Health Care

Trump to declare opioid epidemic a national emergency

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President Trump on Thursday said he is drafting paperwork to declare the opioid epidemic a national emergency.

“The opioid crisis is an emergency, and I’m saying officially right now it is an emergency,” Trump said. “It’s a national emergency. We’re going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis.”

Trump made the announcement during an appearance Thursday outside his Bedminster Golf Club in New Jersey, where he is on a 17-day vacation. When pressed by reporters on whether he needs emergency powers, Trump said, “We’re going to draw it up, and we’re going to make it a national emergency.”

“It is a serious problem the likes of which we have never had. You know when I was growing up, they had the LSD and they had certain generations of drugs. There’s never been anything like what’s happened to this country over the last four or five years. And I have to say this in all fairness, this is a worldwide problem, not just a United States problem. This is happening worldwide. But this is a national emergency, and we are drawing documents now to so attest.”

A few hours later, the White House in a statement said Trump has “instructed his administration to use all appropriate emergency and other authorities to respond to the crisis caused by the opioid epidemic.”

Declaring a national emergency was the “first and most urgent” recommendation from an interim report released last week from a White House commission tasked with helping curb opioid abuse.

So far, six states have declared statewide emergencies for the opioid epidemic and used the declaration to help increase access to the opioid overdose reversal medication, naloxone.

But declaring a national emergency for drug abuse is new territory for the federal government.

“I think that the important message when we’re talking about the federal level is there really is not a lot of precedent for a federal declaration for a non-communicable health condition,” Lainie Rutkow, an associate professor at Johns Hopkins Bloomberg School of Public Health, said.

“That means, I can tell you what I think might happen, but I can’t point you to the model because we haven’t really seen this before.”

There’s a few routes Trump could take.

He could declare a national emergency under the Stafford Act, which is usually reserved for natural disasters or terror attacks.

Or Health and Human Services Secretary Tom Price could declare an emergency under the Public Health Service Act, typically used for infectious diseases like Zika. The administration could also do both, Rutkow said.

“In theory, funds are available under both,” Rutkow said, “but funds are limited.”

Several sources pointed to the message a national declaration sends.

“A state of emergency declaration for the opioid crisis might feel good, but the truth is that declaring a Stafford Act emergency — the same way we do for storms or terror attacks — would be mostly symbolic,” Rafael Lemaitre, a former FEMA director of public affairs, wrote in an email.

Of a public health emergency declaration, “remember – the opioid crisis requires both a public health AND public safety response, and HHS isn’t equipped to seamless[ly]l oversee and direct prosecutions, DEA investigations and border security,” wrote Lemaitre, who also served as a communications director for the White House’s drug policy office.

Trump’s declaration could allow for the easing of some rules and regulations, but there’s a limited amount of money in the public health emergency pot, said Richard Frank, who previously served as the HHS’s assistant secretary for planning and evaluation. He is now a professor of health economics at Harvard Medical School.

There’s a lot of “paperwork and a lot of reporting” for a public health emergency, since they must be re-authorized every 90 days, Frank said.

Some advocates applauded the decision, such as Patty McCarthy Metcalf, executive director of Faces and Voices of Recovery. But she urged that Trump’s action be more than a communication tool.

“We need help,” she said. “We need resources. We need financial resources, regulations and policies that help.”

According to the interim report, a national declaration would allow the HHS secretary to negotiate a cheaper price for naloxone.

The purpose of such a declaration, the report said, would be to “empower your Cabinet to take bold steps and would force Congress to focus on funding and empowering the Executive Branch even further to deal with this loss of life. It would also awaken every American to this simple fact: if this scourge has not found you or your family yet, without bold action by everyone, it soon will.”

On Tuesday, Trump received a private briefing on the opioid crisis with administration officials and advisers.

In brief comments before that meeting, Trump vowed an intense effort on opioids, saying he would work with law enforcement inside and outside of the country against “drug dealers that poison our communities.”

After the briefing, Price indicated that the administration would not declare the opioid epidemic a national emergency, saying the White House already is empowered with the resources to help address the problem.

Price said other national emergencies for public health have been focused on a “time-limited problem, either an infectious disease or a specific threat to public health.”

– This story was updated at 6:24 p.m.

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