President Donald Trump last week made it official: Our battle against opioid addiction is now a national health emergency.
The declaration, which came on Thursday, wasn’t a particular surprise: Trump had hinted back in August that he thought addiction to and overuse of opioid drugs had risen to the level of an emergency, but this being Trump, you didn’t know for certain until last week’s speech. Trump’s declaration last week came in advance of the recommendations from the president’s commission on opioids, which will be released this week in a public report.
There’s little doubt, of course, that opioid addiction in the United States has reached the level of a full-fledged health crisis: Experts say opioid addictions and overdoses now kill more than 100 Americans every day. Oregon has not been spared.
The president said some good things in his speech, and many press accounts focused on the flashes of empathy he showed. (It says something about both Trump and the press coverage he’s attracted that anyone would find even touches of empathy newsworthy, but never mind.) Trump also spoke movingly about the struggles his brother Fred faced with alcoholism.
So, on one level, we have little doubt that Trump is serious when he says that “we can be the generation that ends the opioid epidemic. We can do it.”
And we could. But the declaration is just the start of that fight — and, in some ways, it’s mostly symbolic. The federal public health emergency Trump declared turns out to be a 90-day renewable measure that allows state and federal entities more flexibility in deploying anti-opioid resources. But, as The Atlantic noted in an article last week about the declaration, it looks better on paper than it does in real life: For one thing, the Public Health Emergency Fund has been virtually defunded for years — and remained so even after President Barack Obama requested its reauthorization after the Zika outbreak.
The Trump administration has broadly hinted that it plans to approach Congress for additional funding to deal with opioids, but we’ll see if this issue really becomes a priority — and we’ll see to what extent Congress is willing to fund the issue.
Trump already has endorsed some of the proposals from his commission, including relaxing rules requiring in-person doctor’s appointments for medication-assisted drug abuse treatment, requiring special training for prescribers and providing substance-abuse technical assistance to states. Those proposals have promise.
Trump also endorsed some initiatives already under way, including a private-public partnership to develop nonaddictive alternatives to opioids. Trump also mentioned initiatives to rethink how we manage pain, including one effort focusing on research on pain management for service members and veterans. All that sounds promising. But these programs won’t amount to much unless they come with adequate funding.
There are other cautionary signs to heed here: Outside these proposals, other administration initiatives — such as the work underway in the Justice Department to revitalize the generally failed federal war on drugs — would seem to run counter to Trump’s efforts to offer treatment to those in the throes of addiction. And the president’s efforts to tout what appeared to be a renewed “Just Say No” public-outreach campaign would be almost charmingly naive, if the stakes weren’t so high.
In addition, efforts to gut the Affordable Care Act, which expanded the reach of programs to treat addiction, may prove devastating to the rural areas that have been among the hardest-hit by opioid addiction.
But it may be too much now to ask for a coherent strategy, on any topic, from this administration. For the moment, the initiatives Trump outlined last week show promise. But the president and members of his administration need to follow through on that promise.