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Trump addresses opioid crisis by declaring 90-day public health emergency.

President orders 90-day public health emergency

- By Noam N. Levey noam.levey@latimes.com

WASHINGTON — President Donald Trump made sweeping new promises Thursday to mobilize the federal government against the deadly opioid epidemic, but his language contrasted sharply with an order that stopped well short of a major new commitment of resources for a crisis that last year killed more than 64,000 Americans.

Although Trump directed the U.S. Department of Health and Human Services to declare a limited 90-day public health emergency, he declined to declare a broader national emergency or ask Congress to fund any expansion in treatment or insurance coverage for Americans struggling with addiction.

Senior administra­tion officials say they hope Congress will provide more funding in a spending bill later this year, though officials would not say how much money the White House is seeking.

Speaking at the White House on Thursday, surrounded by the families of Americans touched by the epidemic, Trump insisted he is committed to an unpreceden­ted new effort to take on the spread of opiates, including heroin, prescripti­on painkiller­s and dangerous synthetic drugs such as fentanyl.

“We cannot allow this to continue. It is time to liberate our communitie­s from this scourge of drug addiction,” the president said in a lengthy address. “We can be the generation that ends the opioid epidemic.”

Trump, who campaigned extensivel­y on the issue last year, has been under pressure for months to step up the federal government’s response. He has been promising since summer that he would declare an emergency, a technical step that can free up funding and loosen regulation­s.

The new order will allow some limited new steps, such as enabling patients in rural parts of the country to access medication for addiction treatment through telemedici­ne, administra­tion officials said.

The order also should allow federal agencies to redirect some existing grant money to focus on opioidaddi­cted patients.

And it may make it easier for state Medicaid programs to pay for inpatient treatment for people with substance abuse disorders, a practice that was restricted decades ago amid widely publicized abuses at many institutio­ns.

But many public health officials have been urging the White House to take more aggressive steps in response to an epidemic that is killing more people than AIDS did at the height of that crisis.

The need for treatment remains enormous, with just 1 in 10 addicted Americans getting specialty treatment, according to the U.S. surgeon general.

Although Congress appropriat­ed some additional funding last year, most state leaders, public health officials and addiction specialist­s say much more is needed. “We certainly agree that it is a health emergency, and anything that highlights the problem is helpful,” said Dr. Joe Parks, medical director at the National Council for Behavioral Health. “If we want to take care of this epidemic, we need more health insurance coverage, not less.”

The administra­tion still doesn’t have a permanent Health and Human Services secretary or a director of the Drug Enforcemen­t Administra­tion, and Trump’s pick for drug czar, Rep. Tom Marino, R-Pa., recently withdrew his nomination.

At the same time, the Trump administra­tion has worked for most of the year to roll back the Affordable Care Act, which has helped many states expand treatment for patients with a substance abuse disorder.

Republican plans to repeal the 2010 law, often called Obamacare, would have cut hundreds of billions of dollars of federal health care aid to these states and others.

Trump stressed Thursday that his administra­tion has already taken steps to bolster the federal response to the opioid crisis.

Trump also ticked off other efforts his administra­tion is taking, including prosecutin­g drug trafficker­s, educating physicians about how to safely prescribe opioids and supporting research into nonaddicti­ve pain medicines.

This week, Food and Drug Administra­tion Commission­er Scott Gottlieb said his agency plans to encourage wider use of medication­s such as methadone and buprenorph­ine to treat patients with opioid addiction. These so-called medication-assisted treatments continue to be stigmatize­d in many places.

It remains unclear what effect Trump’s new order will have on the crisis.

His administra­tion has pushed unpreceden­ted cuts in federal aid to states for their Medicaid programs.

In recent years, funding made available through the Affordable Care Act has allowed states including Ohio, West Virginia and Kentucky to open Medicaid to poor, working-age adults, a population often most likely to face substance abuse issues.

 ?? ALEX WONG/GETTY IMAGES ?? President Donald Trump signs an order allowing limited new steps in the opioid crisis.
ALEX WONG/GETTY IMAGES President Donald Trump signs an order allowing limited new steps in the opioid crisis.

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