BIG SI-I()TS USA ー 00 Da Washington, D. C. ー President Donald Trump poses for a portrait in the Oval Offce onApril 21. ln the days before April 29 , which marks the 100th day of hiS administration, Trump posted a tweet complaining that it was unfair tO grade him on such a short periOd in Offce, even though he vowed on the campaign trail tO complete at least 60 ofhis policy proposals during his first 100 days. Supporters call the appointment Of Supre me CourtJus- tice Neil Gorsuch and the dismantling ofa swath ofObama-era regulations successes, while the debacle over a health care bill was a notable failure. ANDREW HARNIK

P A F R A N C E R E L I G 1 0 N 工 S L A N D S N R U S S 工 A D R U G S SPYTALK AL-QAEDA KILLING THE NEXT BIN LADEN lnside America's hunt to take out Ayman al-Zawahiri, the elusive leader of Al-Qaeda HE HAS BEEN the forgotten man in the West's de sp e rate c amp aign tO obliterate the lslamic State militant group (ISIS). He didn't even merit a cameo in the celebratory coverage Of Osama bin Laden's death at the hands of し S. Navy SEALs in 2011. For several years, he has been described as the leader ofa spent force. Yet Ayman aI-Zawahiri, bin Laden's mentor and successor, remams a key player in an attack threat tO America that retired Marine Corps GeneralJohn Kelly, the し S. homeland security secretary, says is worse tOday than what we experienced 16 years ago on 9 / 11. ” And if 0 伍 - cials in the Donald Trump administration have their way, al-Zawahiri's name Will soon be as familiar tO the world as bin Laden's once was. The White House signaled a tougher new appro ach tO eliminating al-Zawahiri and his mil- itant allies in early ApriI with the appointment of Lisa Curtis to head the south Asia desk for the NationaI Security Council. A well-known former CIA analyst, congressional staffer and foreign policy hawk in Washington, D. C. 's think tank circtllt, Curtis caused a stir in February when she co-authored a piece arguing that the U. S. "should … hold Pakistan accountable for the activitie s Of all terrorist groups on its s Oil. ” Pakistan s Inter-Service s lntelligence agency (ISI) has b een protecting the Egyptian-born al- Zawahiri, a trained surgeon, since し S. forces evicted Al-Qaeda from Afghanistan ⅲ late 2001 , several authoritative sources tell Ⅳビルた . His most likely location today, they say: Karachi, a teemmg port city 0f26 million on the Arabian Sea. Like everything about his location, there's no posifive proo says Bruce Riedel, a 30-year CIA veteran whO was the top adviser on South Asia and the MiddIe East for the past four し S. presi- dents. "There are pretty good indications, includ- ing some 0f the material found ⅲ Abbottabad, where bin Laden was slain, 'that point in that direction," he adds. "This would be a logical place to hide out, where he would feel pretty comfort- able that the Americans can t come and get him. E I S R A E L Ⅳ耘ん rvrtmg り N00 。。。 k 当 @SpyTalker 」 EFF STEIN BY N E W S W E E K 12 M A Y 0 5 , 2 017

an ulcer and organ damage from his opioid use. But, he added, optimistically, "l'm deal- ing with it, you know?" Another middle-aged man drew murmurs Of encouragement When he announced his wife had recently helped him get an appointment tO see a psychiatrist. people fighting addiction are, on average, more likely t0 alSO suffer from Other serious health conditions, such as mental illness. Their drug use takes a t011 on their bodies, leading t0 problems like gas- tritis and liver disease. And they are at greater risk Of congestive heart failure and pneumo- ma, according tO the Association for Behavioral HeaIth and Wellness. Heroin addicts are at high risk for HIV, AIDS and hepatitis C because of their use ofneedles. ln addition to ramping up Medicaid funding and getting more people insured, one 0f the primary ways Obamacare has tried tO combat drug use is by making it easier for addicts t0 get the health care they need. ln addition to requir- ing insurers tO cover mental health and addic- tion-related servlces, the law has created new programs tO encourage care that brings all the doctors treating a patient together in one coor- dinated system. "We need to find ways to get them intO comprehensive and well-coordinated treatment," Saloner says, "[but] if there aren t the resources t0 make it happen, it s probably not going t0 happen ・ lt takes time tO deploy a network Of case man- agers or t0 enroll people in programs like Agus's that help those in treatment get on Medicaid and link them tO primary care physicians. Several states, including Maryland, have pilot programs tO better centralize care, including for people battling addiction. But they're not widespread. And Frank, the Harvard economist, says it will take more time before the supply Of treatment facilities catches up with demand. Even with the surge msurance coverage and public and pri- vate investment since Obamacare, 'those things don't come up overnight," he says. And you need the workforce tO dO it. The funding pipeline has also been slow to reach providers. Agus says she's struggling t0 find funding to expand her programs, which ・ ncludeproviding -me art- nering with local jails tO help treat inmates leav- ing prison. Though Baltimore has the highest rate 0f opioid-related deaths in Marylandßhe's been unable tO secure money from the city and is instead turning tO private foundations. The concern now is that the threats tO Obamacare will continue tO SIOW or even halt the progress being made. The Trump White House asestablishedaOmnuss10mondrug addictio and opioids. And the Health and Human Ser- vices Department has started tO hand out state grants funded by a bill Congress passed lastyear. But as Frank pointed out in a January op-ed, that law's $ 1 billion in funding for opioid treatment is a fraction 0f the estimated $ 5.5 billion worth 0f mental health and addiction treatment funding Obamacare covers for low-income people each year. And if the latest version 0f the GOP plan, currently under negotiation, becomes reality, states would be allowed tO waive the "essential health benefits, ” which would add another road- block t0 treatment. "We know what happens tO... addiction and mental health care under msurance when you don't have those types Of requirements," says Frank. "You're looking at significant cutbacks. Miller understands why people might be pushing t0 repeal Obamacare. She believes the law has hurt some Americans, including her, by increasing health insurance costs. But she's UNDER OBAMACARE, ADDICTS HAVE STARTED TO RECEIVE MORE ACCESS TO TREATMENT, BUT PROGRESS HAS BEEN SLOW. willing t0 pay that price. "lt affected a 10t more people in a better way," Miller says, particularly when it comes tO mental health and addiction. while she doesn't think the government is responding tO the opiOid crisis with the urgency it should, it'sstill farADettevthan the alterna- tive—repealing Obamacare and shrinking fed- eral health care funds. "l'll put it this way, Miller says, before Obamacare, there's noth- ing tO talk about be c ause [tre atme nt option are] nonexistent, SO at least there's [now] some- ng there for our loved ones. ”ロ P A G E 0 N E / D R U G S NEWSWEEK 21 MAY05, 2017