in meth adulteration over the Summer, starting in May 2024, exactly corresponding to the increase in border seizures," the researchers report. "The number one adulterant of meth was fentanyl. So, the impact of the border seizures may be bi-directional: Decreasing fentanyl-only overdoses and increasing fentanyl-methamphetamine overdoses."

More generally, drugs seem to be "getting cheaper and cheaper across the board," Dasgupta et al. note. "If drug prices have been dropping for the past couple of years," they say, it is hard to credit "any suggestion that drops in [overdose] deaths have anything to do with interdiction efforts or the drug supply being significantly affected," let alone to the extent "where we see hundreds of thousands of people stopping use….If the drug supply is affected in such a way, it would almost certainly cause a rise in drug prices, where we have seen just the opposite."

Such subtleties seem to be lost on Bondi. Fox News reports that her former colleagues in Florida "expect she will bring the same playbook to Washington—this time with an eye to cracking down on drug trafficking, illicit fentanyl use, and the cartels responsible for smuggling the drugs across the border."

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