President Donald Trump will on Thursday officially declare a national public health emergency over the US epidemic of opioid drug overdoses, according to senior administration officials, addressing a scourge killing tens of thousands of people nationwide.
Under Trump’s direction, the secretary of the US Department of Health and Human Services will declare a 90-day national public health emergency, subject to regular renewal. The declaration “gives us power to do things that you can’t do right now,” said Trump on Wednesday, in remarks made outside the White House.
Public health officials are hoping the announcement, promised by Trump since August, will shift federal funding for local addiction recovery and overdose prevention efforts to hard hit places. However, the federal fund for public health emergencies is empty, meaning new money will have to be added in federal budget negotiations this year to start new programs. The administration has previously supported calls for an extra $ 15 to $ 45 billion in federal funding to address the overdose crisis in failed health care bill negotiations earlier this year.
“With an emergency declaration, the Trump administration has an opportunity to chart a new course on the overdose crisis and reset its approach to drug policy,” Grant Smith of the Drug Policy Alliance wrote Wednesday, calling for a shift from relying on law enforcement toward medical treatment of addiction. “Anything short of this will needlessly cost many more lives.”
The president informally declared the crisis an emergency on Aug. 10 in apparent off-the-cuff answer to a reporter’s question. “The opioid crisis is an emergency, and I’m saying officially right now it is an emergency,” Trump said at the time. (His then-health secretary, Tom Price, had said just two days before no emergency declaration was needed).
Overall, opioid overdose deaths quadrupled from 8,050 in 1991 to 33,091 in 2015, according to the Centers for Disease Control and Prevention, with provisional data pointing to 53,000 deaths last year. An initial wave of prescription painkiller deaths was succeeded by a sharp jump in heroin deaths in this epidemic, both now killing around 15,000 people a year. Those deaths have been surmounted by deaths from illicit fentanyl, an opioid 10 to 30 times stronger than heroin, which has infiltrated the illicit drug supply since 2012, last year killing more than 20,000 people.
Opioid drugs, whether in prescription painkillers such as Vicodin or illicit heroin, commonly trigger a physical dependence in people who take them for extended periods of time (estimates range from about 5% to 20% of patients being vulnerable), with almost half of patients who take them for a month still using them a year later, one recent study found.
Nevertheless, physicians and pharmaceutical firms began providing opioid painkillers to patients on a massive scale starting in the 1990’s, with prescriptions peaking at more than 300 million in 2012.
Largely as a result of these prescriptions and a surge in heroin supplies, nearly 12 million people are thought to yearly misuse opioids nationwide, with parts of the Deep South, Appalachia, and New England hit particularly hard by overdoses as a result. More than 1,000 people a day are treated in emergency departments for prescription opioid overdoses.
Federal limits now mean that only about 4% of doctors can prescribe drugs used to taper down the doses of those people. Those limits could also be adjusted under a national emergency declaration. The Department of Health and Human Services might also waive limits on Medicaid paying for addiction treatment in working age adults to facilities with 16 or fewer beds, a boost to the recovery industry.
A former Office of Drug Control Policy official, Regina LaBelle, warned that the proof of Trump’s declaration will only come if federal dollars follow his declaration.
Even without extra funds, the declaration will allow treatment for recovery from addiction by tele-medicine to start, permitting remote prescription of drugs meant to stave off withdrawal pains, a boon for people in rural areas short on physicians. And it will allow rapid deployment of specialists to areas suffering overdose outbreaks previously prevented by federal hiring rules.
A Trump-named commission headed by Gov. Chris Christie of New Jersey is expected to release a report on an overall strategy for combating the opioid crisis on Nov. 1.
