- President Donald Trump on Thursday declared the opioid crisis a national public health emergency, a step down from the national emergency he said he would declare more than two months ago.
- The order will loosen some regulations, allow states to be more flexible with how they spend federal dollars and increase telehealth addiction treatment efforts. It does not, however, provide any immediate new funding, and Trump did not ask Congress for emergency funding.
- Industry groups and public health officials generally praised the declaration as a step in the right direction, but acknowledged that opioid misuse is a massive problem for the country that will require significant efforts — and resources — to overcome.
More attention has come recently to opioid addiction and overdose as the epidemic has reached a staggering toll. Nearly 100 people in the U.S. die every day from an opioid overdose, according to the Centers for Disease Control. Addressing the issue will require coordinated efforts from providers, payers, drug companies, pharmacists and community support groups.
Healthcare professionals are eager to see this action toward easing the opioid crisis, but they note the Trump administration is pursuing budget cuts elsewhere that could hamper progress. The president’s proposed budget would cut Medicare and Medicaid by nearly $2 trillion.
Those who criticized the emergency declaration as not doing enough said they would like to see a more concrete plan for addressing the epidemic. It’s a concern Joshua Sharfstein, associate dean at Johns Hopkins’ Bloomberg School of Public Health, expressed earlier this year. “You need both a strategy and a mechanism to really accomplish it, and right now they just seem to be in a bit of a holding pattern,” he told Healthcare Dive.
The order also does not specifically mention naloxone, a drug that can reverse overdoses. Policy experts have suggested the federal government could negotiate lower prices for naloxone to expand its availability.
The American Hospital Association said it applauds the order, and would like to see a change to the Medicaid Institutions for Mental Disease exclusion, which bars Medicaid from paying for care at mental health and substance use disorder residential treatment facilities with more than 16 beds.
Progress in lowering the death toll from opioid misuse will be difficult for many reasons. The profit available from opioid pain relievers has led to feet dragging (or worse) by some who have a role to play in controlling the crisis.
Recent reporting from ProPublica and the New York Times found insurers restricting access to pain relievers that are safer and less-addictive than opioids because the alternative drugs cost more. Prescribers across the country have been caught selling prescriptions without patient consults. There are also doctors who are not acting criminally but fail to perform due diligence in the face of a patient who may be doctor shopping, as well as those who do not pursue safer treatment options that could be just as effective.
There are also some bright spots, though. Intermountain recently launched a plan to cut opioid prescriptions by 40% by the end of next year. The health system is training prescribers, exploring alternative pain management techniques and educating patients on proper disposal of medications.