‘We must act boldly to stop it’

Panel urges Trump to de­clare a na­tional emer­gency over the opi­oid epi­demic.

Los Angeles Times - - THE NATION - By Ann M. Sim­mons ann.sim­mons@la­times.com Twit­ter: @AMSim­mons1

Declar­ing that the “na­tion is in cri­sis,” the White House com­mis­sion on opi­oid ad­dic­tion has rec­om­mended that Pres­i­dent Trump de­clare a na­tional emer­gency over the epi­demic that each day kills dozens of Amer­i­cans.

“Your dec­la­ra­tion would em­power your Cab­i­net to take bold steps and would force Congress to fo­cus on fund­ing and em­pow­er­ing the ex­ec­u­tive branch even fur­ther to deal with this loss of life,” the Com­mis­sion on Com­bat­ing Drug Ad­dic­tion and the Opi­oid Cri­sis wrote in its in­terim re­port re­leased Mon­day. “It would also awaken ev­ery Amer­i­can to this sim­ple fact: If this scourge has not found you or your fam­ily yet, with­out bold ac­tion by ev­ery­one, it soon will.”

The com­mis­sion, led by Chris Christie, the Repub­li­can gov­er­nor of New Jer­sey, was cre­ated in March and charged with study­ing ways to com­bat and treat drug abuse, ad­dic­tion and the opi­oid cri­sis. Cit­ing data from the U.S. Cen­ters for Dis­ease Con­trol and Pre­ven­tion, the com­mis­sion said the epi­demic claims an av­er­age of 142 lives a day.

“We must act boldly to stop it,” the com­mis­sion wrote. “The opi­oid epi­demic we are fac­ing is un­par­al­leled.”

Be­tween 1999 and 2015, more than 560,000 peo­ple in the United States died of drug over­doses, a death toll larger than the pop­u­la­tion of At­lanta.

In 2015, nearly two-thirds of drug over­doses were linked to opi­oids, in­clud­ing Per­co­cet, OxyCon­tin, heroin and fen­tanyl. There were more than 50,000 deaths from drug abuse and ad­dic­tion in 2015, ac­cord­ing to fig­ures re­leased by the White House when the com­mis­sion was cre­ated.

The com­mis­sion, which said it had re­ceived in­for­ma­tion and sug­ges­tions from nu­mer­ous groups and in­di­vid­u­als, of­fered sev­eral other rec­om­men­da­tions. They in­clude in­creas­ing the ca­pac­ity for treat­ment, man­dat­ing ed­u­ca­tion ini­tia­tives for pre­scribers and boost­ing re­sources for law en­force­ment agen­cies to fight the traf­fick­ing and dis­tri­bu­tion of il­licit fen­tanyl.

The pro­pos­als also call for es­tab­lish­ing a na­tional pro­gram to ex­pand ac­cess to med­i­ca­tions that have been shown to re­duce over­dose deaths.

One of those drugs, nalox­one, which is con­sid­ered to be “a life­saver that rapidly re­verses opi­oid over­dose,” should be pre­scribed with opi­oids in cer­tain cases and dis­pensed through stand­ing pre­scrip­tions, the com­mis­sion said.

The rec­om­men­da­tions were greeted with mixed re­views by anti-ad­dic­tion groups and ex­perts in opi­oid abuse.

“I think they of­fer a wel­come de­par­ture from the Trump ad­min­is­tra­tion’s over­all ap­proach to drug pol­icy so far,” said Grant Smith, deputy di­rec­tor of na­tional af­fairs at the New York-based non­profit Drug Pol­icy Al­liance, not­ing the ad­min­is­tra­tion’s at­tempts to roll back health­care for peo­ple who strug­gle with ad­dic­tion. The Af­ford­able Care Act en­abled mil­lions of peo­ple to get treat­ment and health ser­vices, Smith said.

He praised the rec­om­men­da­tions to ex­pand ac­cess to med­i­ca­tion-as­sisted treat­ment and re­duce fear among those who need to call 911 in the case of an over­dose.

But there were sev­eral “glar­ing omis­sions” in the re­port, Smith said. They in­clude fail­ing to ad­dress the is­sue of the crim­i­nal­iza­tion of peo­ple who use il­licit sub­stances.

“The re­al­ity is that law en­force­ment, in a num­ber of places around the coun­try, are in­creas­ingly turn­ing to­ward mea­sures that re­crim­i­nal­ize over­dose,” Smith said. “… This is the ele­phant in the room that needs to be ad­dressed if we’re re­ally go­ing to make last­ing progress in re­duc­ing de­mand for sub­stances and re­duc­ing bar­ri­ers to treat­ment and other ser­vices and end­ing the opi­oid cri­sis.”

Dr. An­drew Kolodny, ex­ec­u­tive di­rec­tor and co­founder of Physi­cians for Re­spon­si­ble Opi­oid Pre­scrib­ing, said he would have liked to have seen more em­pha­sis on fed­eral fund­ing to help states tackle the opi­oid prob­lem.

“I be­lieve we need $60 bil­lion over 10 years to ad­dress this prob­lem,” Kolodny said. “I would have liked to have seen them call on the fed­eral gov­ern­ment to make an enor­mous in­vest­ment ex­pand­ing ac­cess to the most ef­fec­tive treat­ment for opi­oid ad­dic­tion.”

Kolodny, who is a re­searcher at Bran­deis Univer­sity and spe­cial­izes in opi­oids, said he was con­cerned that treat­ment cen­ters were be­ing re­quired to have cer­tain drugs that were not proved to be ef­fec­tive.

Kolodny said that bring­ing the opi­oid epi­demic un­der con­trol re­quired bet­ter reg­u­la­tion of pre­scribers and the com­pa­nies that make opi­oids.

The White House com­mis­sion has promised a fi­nal re­port lay­ing out ad­di­tional rec­om­men­da­tions but did not say when it would be fin­ished.

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