W

ASHINGTON — President Trump will instruct the Department of Health and Human Services to declare the opioid crisis a public health emergency, the administration said Thursday.

It is a major step in combating the drug epidemic and a major follow-through on a longstanding presidential promise. But White House officials were quick to caution that the administration’s response won’t end with the declaration, with a number of new rules and actions expected to be issued in the coming weeks.

As of Thursday: What does the emergency declaration entail?

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What’s in it

Telemedicine: The administration said a regulatory change would allow for the prescription of “medicine commonly used for substance abuse or mental health treatment” via telemedicine. Addiction experts have said that would be a major step toward allowing individuals in rural areas with substance use disorder to access care.

Personnel: The declaration allows HHS, and states with governors who request it, to “make temporary appointments of specialists with the tools and talent needed to respond effectively” to the crisis.

Labor grants: In a move it said is “subject to available funding,” the White House will instruct the Department of Labor to issue “dislocated worker grants” to those displaced from the workforce due to the opioid crisis.

HIV/AIDS resource shifts: The administration said it would shift resources within existing programs aimed at delivering HIV/AIDS care to better serve those with both HIV/AIDS and substance use disorder.

What’s not

Money: The emergency declaration relies on a public health emergency fund that, according to HHS, currently is worth only $57,000. Senior administration officials said they expected the opioid crisis to figure heavily into ongoing budget negotiations and a spending bill Congress must pass by December, but declined to specify a dollar figure.

IMD exclusion: The emergency declaration does not change a law that treatment advocates have criticized as creating a bottleneck for delivering some addiction care — a ban on Medicaid reimbursements for treatment facilities with more than 16 beds. The administration could change the rule in the future, or Congress could take up already-introduced legislation that would eliminate the restriction.

Increased access to overdose reversal drugs: White House officials did not discuss efforts to make overdose reversal drugs like naloxone more widely available on Thursday morning. Advocates had hoped for funding, a form of drug price negotiation, or access to the Centers for Disease Control and Prevention’s Strategic National Stockpile to allow local governments and health providers to distribute more of the drugs.

Changes to privacy and patient information laws: The action on Thursday will not address privacy laws that some experts say prevent doctors from prescribing opioids with the best available information, either via regulatory changes or the endorsement of a bill currently before Congress.

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  • “Our people are dying. One hundred seventy-five people a day, every day, are dying in the United States from this (opiod) epidemic,” said commission chairman Gov. Chris Christie of New Jersey, one of five politicians who served on (Trump’s) six member panel.

    “If a terrorist organization was killing 175 Americans every day on American soil, what would you be willing to pay to make it stop? I think we’d be willing to do anything and everything to make it stop. And that’s the way we now need to see this, because this is an attack from within. We are killing ourselves.”

    Oh, really?

    The NIH estimates that nearly 34 percent of U.S. adults can be classified as “obese,” meaning they have a body mass index of more than 30. By this standard, a man who stands 5-foot-11, Christie’s reported height, would be obese if his weight reached 215 pounds. While Christie does not disclose his weight, it appears to exceed the 286 pounds that would place him among the 5.7 percent of American adults whom NIH classifies as “extremely obese.”

    https://www.washingtonpost.com/opinions/chris-christies-big-problem/2011/09/29/gIQAAL7J8K_story.html?utm_term=.26746c6da25d

    “According to the National Institutes of Health, obesity and overweight together are the second leading cause of preventable death in the United States, close behind tobacco use. An estimated 300,000 deaths per year are due to the obesity epidemic.”

    https://www.wvdhhr.org/bph/oehp/obesity/mortality.htm

    That’s 822 per day… almost FIVE TIMES as many as all opiod users… both legitimate and illegal, and Chris Christie is in that group.

    Would it not be equally fair to use the Governor’s own words to refer to the obesity epidemic, by merely changing the number of “victims” from 175 to 822? Let’s try it:

    “Our people are dying. Eight hundred twenty-two people a day, every day, are dying in the United States from this (obesity) epidemic,”

    “If a terrorist organization was killing 822 Americans every day on American soil, what would you be willing to pay to make it stop? I think we’d be willing to do anything and everything to make it stop. And that’s the way we now need to see this (obesity problem), because this is an attack from within. We are killing ourselves.”

    Is there anybody in Trump’s Whitehouse who can see the flaws in this thinking? Even if you take the 175 people a day who are allegedly dying from the “opiod epidemic,” how many of them do you suppose are long term chronic pain sufferers who have a long history of successfully managing opioid useage in a responsible manner, and how many are likely to be junkies making Fentenal tea, injecting heroin, or buying legitimate opioids illegitimately on the street with no medical supervision? Even if chronic pain sufferers had to choose between a long life of constant misery or a shorter life with at least enough pain reduction to remain functional rather than bedridden, how many people would choose a longer, more painful life? I think all of us who have to live this way know the answer to that one.

    ALSO according to the CDC:

    “Cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including more than 41,000 deaths resulting from secondhand smoke exposure. This is about one in five deaths annually, or 1,300 deaths every day.”

    YES! 1,300 people die every day from smoking cigarettes, but Chris Christie thinks we need to go to war over 175 people dying every day from opiod use, yet tobacco use is legal, and merely an optional lifestyle choice that has absolutely no redeeming value, like relieving the chronic pain that legitimate opiod users need to alleviate just to have something close to a normal, functional life.

    https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm

    ALSO, 241 people are dying from alcohol abuse every day, 30 people are dying from alcohol-related car crashes… every day, and 1315 are dying from tobacco use… every day. Is it too much to ask, to choose our battles a little more wisely?

  • I’m 69 years old, still have to work every day to get by, and suffer with debilitating chronic pain every waking hour of my life. I take 10 mg Oxycodone tablets… four and a half of them a day, and I’m so stingy with them that I break them in half. It doesn’t give me any sort of “high,” and I’m not looking for one. I just want to be able to make a living, instead of having to lay in bed all day and worry about how I’m going to pay my bills. I’ve successfully managed my medications for years, never had an overdose, never run out early, because I have to budget my pills even more carefully than my money.

    Now, I’m very worried about what’s going to happen the next time I see my doctor. Those who claim that opioids can’t be used to manage chronic pain long term, and think that those of us who have to live this way actually like it, are very sadly mistaken. I wish every one of them could experience the hell that chronic pain sufferers have to deal with every day. It’s always there, and it’s relentless. It affects not only your physical quality of life, but your mood. You become irritable and depressed. You simply have no clue unless you’ve experienced it.

    Let’s do something about the real culprits here… the people who just want to get high for kicks, or get prescriptions they don’t need and sell them. THESE are the people the Government should be going after. These are the people most likely to overdose, and if it isn’t opioids, it’ll be something else. Even if someone told me that responsible use of opioids would shorten my life, I’d still choose that over a longer life in constant agony. Why can’t people understand this? The very unfortunate side effect to the current approach, is a lot of chronic pain sufferers are going to feel so desperate, that they’ll end up resorting to becoming heroin addicts. Those who choose that option will be much more likely to die of an overdose, catch some nasty disease, or wind up in prison. NONE of those consequences are going to benefit society or those unfortunate enough to wind up making that decision. There’s simply GOT to be a better way to deal with this!

    • Your situation sounds identical to mine,I’ve been living with severe chronic back pain for 20 years,it is a living hell to say the least,I’ve been on Vicodin to help combat it,thank god or I would of died long ago without it,and I’m the same way with my meds,very responsible,god help all of us

  • Big question: When are they going to pass strong laws that doctors have to stop prescribing opioids when Tylenol or Aspirin will do the job against pain? As a matter of fact, it was doctors’ prescriptions that made opioids so popular and so easily accessible to addicts. There are other pain prescriptions that will do the job as well. In addition, there is the problem of prescription addicting substances that are used as TREATMENTS for addiction! Nobody has EVER addressed that situation, except recovered addicts who KNOW from experience that drugs do not help in recovery from addiction, and in fact often do harm by cross-addicting the patient. Meanwhile, Trump’s Executive Order sounds like more of the same old same old that has been used so un-successfully for at least four decades.

  • This is not going to change access!
    Stop the cash flow addiction per CIA operatives. The addiction drops significantly! Ask Portugal!
    1 in 10 would become an addict from post operative surgeries.
    Then we have the people with chronic diseases that can not take NSAIDS so what option do we have people that function responsiblely already?
    The humanitarian level in the USA is about zero!

    • This is seriously distressing for those of us who are paying the price for everyone else who cannot and will not follow the rules. I was diagnosed with Multiple Sclerosis right before I turned 26 after a year of testing in 2003. I have had debilitating pain associated with my MS and was sent to the Mayo Clinic in 2004 because of it. My disease has progressed to primary progressive and never have a remission with it. I deal daily with symptoms. In 2007 I was dealing with increased pain in my lower back and legs I couldn’t understand but my neurologist simply chalked up to my MS, I however wasn’t satisfied. He finally sent me to a pain management specialist whom I’ve seen sense, he did an MRI of my spine to find I had suffered a traumatic injury which most would immediately know and be having emergency surgery for, however I had no clue how I had shattered my lower back. At 32 I was in need of a 3 level fusion which is a very risky operation. My films were sent to dozens of surgical specialists that were amazed I was walking around with such an injury. All agreed I needed surgery and once they would find our about my MS they refused to touch me. One highly regarded neurosurgeon looked me in the eyes and said “Jenifer, you without a doubt have to have surgery and I cannot imagine the pain you must be in, however I cannot or do not feel confident in doing this operation right now, if you could suffer for an additional 10 years I would do it but to be perfectly honest I don’t want to be known as the Dr that paralyzed the beautiful 32 year old Mother.” I was crushed. It was over a year before I found a neurosurgeon who wasn’t terrified to operate. So I was fused L2-S1 at 32. The operation was enormous as was recovery. Having dozens of titanium drywall screws in my spine causes me horrible pain, they cannot ever be removed. I have been on all types of narcotics at some point in my epic journey and I can tell you I have hated every one. From Lortab, Morphine, Dilaudid, Fentenyl, Methadone, Vicodin, to what I have been on since 2007 Oxycontin ER with Roxycodone IR. I have never once experienced a “pain free day” and I also realize there’s never going to be one for me. I have never taken my medication any other way than how it’s been prescribed because I also know I’m not the Dr. I realize the damage all the medications I have to take are doing to my kidneys and liver so in 2012 I asked for a pain pump in hopes to eliminate all need for oral pain medication. My body rejected the foreign object and it made me very ill, so less than a year later and it was removed. It took 6 surgeries in a 12 week period to deal with the removal and damage from a Dr’s mistake. What everyone is failing to discuss are those of us who play by the rules every day, we don’t self medicate, don’t buy our medications off the street and we have chronic, legitimate pain. Tylenol I promise you does not do a thing for me, I’ve tried it all. It’s also very personal to me as I ended my 18 year marriage due to my husbands abuse of these very same prescribed medications. I fought 4 plus years keeping his secret and suffering in silence as he stole from me and lost everything we worked to build, our home, savings all gone. Addicts become the best liars because all they want is their fix, no matter the cost. These governmental hammers coming down are having far reaching effects that aren’t right. I shouldn’t go in to pick up my scripts as I do every month to find my Dr has changed something like Oxycontin ER without so much as a call or appointment. Those kinds of things should not be taking place because pain mgmt drs feel like they are going to be in trouble because of the CDC telling them they can no longer actually care for patients as individuals based on their history and tolerance, they have to look at them as a group, category by age, sex and what the CDC says that person should be able to “get by with” on a daily basis on morphine. Well that’s just great if morphine works for you, it does nothing for me and that’s been well established. They are removing all personal history and patient care from what needs to be extremely personal. What needs to be established is pre-counseling before prescribing so people understand the actual physical addiction that can develop if they do not follow directions. These people dying aren’t those of us following the rules, they are combining things that should never be put together along with illegal substances all in an attempt to find that pain free day. People need to know if they have chronic pain they won’t likely have a pain free day, however they can have managed pain so they can function and live. I’ve never felt I’ve had the right to self medicate to see if I could find the elusive line to pain free, as I feel even after the countless operations and hospitalizations that God gave my all this so that I can help others. I’m an advocate for the MS Society, I talk with newly diagnosed or whatever they need me to do. I realize that everything I do my kids witness and I have to always show them that no matter what you’re faced with in life, you never give up your will to fight. Please understand this fight has another side to it that’s not being represented here. As I said, I hate taking medication and I would give anything to be free of it all, but here I am, I have to keep fighting everyday. I have to keep living. Thank you, sorry for the novella but this is a very personal issues for me.

      Jenifer
      42, Mother, Wife, Nana, Fighter.

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