One of the silver linings in President Donald Trump’s first budget blueprint was the supposed addition of $500 million in fiscal year 2018 to fight the opioid epidemic. Finally, it seemed, Trump was living up to his promise to “expand treatment for those who have become so badly addicted.”
We now know, however, that Trump’s budget blueprint line on opioids was misleading — and Trump is not, in fact, proposing an increase in drug treatment spending above funding that already exists.
The budget blueprint promised “a $500 million increase above 2016 enacted levels to expand opioid misuse prevention efforts and to increase access to treatment and recovery services to help Americans who are misusing opioids get the help they need.”
It turns out that the $500 million referenced in this line is actually funding that was already approved by Congress and President Barack Obama — not Trump — late last year in the 21st Century Cures Act. That law added $1 billion for drug treatment over two years — $500 million in the current fiscal year (2017) and $500 million in the next fiscal year (2018). Trump played no role in this additional funding.
Asked by US Rep. Katherine Clark (D-MA) about this, Health and Human Services Secretary Tom Price confirmed that’s the case. “I think the $500 million is the $500 million from the Cures Act,” Price said. “Yes, ma’am.”
I previously asked Trump administration officials if this was the case, but I got no straight answers. Now we have confirmation — an indication that Trump really may not do much more on one of the biggest public health crises facing America today, even as drug overdoses now kill more people annually than cars or guns.
So far, Trump is all talk, no action on opioids and drug treatment
The news is telling: It suggests that despite Trump’s promises on the campaign trail, he won’t, based on his planned budget and other actions, spend more on drug treatment to deal with the opioid crisis.
But there’s a case to be made for more spending. According to 2014 federal data, at least 89 percent of people who met the definition for a drug abuse disorder didn’t get treatment. Patients with drug use disorders also often complain of weeks- or months-long waiting periods for care. (Even Prince, a rich superstar musician, couldn’t access care quickly enough — and died as a result.) More spending could help alleviate these gaps.
Trump on Wednesday rolled out a commission, headed by New Jersey Gov. Chris Christie, that may in part evaluate whether some federal funding streams could be redirected to address the crisis. But it remains unclear whether the commission will actually do, well, anything. It will put out a preliminary report in three months and a final one in the fall with its findings, and it will then be up to the Trump administration to decide whether to put those recommendations into effect.
What we do know is that Trump’s budget won’t increase drug treatment spending. We also know Trump has proposed $100 million in cuts to the Substance Abuse and Mental Health Services Administration’s mental health block grants, which could ultimately impact some addiction services. And we know the health care reform bills that Trump has supported could cut as many as 2.8 million people with drug use disorders from their health insurance.
This is the reality of Trump’s policy on opioid epidemic: a lot of talk, but so far very little, even negative, action — as tens of thousands of people die of overdoses every year.
For more on the opioid epidemic, read Vox’s in-depth explainer and visual explainer.