If opioid crisis is emergency, what’s next?

In August, President Donald Trump declared the opioid crisis “a national emergency,” but now he is being criticized for following up with little concrete action. In a day of appearances at opioid roundtables Friday in Columbus,

Trump’s acting drug czar didn’t even mention the declaration — at least not publicly.

Richard Baum, acting director of the Office of National Drug Control Policy, attended a closed event held by Ohio Attorney General Mike DeWine and then skipped out on a scheduled “media availability” with reporters. A little later, at a public roundtable held by the Franklin County Sheriff’s Department and the National Sheriffs’ Association, Baum spoke at length about “how serious the Trump administration is about the (opioid) problem.”

He mentioned a Trumpappointed panel led by New Jersey Gov. Chris Christie that recommended the emergency declaration and other measures that have yet to materialize. And Baum described efforts to limit new supplies of particularly lethal opioids that are coming into the country through the mail.

“There’s a lot happening to crack down on imported fentanyl,” said Baum, who leads an agency whose budget Trump proposed to cut by 95 percent in May.

The president later backed off the proposal and on Aug. 10 took a different tack.

“The opioid crisis is an emergency, and I’m saying officially right now it is an emergency. It’s a national emergency. We’re going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis,” he said.

Last week, Sherrod Brown of Ohio and 10 other Senate Democrats sent Trump a letter, urging the president to follow up on his declaration with real action. So far, they noted, Trump hasn’t acted on the Christie group’s recommendations other than to promise to declare a national emergency.

“He’s continued to make us think something’s going to happen,” Brown said after attending the sheriffs’ forum Friday.

DeWine, who is seeking the Republican gubernatorial nomination, said Baum did speak about the emergency declaration in the earlier, closed roundtable.

“He said the lawyers are looking at this and seeing how it can be done under the law,” DeWine said.

Meanwhile, at the sheriffs’ conference, law enforcement and other officials talked about their struggles to deal with an epidemic that is very much an emergency for them. Patrick Royal of the National Sheriffs’ Association said his group decided to help convene the first such session in Ohio, a state particularly hard hit by the crisis.

“If somebody has to start bringing people together, why not us?” he asked. “There’s hope that this will happen in other places.”

Some at the roundtable talked about the drain overdoses can have on rural-county sheriff’s offices, while others talked about the importance of getting treatment for addicts who end up in their jails.

Shruti Kulkarni, policy director for the Washington, D.C.-based Center for Lawful Access and Abuse Deterrence, said every dollar spent on such treatment avoids the need to spend $7 on criminal justice expenses. Others at the conference said that without supporting treatment, some medications for addiction can just push people into other illicit drugs.

Brown said it’s impossible to address the crisis without protecting the program that is by far and away the biggest government funder of addiction treatment in Ohio: Medicaid. Trump and most Senate Republicans are pushing a health-care bill that would deeply cut funding for the program, and contains no specific allocation for the opioid battle.

“To advocate cutbacks in Medicaid while you call this an emergency is sort of whistling past the graveyard,” Brown said.

He slammed U.S. Rep. Jim Renacci’s claim Thursday that there’s no evidence that Ohio’s Medicaid expansion, with its $650 million a year for treatment, is helping with the opioid crisis.

Noting that 200,000 Ohioans are getting treatment because of the expansion, Brown said, “Does Renacci just want to give up on them and that many lives in this state? It was a pretty hard-hearted thing to say.”

DeWine, who is running against Renacci and others for the GOP gubernatorial nomination, declined to comment on Renacci’s claim. But he said as governor, he would prioritize treatment.

As for the health bill in the Senate, DeWine said, “I don’t think anyone knows exactly what’s in the bill. And I’ve talked to several people who should know.”