Overdose deaths from opioid drugs are claiming more lives across the country than any other injury-related cause, easily surpassing traffic accidents and firearm-related deaths. The death toll from opioid overdoses reflects one of the most dire public health crises facing the nation today.
President Trump has promised to end the opioid overdose crisis, and he created a bipartisan commission headed by N.J. Governor Chris Christie (R) to come up with recommendations on how to do that.
{mosads}In July, the commission’s initial report to the president recommended that Trump declare the crisis a national emergency and boost the federal government’s public health response. Trump’s response to his commission’s report was that he would declare a national emergency. That was nearly three months ago and the president has yet to act.
Rather than seize upon his commission’s recommendations, Trump has seemed more inclined to embrace “strong law enforcement” and hardline approaches to drugs. The president’s first budget to Congress proposed boosting funding for law enforcement at the expense of treatment. The president’s first nomination for drug czar once advocated forcibly hospitalized in prisons anyone caught with a small amount of marijuana or other drugs.
The nominee, Tom Marino (R), recently withdrew from the nomination after revelations emerged that he helped spearhead passage of a law that limits the ability of the Drug Enforcement Administration to crack down on opioid drug distributors. Over at the Department of Justice, Trump’s attorney general, Jeff Sessions, has pursued a hardline drug war agenda that history assures will do more harm than good.
This crisis presents a dilemma for the president. For Trump to have any chance of success at rolling back this crisis, he must commit to a robust public health response from the federal government that boosts evidence-based health interventions at the state and local level. Many of Trump’s opioid commission’s initial recommendations supported this approach and should be implemented. But this kind of approach is something Trump has indicated he has been loath to do, given his track record on drug policy and health care.
Trump’s commission also urged the president to declare a national emergency. But Trump’s proclivity to favor hardline drug enforcement and tough rhetoric should give reason to worry what a declaration of national emergency would mean under this president. Congress will need to be vigilant against Trump and Attorney General Jeff Sessions taking additional steps to escalate the drug war in the name of fighting the opioid crisis.
It is true though that an emergency declaration could do some good to reduce red tape that hinders access to effective opioid treatments if properly executed. An emergency declaration could also allow the Trump administration to free up health money for the crisis, although it’s unclear if such funding adequately exists. Congress will likely have to deliver on any additional health funding for this crisis.
The Trump administration should also use an emergency declaration to eliminate barriers to opioid treatment and support cutting edge research. Trump should work with Congress to eliminate government red tape that has restricted access to methadone and buprenorphine forms of medication assisted treatment, which are considered by science to be the most effective therapy for opioid dependence but are too hard to access. The administration should also expand access to naloxone, the medication that rapidly reverses an opioid overdose, and look at ways to reduce the price of the drug.
The administration should prioritize research that looks at non-opioid therapies for treating pain, including medical marijuana, which evidence indicates can reduce opioid use and reduce overdose deaths when used as a medicinal substitute for opioid medications.
People are also less likely to overdose if they are informed about the drugs they are taking, which makes investment in drug checking kits that can help users detect fentanyl and other potent drugs critical to lowering the death toll.
With an emergency declaration, the Trump administration has an opportunity to chart a new course on the overdose crisis and reset its approach to drug policy. This will require Trump to put the public health arm of his administration to work on health approaches that are proven to succeed. Anything short of this will needlessly cost many more lives.
Grant Smith is deputy director of national affairs with the Drug Policy Alliance.