Addiction and the 2020 Presidential Race

This article, in a slightly edited form, first appeared on Pain News Network on July 27, 2019.

I found the recent story about Hunter Biden‘s drug and alcohol problems disturbing, not because he has (or has had) an addiction — there’s no shame in that — but because of the way the media tiptoes around the problem. There seems be some reluctance to discuss Hunter’s problem because of the way it may affect Vice President Biden’s bid for the presidency in 2020.

To me, this illustrates a serious barrier to adroitly addressing the terrible disease of addiction.

Drugs, politicians, and their families

Marijuana is not considered a hard drug today, but it was considered a serious drug of abuse about 27 years ago, when President Bill Clinton admitted he had used it. The stigma attached to using marijuana at the time was such that he disingenuously claimed he didn’t inhale.

He wasn’t the only president who used, and may have sometimes abused, chemicals, nor was he the only president whose reputation took a hit when his drug use was exposed to the public. President Richard Nixon was reported to have an alcohol problem that worsened as his presidency neared its end.

President George W. Bush reportedly used cocaine in his youth. ABC News even polled voters to find out whether his cocaine use might affect their willingness to vote for him. President Barack Obama admitted that he had inhaled marijuana and used cocaine. He was also a cigarette smoker with a nicotine addiction, and dealt with media inquiries about his attempts to quit throughout his presidency.

Hunter Biden is not the only family member of a presidential candidate with addiction. Jeb Bush’s daughter, Noelle Bush, also had a drug problem. New York City Mayor Bill de Blasio’s daughter, Chiara de Blasio, has battled a drinking and drug use due to depression. Sen. Amy Klobuchar’s father, James John Klobuchar, has struggled with alcohol his whole life. President Trump’s brother, Fred Trump, Jr., died of complications related to alcoholism. This disease contributes to an estimated 88,000 deaths per year.

The 2020 Presidential Race

Clearly, the endemic nature of addiction in our culture means that we should be interested not if, but how, our candidates deal with the presence of drugs in their lives. Are they able to talk openly about drug use instead of letting it remain a dark and shameful secret? Are they compassionate and supportive of family members who struggle? To what extent do they personally use drugs and alcohol in daily life — and by extension, how well do they cope with stress? These are relevant, appropriate questions as we interview candidates for a job that impacts the entire world.

It’s inappropriate to determine which of the 2020 presidential candidates gets our vote on the basis of whether or not their family members struggle with addiction. However, one criteria we can use for voting is a candidate’s awareness of, and stance toward, the critical issue of addiction in our collective lives.

Here are the points on which I evaluate a candidate in regard to addiction and drug issues:

1) How much awareness do they demonstrate on the basic issues, including:

  • Do they know the difference in the prevalence of prescription opioid vs. illicit opioid abuse?

  • Do they know that addiction is not determined by the drug, but by genetic and environmental factors?

  • Do they know that the volume of pills prescribed to people in various parts of the country does not determine the number of overdose deaths?

  • Do they know that the prevalence of overdose deaths correlates with the loss of jobs and lack of income opportunity?

2) Will they destigmatize the disease of addiction by:

  • Decriminalizing the use of drugs?

  • Acknowledging addiction is a disease?

  • Understanding that babies cannot be born addicted?

  • Educating people that physical dependence and withdrawal can occur without addiction?

3) Do they favor access to substance abuse treatment in a timely fashion for everyone who needs it, regardless of their ability to pay?

4) Will they advocate for people in pain to receive opioid therapy when appropriate at the dose determined by their provider, rather than by the government?

5) Will they acknowledge the unintended consequences of the CDC opioid prescribing guideline?

Shining a Light on Addiction

The ideal candidate should recognize the tragedies associated with all addictions, not just with prescription opioids. He or she must recognize that addiction is part of being human, and that some people are more vulnerable to addiction than others, just as some people are more vulnerable to developing cancer or heart disease. Whoever becomes or remains our president must shine the light of information on addiction, rather than hide it in the darkness of misinformation, shame, and denial.


Lynn R. Webster, MD, is a vice president of scientific affairs for PRA Health Sciences and consults with the pharmaceutical industry. He is author of the award-winning book, The Painful Truth” and co-producer of the documentary,It Hurts Until You Die.”

You can find him on Twitter: @LynnRWebsterMD.



  1. Kathy C on July 28, 2019 at 2:36 pm

    We have to remember that most of these politicians took money from the pharmaceutical industry, and are protecting the industries that are profiting. Opiates and addiction are emotionally charged attention getting words which politicians use to get attention. The pharmaceutical industry demonized pain patients and their physicians, and blamed them for the so called opioid epidemic, in order to draw attention away from the industry and the politicians who continue to protect these industries.

    There can’t be a meaningful response to any of this, until the role of media, and money in politics is fully exposed. There won’t be any credible action until they start looking at all of this objectively. We have seen 22 years of inaction, regulatory capture, and misdirected action. The incredible amount of money in our healthcare pharma and insurance industries, has undermined our Democracy.

    The media continues to misinform on this topic, and run an industry friendly narrative. The media sensationalized opiates, and addiction, while ignoring the Epidemic of Despair. Way back in the early 2000s they did reality TV, where addiction was viewed as entertainment and advertising for expensive and ineffective treatment.

    No one has discussed the role of marketing and social media , and how the FDA and FTC no longer regulate health marketing. One would think that the so called opiate epidemic, the Anti Vaxx movement, and the marketing of E Cigs to children, would have forced politicians to look at the role of health marketing, and propaganda.

    There is only one presidential candidate taking on the pharmaceutical industry, that not only deceptively marketed these opiates, but rebranded old pharmaceuticals, raised the price and marketed them as a cure. This country is still in denial about addictions, and appears to choose to remain that way. The media will pick up stories of candidates families addiction problems and use them to humanize the candidates, or demonize them , as needed.

  2. Stuart Percell on July 29, 2019 at 3:07 am

    “Humanize,” that’s quite a stretch, even for the most optimistic among us. You’re being far to kind.

  3. Greg on July 29, 2019 at 2:03 pm

    Well, I can safely tell you which party is embracing the CDC Guidelines and implementing draconian regulations. Democrats. They believe in more government intrusion into our medical care and our daily lives, not less. Look at all the states implementing the CDC Guidelines as law and then compare it against the party in control(ie OR, ME, CT, MA, NJ, NY, MI, MT, WA, OH, CA, NV). What has that accomplished? Increased suicides and pain patients seeking illicit opioids to self medicate. Just remember whose administration started the country down this road in 2016. Obama. The state I live in, Texas, had only implemented two regulations regarding opioids since 2016. One is the creation of a prescription monitoring program and the other is limiting acute pain prescribing(PMP) of opioids to 10 days. Both are reasonable regulations. Doctors and pharmacies should be checking the PMP regularly to look for cases of doctor shopping and potential drug interactions. The 10 day limit is reasonable since any patient needing surgery, having an injury or other medical condition requiring opioids would be seen in a follow up appointment anyways within that same timeframe. Some other states have implemented 3 day limits which are completely ridiculous and burdensome. If we, as a nation, have learned anything since 2016 it’s that we need much less government oversight and/or regulation of the patient/doctor relationship. Democrats largely see it the other way around.

    • Rochelle Odell on August 4, 2019 at 10:22 pm

      I beg to differ on the Democrats being overwhelmingly behind what is happening today. Sadly both parties are behind what’s happening with the intrusion into what should be very personal healthcare between a patient and their physician. That intrusion is across the board, even conservatives, of which I am.

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