Physicians, policy experts, and health consultants reacted positively to the news of the Trump administration’s decision to declare the opioid epidemic a national emergency. But what the President does next will determine how successful his efforts are, they suggested.
“The opioid crisis is an emergency … 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,” the president told reporters Thursday afternoon, two days after his administration declined to issue such a declaration.
But how the paperwork is drawn will determine what happens next, said Tom Coderre, a senior adviser at Altarum, a nonprofit health system, speaking of Trump’s actions.
Trump could employ either the Public Health Service Act or the Stafford Act to implement the protocols of a national emergency, explained Coderre, who served as senior advisor to the administrator at the Substance Abuse and Mental Health Services Administration (SAMHSA) under former president Obama, and has been in long-term recovery since 2003.
By declaring a national emergency under the Public Health Services Act, Coderre said, Trump could take the following actions:
- Make grants, establish contracts and conduct investigations
- Waive or modify certain requirements for Medicaid, Medicare and CHIP, and HIPAA Privacy Rule
- Modify drug pricing (e.g., use wholesale acquisition costs)
- Deploy the Public Health Services Corps
- Access “no year funds” that are available for an indefinite time period without fiscal limits
But the president would have fewer of these options under the Stafford Act and it’s not clear which direction he’s headed, Coderre added.
On July 31, the Commission on Combating Drug Addiction and the Opioid Crisis, chaired by Gov. Chris Christie (R-N.J.), issued an interim report that said a national emergency declaration would allow the government to “use every tool at our disposal to prevent further American deaths.”
The report called for mandatory prescriber education about opioids prescribing, and recommended more funding for medication assisted treatment (MAT) and to require it at every licensed treatment facility.
It also encouraged the president to direct funding to improve data sharing among state-based prescription drug monitoring programs and to develop and distribute fentanyl detection sensors to law enforcement agencies.
And the commission urged…