Opioid Crisis Is a Nationwide Public Health Emergency: Officials
WASHINGTON—President Donald Trump is formally declaring America’s opioid addiction crisis a nationwide public health emergency this afternoon.
Senior administration officials briefed media this morning on a call, saying the president has his own personal story on the crisis, which he may also share today.
In 2016, more than 64,000 people died of drug overdoses in America, according to preliminary numbers. Early numbers for 2017 indicate the problem is worsening—mostly due to the synthetic opioid fentanyl, which is 50 times more powerful than heroin and 100 times more potent than morphine.
Today, Trump will direct Health and Human Services to announce a nationwide public health emergency under Section 319 of the Public Health Service Act, an official said.
Trump will also direct heads of all other departments and agencies to “exercise all appropriate emergency authorities that they have to reduce the number of deaths and minimize the devastation caused by the opioid crisis,” a White House official said.
The public health emergency will terminate in 90 days, but can be renewed.
No additional funding has been appropriated, but some money is being moved from existing grant programs. Officials said they are working with Congress to include additional funds in the budget.
“This type of funding has been the subject of previous years’ budget deals. We expect that this year will be no exception,” an official said.
The actions under the declaration are based on recommendations made by the Commission on Combating Drug Addiction and the Opioid Crisis, which Trump established in March. The commission published an interim report in July and the final report is due on Nov. 1.
Specific Actions Under the Declaration
An email from a White House official says the declaration:
- Allows for expanded access to telemedicine services, including services involving remote prescribing of medicine commonly used for substance abuse or mental health treatment.
- Helps overcome bureaucratic delays and inefficiencies in the hiring process, by allowing the Department of Health and Human Services to more quickly make temporary appointments of specialists with the tools and talent needed to respond effectively to our Nation’s ongoing public health emergency.
- Allows the Department of Labor to issue dislocated worker grants to help workers who have been displaced from the workforce because of the opioid crisis, subject to available funding.
- Allows for shifting of resources within HIV/AIDS programs to help people eligible for those programs receive substance abuse treatment, which is important given the connection between HIV transmission and substance abuse.
Since Trump took office, more than $1 billion in funding has been allocated or spent directly addressing the drug addiction and opioid crisis, according to administration officials. Another $254 million in funding for high-risk communities, law enforcement, and first responder coordination and work has been awarded.
Since April, more than $800 million has been distributed for prevention, treatment, first responders, prescription drug monitoring programs, recovery and other care in communities, inpatient settings, and correctional systems.
Prescribing and Alternatives to Opioids
The Food and Drug Administration (FDA) is imposing new requirements on the manufacturers of prescription opioids to help reverse the overprescribing that has fueled the crisis. Previously, only long-acting opioids—about 10 percent of opioid prescriptions—were subject to strict regulation. Recently that was expanded to include immediate release opioids. The new requirements will make all opioids that are manufactured subject to the same strict regulations.
The National Institutes of Health has initiated discussions with the pharmaceutical industry to establish a partnership to investigate non-addictive pain relievers and new addiction and overdose treatments, as well as a potential vaccine for addiction.
The Department of Defense, Department of Veterans Affairs, National Institutes of Health, and Department of Health and Human Services are collaborating on a six-year, $81 million joint research partnership focusing on nondrug approaches to managing pain in order to address the needs of service members and veterans.
Treatment and Prevention
In 2016, more than 11.5 million Americans ages 12 and older reported misuse of prescription opioids in the past year, and nearly 950,000 Americans reported heroin use in the past year.
Eighty percent of new heroin users started their addiction on prescription drugs—often obtained through a friend or family member.
The new declaration puts a lot of focus on giving broader access to treatment.
“I think we’re saying this is important and we value these lives—each and every life is of infinite worth,” an administration official said. “And we can save these lives and there’s hope, there’s evidence-based treatment programs to bring people out of this dark night.”
The official said reducing the stigma around addiction is a critical reason to talk about the issue more, saying “it has been in the shadows.”
First Lady Melania Trump recently visited Lily’s Place, a recovery center for babies with Neonatal Abstinence Syndrome (NAS). NAS occurs when a baby suddenly experiences withdrawal after birth because it was exposed to illegal and/or prescription drugs while in the womb. Symptoms range from excessive crying and irritability to difficulties with breathing and feeding.
In 2014, the number of babies born drug dependent had increased by 500 percent since 2000, and children being placed in foster care due in part to parental drug abuse is going up—now it is almost a third of all child removals.
“By placing a priority on the whole family, infants born dependent on drugs are given the best opportunity to thrive because their parents are also given the support and tools they need to recover and succeed, as parents and members of their community,” Mrs. Trump said during the visit Huntington, Virginia, on Oct. 10.
Trump is also putting action into the prevention side of the equation.
“The best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place. If they don’t start, they won’t have a problem,” he said.
The Centers for Disease Control and Prevention (CDC) has launched the Prescription Awareness Campaign, a multimedia awareness campaign featuring the real-life stories of people who have lost loved ones to prescription opioid overdose and people in recovery.
The Department of Justice’s Opioid Fraud and Abuse Detection Unit has targeted individuals that are contributing to the prescription opioid epidemic, has netted the largest-ever health care fraud takedown, has secured the first-ever indictments against Chinese fentanyl manufacturers, and has seized AlphaBay, the largest criminal marketplace on the Internet and a major source of fentanyl and heroin.
The State Department has secured a binding UN agreement making it harder for criminals to access fentanyl precursors ANPP and NPP.