What National Emergency?

August 24th, 2017 by Trudy Henson

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Photo Credit: Nicholas Kamm/AFP/Getty Images

It’s been two weeks since President Trump said he considered opioid addiction a “national emergency” and was having papers drawn up to that effect. The announcement followed the recommendation of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, and was met with approval from the public health community, even as some debated what a declaration would mean in practical terms.

However, two weeks later, there has been no official declaration of an emergency, as the New York Times, among others, has pointed out. The difference is no small linguistic nuance: an official declaration sets into motion a number of options for response—including access to funding and enhanced coordination—that many states have deemed (at the state level) necessary for a comprehensive response.

States that have declared state-level opioid emergencies, including Maryland, have used the declaration to access funding, change prescription guidelines, and increase access to naloxone. Some, such as Arizona, have been able to improve access to real-time data to get a more comprehensive picture on daily overdose deaths and babies born dependent on opioids. Others have used the declaration to issue standing orders for Naloxone, to make it available to the public. (Easily accessible Naloxone, used to counteract an overdose, as well as free training on how to use it, is an increasing trend in areas hardest-hit with opioid addiction.) Maryland, after declaring an opioid emergency, established the Opioid Operations Command Center, which has been working to increase coordination among agencies, overcome information gaps, and educate the public on opioid addiction.

A national declaration of emergency works a little differently than a state-level declaration, as one commentator points out, but an official national declaration could impact the opioid response in critical ways, including opening several avenues of access to much-needed federal funding; potential deployment of public health workers; and waivers of certain requirements that could increase access to addiction medication and Medicare-funded treatment. In his speech two weeks ago, President Trump said “[they] were going to spend a of time, a lot of effort and a lot of money” on the opioid crisis, but his announcement did not include any specific plans.

Many initiatives, from education campaigns to novel treatment and legislative approaches, are making an impact on the opioid epidemic. But as public health and health care workers have found, and as states are finding, there is no easy roadmap to successfully and comprehensively addressing the epidemic that is projected to kill half a million Americans in the next decade. Substantively addressing the problem may be difficult and costly, but as the President’s own commission on opioid addiction pointed out, the first step is to “put the full weight of [the President’s office] behind this emergency” and properly declare a state of emergency.

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