By not including funding, Trump falls short in response to opioids
President Donald Trump’s declaration that the opioid crisis is a national public health emergency fell far short of a robust response to the problem. While it clears the way for states to take some additional steps to address the escalating toll from prescription painkillers and other drugs, the move doesn’t bring with it significant money for more treatment or relax federal rules that could open the door to adding more slots in drug rehabilitation facilities. The administration needs to provide more leadership and work with Congress to find the billions of dollars necessary to confront a national epidemic that is killing 175 people aday.
More opioids are consumed in America than anywhere else, and enough were prescribed in 2015 to accommodate every American around the clock for three weeks, federal figures show. The death toll from opioid abuse has risen to 64,000 Americans last year from 52,000 in 2015, with 4,000 of those deaths in Florida. The number of opioid overdoses has quadrupled since 1999, and some 27 million people are reported to be using prescription or illegal drugs.
The nation is awash with narcotics, and the substance-abuse treatment system is in no shape to handle the caseload. That’s what makes Trump’s pronouncement last week so disappointing. It needed to be the first step toward serious action this year.
The declaration clears the way to shift grant money from some existing public health efforts to fight opioid abuse, permits the hiring of specialists to address the problem and expands the use of telemedicine so services are more available in remote areas. But the designation brings no new money, leaving the nation’s public health emergency fund with a paltry balance of $57,000.
The administration rejected calls to declare the crisis a full-blown national emergency, which a commission that Trump appointed urged him in July to do, and which Trump had suggested he would agree to make happen. Explaining the move, the White House said the opioid crisis was a long-term problem that should not be treated like a hurricane or other immediate disaster. While a national declaration would have made cash available now, the designation matters less than the resources the government will bring to bear.
Advocates say it will cost tens of billions of dollars to expand substance abuse programs to the necessary level. Only one in 10 of those addicted receives any kind of treatment, thanks to a lack of services and cost barriers to those without an ability to pay. The government should remove an existing policy that prevents Medicaid from paying the costs at larger inpatient treatment facilities. It needs to crack down on the import of fentanyl, a cheap and potent synthetic drug, and get the drug naloxone, which counteracts overdoses, into the hands of more first responders.
The Trump administration says it will lobby Congress for a new appropriation as part of an end-of-year budget deal. But that remains to be seen, and officials would not commit to a dollar amount.
This epidemic has left few families and no corner of the nation untouched, and any effort to curb it will require money, a focused national strategy and a sustained commitment to carry it out.