Trump Declares Opioid Crisis a National Public Health Emergency
The opioid crisis within the United States has been growing for well over a decade. Finally, as it has begun to reach unprecedented proportions President Trump has decided to declare the opioid crisis a national public health emergency. During his address on October 26th, President Trump directed the federal government to “use every appropriate emergency authority” to tackle the issue.
The issue at hand is the fact that the opioid crisis has gradually grown into a significantly deadly situation over the past decade. According to the Centers for Disease Control there were over 64,000 fatalities due to drug overdoses in 2016. While not all of those deaths were due to opioids, a large majority of them are. Opioids like oxycodone, hydrocodone and fentanyl are widely recognized as the main culprit to the continued and unwavering increase in overdose deaths year after year as more and more people become addicted to them.
The national public health declaration will allow for an increase in the amount of effort and resources that the executive branch of the government is able to commit towards stopping this issue, however it is notable that Trump did not declare the opioid crisis a national emergency as many experts have been calling for. The difference is that a national emergency would have opened up the ability to use federal Disaster Relief Fund resources to help finance any form of solution.
Still, while the recent declaration by the President shows that Washington is at least aware of the issue at hand, a deep understanding by the executive branch on how to solve the opioid crisis is speculative at best.
Origins of the opioid crisis
While fatal overdoses have risen for all forms of opiates, including heroin, most experts point to prescription opioids as the biggest factor in the recent rise of opiate addiction across the country. Prescription opioids like oxycodone (Percocet, Oxycontin) and hydrocodone (Vicodin) are often the gateway many people enter on their perilous journey into opiate addiction. Whether obtained legally in the form of a prescription from a doctor, or from the medicine cabinet of a family member or a close friend, these pain killing medications have a very high potential for addiction and are widely prescribed across the country.
The abundance of these addictive opioids, as well as the ease in which they can be acquired, has gradually placed more and more Americans into situations where they find themselves helplessly addicted to prescription opiates. After more than three decades of widespread prescribing of these medications, it is estimated that over 2 million Americans now regularly use some form of opiate. In fact, while the United States only has around 4.4 percent of the total global population it is estimated that we use around 80 percent of the total opioid supply in the world. This single figure alone highlights how dependent our society has become on pain killing medications.
The problem which led from widespread use of opioids to a full blown opioid crisis has to do with just how addictive these substance can be. Not only do prescription opioids have the potential to cause serious physical dependence, which can lead to uncomfortable withdrawal symptoms if someone stops taking them, but they can also be extremely psychologically addictive. Many times after a person either takes prescription opioids for either a legitimate medical condition or recreationally after getting them from a friend or family member, they can become addicted. After the prescription runs out many times people will turn to street drugs like heroin to continue to feed their addiction because often times it is not only easier to acquire but cheaper as well.
The continued widespread use of these prescription opioids is essentially creating more addicts with every passing day. Unfortunately the way that out healthcare system is currently constructed, it is much easier to become addicted to opioids than it is to be successfully treated for an addiction to them. This, which is the crux of the issue in the overall opioid crisis, has been going on for over a decade and leaves us where we are today; Millions of Americans struggling with an addiction to opioids without widespread access to treatment. It is because of this fact that people are dying, because the sad fact about opioid addiction is that when left untreated it is often times fatal.
What will the declaration of a national public health emergency accomplish?
Exactly what President Trump’s recent declaration that the opioid crisis is a national public health emergency will accomplish is yet to be known. According to PolitiFact there are a few things which the declaration outlined for the federal government to begin to take action on:
- Temporary appointments of specialized personnel to assess and address the emergency
- Allow for the Drug Enforcement Administration to expand telemedicine access for patients in the treatment of addiction
- Create new flexibilities within the HIV/AIDS program
President Trump also made vaguer statements alluding to increasing the availability of treatment to many be repealing certain restrictions which apply to treatment centers which keep them from offering care to more clients. He was most likely referencing the fact that current law states that federal Medicaid funding cannot be used in mental health facilities with more than 16 beds. This was later confirmed in a tweet by Trump.
As stated before, actions like these are certainly a step in the right direction. At the very least it is promising that the head of the federal government is taking notice of the fact that the opioid crisis is something that needs to be addressed not and not later. However, it seems that Trump and many of his fellow Republicans have been unwilling to make more than tiny steps towards actually doing what is going to be required if we are to make a significant dent in this issue. Small tweaks to existing laws and practices are not going to suffice, what’s required is a fundamental and drastic shift to the way we utilize healthcare and treat the disease of addiction in this country. Unfortunately, that is going to require a significant investment on the part of not only the federal government but the individual states as well. With Republicans holding control over much of the federal government however, increased spending is something that is likely going to be hard to come by.
Why haven’t we fixed the issue yet?
While the issue of the opioid crisis has been known to some for quite a while now, it has only begun to enter into the national conversation within the past year or two. Now that it is being covered in the national media with regularity, what is becoming apparent is the fact that perhaps the biggest hurdle to overcoming this issue once and for all is the stigma behind addiction itself and the fundamentally incorrect notions this creates about how to overcome it.
Recently Trump called for “really tough, really big, really great advertising” in order to “teach young people not to take drugs.” This is certainly a nice sentiment, however if it sounds somewhat familiar you’re not wrong. This is very similar to the Reagan era campaign to “Just say no” to drugs which was pushed on the American public during the height of the crack epidemic. Crack eventually faded from being a national epidemic, but what didn’t was addiction in general. The reality of the situation is that the real fight against the opioid crisis is not with opiates but with addiction itself. What was once written off as nothing more than a lack of will power and a moral failing is now widely agreed upon as a specific mental health disease. Just like any other disease, the answer to overcoming it is specific medical treatment.
While Trump and his administration seem to be publically taking steps, however minimal, to address this issue. It is concerning that a lot of the rhetoric surrounding the opioid crisis is still based on old ideas about the nature of addiction. Many people still believe that addiction is a choice that individuals choose to make rather than a disease, while this has essentially been disproven the idea still persists throughout a significant portion of the population. This may explain why many are still reticent to commit the amount of money that solving this opioid crisis is going to require, insisting that those suffering, and dying, from the disease have gotten themselves into the situation and should deal with the consequences.
How do we solve the opioid crisis?
The opioid crisis is something that has not come about because of one simple issue, nor has it popped up overnight. Because of this, the solution to the issue is similarly complex and will not take place immediately. The real solution is going to come from a concerted and long term effort on the part of multiple institutions like the federal government, state governments, private healthcare providers and most importantly the American public.
There are two keys to addressing the issue, both with complex answers:
- Significantly reduce the number of new opioid addicts – This is not going to occur with “Just say no” campaigns. While some new addicts come from recreational use of these drugs, a significant portion come in the form of people who are legally prescribed the medications from doctors. While there are certainly situations where pain killers can be very useful tools at a doctor’s disposal, many in the healthcare industry have recently begun to admit that the prescribing of pain killers during the 90s and 2000s was excessive. Stricter prescribing regulations for opiates would help to reduce the overall number of new opioid addicts in two ways. Not only would it lessen the number of those who are prescribed the medications legitimately, but it would also reduce the amount of opioids on the black market which are often times obtained when a person either does not finish their prescribed amount or obtains the prescription under false pretenses.
- Drastically increase the availability of effective addiction treatment – While the above may help to reduce the number of new addicts, the fact is that there are millions of Americans who are struggling with addiction already. Prophylactic policies and changes will not cure them of their addiction, the only real possibility for help here is by providing them with quality and effective addiction treatment. Currently there are thousands of addiction treatment centers across the country, however many of them either accept only private insurance, which many addicts to not have, or cost considerable amounts of money, which many addicts cannot afford. There are state funded and community funded treatment programs however which can provide reasonably adequate care for little to no cost. The issue is that there are simply not enough of them and they lack the funding to offer more modern and effective forms of care. The good news here is that this issue can be fixed rather easily, at least in theory. All it would take is money, however right now it seems like that is something that the federal government is simply not willing to part with to fix the issue.