WASHINGTON—President Donald J. Trump’s commission on the opioid crisis asked him on Monday to declare a national emergency to deal with the epidemic.
The members of the bipartisan panel called the request their “first and most urgent recommendation”.
Trump created the commission in March, appointing Gov. Chris Christie of New Jersey to lead it. The panel held its first public meeting last month and was supposed to issue an interim report shortly afterward but delayed doing so until now. A final report is due in October.
“With approximately 142 Americans dying every day, America is enduring a death toll equal to September 11 every three weeks,” the commission members wrote, referring to the 9/11 terrorist attacks. “Your declaration would 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.”
In addition to seeking an emergency declaration, the commission proposed waiving a federal rule that sharply limits the number of Medicaid recipients who can receive residential addiction treatment.
It also called for expanding access to medications that help treat opioid addiction, requiring “prescriber education initiatives” and providing model legislation for states to allow a standing order for anyone to receive naloxone, a drug used to reverse opioid overdoses.
Some public health experts said the main effect of declaring an emergency would be to make Americans regard the epidemic more urgently.
“It’s really about drawing attention to the issue and pushing for all hands on deck,” said Michael Fraser, the executive director of the Association of State and Territorial Health Officials. “It would allow a level of attention and coordination that the federal agencies might not otherwise have, but in terms of day-to-day lifesaving, I don’t think it would make much difference.”
The governors of Arizona, Florida, Maryland and Virginia have declared states of emergency regarding the opioid addiction crisis; in Alaska, Gov. Bill Walker has issued a disaster declaration.
In addition to Christie, the members of the commission are Gov. Charlie Baker of Massachusetts (a Republican), Gov. Roy Cooper of North Carolina (a Democrat), Patrick Kennedy, a former congressman from Rhode Island (a Democrat), and Bertha K. Madras, a Harvard Medical School professor who specializes in addiction biology.
Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention during the Obama administration, said declaring a public-health emergency under the Stafford Act, as the commission recommended, was usually reserved for natural disasters, like hurricanes.
“This is not a natural disaster; it’s one caused by overprescription of opiates and flooding of illegal opiates into the country,” Frieden said. “The critical measures for reversing the opioid epidemic are improving prescribing and increasing interdiction of illicit opioids.”
Gary Mendell, the founder and chief executive of Shatterproof, an anti-addiction advocacy group, said an emergency declaration would be “a significant first step toward acknowledging the severity of the crisis we face and the urgent need for action, including national emergency funding and suspending regulatory hurdles that limit our ability to save lives”.
Cooper said in a statement that he considered the report “incomplete when it comes to making sure all Americans have access to affordable health care, which includes mental-health and substance-abuse treatment”. He added, “I urge the commission to make a stronger stand on the accessibility and affordability of health care.”
Meanwhile, Chicago now gives at-risk inmates the overdose-reversing drug naloxone upon their release from jail, and Los Angeles is poised to follow suit, putting the antidote in as many hands as possible as part of a multifaceted approach to combatting the nation’s opioid epidemic.
The Cook County Jail in Chicago, which is the largest single-site jail in the country, has trained about 900 inmates how to use naloxone nasal-spray devices since last summer and has distributed 400 of them to at-risk men and women as they got out. The devices can undo the effects of an opiate overdose almost immediately and are identical to those used by officers in many of the country’s law-enforcement agencies.
Sheriff Tom Dart, whose office runs the jail, said addicts are most at-risk of fatally overdosing in the two weeks after getting out because of their time away from drugs while locked up.
“We’ve got to keep them alive [and] if we can get them through that two-week window, they might get treatment, get off drugs,” he added.
Dr. Connie Mennella, the chairman of Correctional Health for the county’s health and hospitals system, which administers the program, said only inmates are being trained to use naloxone, but she eventually hopes their relatives and friends can also be trained.
“We are trying to saturate this community with this drug, and we are educating them to tell their buddy, mother, father how to use it, where they keep it and, ‘If you come home and see me not responding, to go get it and use it,’” she said.
Proponents say such jail programs can be the difference between a former inmate living and dying, as the naloxone often can be administered by an overdosing addict, a friend or family member before emergency responders can reach them.
And Dr. Arastou Aminzadeh, the correctional health-medical director for the Los Angeles County Department of Health Services, said the kits are particularly important for just-released inmates because the same amount of drugs they once used to get high before they were locked up could now kill them.
“Their threshold has dropped but they may use the amount of drugs they used to use,” said Aminzadeh, who is helping Los Angeles jails prepare to begin its naloxone program early next year.
It is too soon to gauge the effectiveness of Cook County’s program, but Dart said anecdotal evidence suggests that the kits have saved lives, including a man who was arrested again, returned to jail and told of how a friend he had trained to use the kit had done so when he overdosed.
New York Times News Service and AP
Image credits: AP/G-Jun Yam