President Donald Trump on Thursday moved to declare a public health emergency over the opioid epidemic — a drug overdose crisis that kills tens of thousands of Americans each year.
“As Americans, we cannot allow this to continue,” Trump said. “It is time to liberate our communities from this scourge of drug addiction.”
Trump directed the acting health and human services secretary, Eric Hargan, to declare a 90-day public health emergency through the Public Health Service Act and instructed other heads of federal agencies to prioritize the opioid crisis.
The move comes nearly three months after Trump’s opioid epidemic commission in July said that the president should “[d]eclare a national emergency under either the Public Health Service Act or the Stafford Act.” Senior administration officials said that they chose the Public Health Service Act because the Stafford Act is typically focused on natural disasters and specific geographic areas.
The declaration is limited, falling far short of the steps experts say is necessary to combat the crisis. But Lainie Rutkow of Johns Hopkins Bloomberg School of Public Health previously told me that it “could make a difference, or it could at least jump-start things that would then be helpful in the longer term.”
The main practical effect of the declaration is to waive regulations to speed up resources going to the opioid epidemic. Senior administration officials said Trump’s order will enable several specific moves:
- It will allow states to shift federal funds dedicated for HIV to also deal with opioid addiction. HIV and opioid use are linked, because HIV can spread through shared needles; Indiana, for example, suffered a big HIV epidemic as a result of opioid misuse.
- It will open up the Public Health Emergency Fund to help address the opioid crisis. But senior administration officials said Congress has not added money to the fund over the past few years, and USA Today reported that there’s only $57,000 remaining in it.
- It will let the Department of Health and Human Services staff up to deal with the crisis.
- It will let patients use telemedicine to get medication-assisted treatment, the gold standard of opioid addiction care, in which medications like buprenorphine and methadone are prescribed to treat addiction. This could help overcome a major hurdle in rural states hit by the crisis, such as West Virginia, which has the highest drug overdose death rate in the US. It can be difficult to get to a doctor capable of prescribing these treatments in these states.
- It will make National Dislocated Worker Grants available to people with opioid addiction. These grants are normally only available to victims of natural disasters.
Trump also announced “a new policy” to overcome an old rule that made it so federal Medicaid funds couldn’t reimburse services from inpatient facilities that treat “mental diseases,” including addiction, with more than 16 beds. Eliminating this barrier could let states open up more treatment options.
None of these steps are significant enough to solve the crisis or even make a big dent in it. Experts estimate that the crisis will take tens of billions of dollars to solve. (For reference, a 2016 study estimated the total economic burden of prescription opioid overdose, misuse, and addiction at $78.5 billion in 2013.) This will likely require action by Congress.
Senate Democrats on Wednesday unveiled a bill that would spend $45 billion over 10 years on the opioid epidemic. The extra money would go to funding prescription drug monitoring, improving doctors’ prescribing practices, expanding access to addiction treatment, and supporting other public health initiatives related to drug misuse and addiction, among other moves. But no Republican senators have signed on to the bill.
On November 1, Trump’s opioid commission is expected to release a final report on the crisis. It’s unclear just how many of the steps Trump and Congress will accept. For now, he’s accepted the commission’s first preliminary recommendation — and declared an emergency.
For more on the solutions on the opioid epidemic, read Vox’s explainer.