Saying it’s “time to liberate our communities from the scourge of drug addiction,” President Trump declared the opioid epidemic a public health emergency Thursday. Sadly, he didn’t “show me the money,” failing to offer the massive, new resources necessary to help reverse the escalating opioid epidemic and sustain millions of Americans in recovery.
While acknowledging that drug overdoses kill 175 Americans a day, the president stopped short of calling this a national emergency with an attendant increase in federal funding for addiction treatment, as called for by his own Commission on Combating Drug Addiction and the Opioid Crisis. He said he looked forward to the release of the commission’s final report, due Nov. 1, and indicated the opioid crisis “will get worse before it gets better.”
In his remarks, the president hinted at changes to the Medicaid Institutions for Mental Diseases exclusion, which prohibits the use of federal Medicaid financing for care provided to most patients in mental health and substance use disorder residential treatment facilities larger than 16 beds. He spoke of educating providers and developing nonaddictive pain medication. But most of his remarks focused on reducing drug demand and increasing public awareness to keeping people from ever using drugs.
The president made no mention of other steps that his aides said he could take, including expanding access to telemedicine services, which would allow providers to remotely prescribe medicine used to treat substance use disorders. Current regulations inhibit access to medication-assisted treatment for opioid addiction in remote areas where there is no access to prescribers. Relaxing these regulations could enable state-licensed community behavioral health organizations to help close the treatment gap for patients in underserved areas. Aides also indicated he might make it easier for federal funding to be redirected from other programs to pay for opioid use treatment.
Robbing Peter to pay Paul will not solve this unprecedented public health emergency. The opioid use epidemic demands sustained commitment, a massive expansion of addiction treatment capacity and increased federal resources. We owe it to every grieving family, every devastated community, and every cash-strapped state in this nation to say, “We are in this for the long haul.”
The numbers are staggering. More than 13,000 Americans have died since Trump first acknowledged this national emergency. Every three weeks, we lose as many Americans as we did in the terrorist attacks of Sept. 11. Drug overdoses are now the leading cause of death for Americans under age 50.
But if your family is affected, the only number that matters is “one.” One youth lost too soon. One child growing up without a mother or father. One promising career cut short.
Addiction is not a moral failing — it is a chronic disease that can be prevented and treated, one from which people can and do recover. Yet as the surgeon general’s report on addiction made clear, only 1 in 10 people who need help for addiction receives it.
The experiences of six states that have declared the opioid epidemic an emergency show that well-crafted declarations increase public awareness, promote sharing of essential data, stem the flow of opioids into hard-hit communities, and arm first responders with lifesaving medication. In addition to supporting this national public health emergency declaration, we call on Congress to pass the Excellence in Mental Health and Addiction Treatment Expansion Act, a bipartisan, bicameral piece of legislation that:
Offers lifesaving treatment by strengthening Medicaid for people with addictions and mental illnesses. The Excellence Act established national standards of care with a corresponding Medicaid funding stream, allowing behavioral health providers to offer comprehensive, coordinated, evidence-based treatment and recovery support services. This expansion would provide for such needed interventions as use of medication-assisted treatment in emergency rooms, engagement in treatment after an overdose, and an enhanced continuum of care.
Streamlines resources by mobilizing state capacity. The Excellence Act expansion would allow 11 states that were poised and ready to transform their behavioral health delivery systems to join the eight states that have such system up and running. “Each and every state that came forward with a plan to increase access to community mental health services should have the support they need,” said Sen. Debbie Stabenow (D-Michigan), one of the original sponsors of the Excellence Act. But keep in mind that 19 states offering integrated health and behavioral health care, monitoring and care coordination, and 24-hour crisis services is just a down payment on what we need to stem the tide of preventable deaths.
Gets boots on the ground by providing the financial support necessary to hire a competent addiction treatment workforce. The treatment that people with addictions receive shouldn’t depend on where they live or from whom they seek care. The Strengthening the Addiction Treatment Workforce Act enhances the Excellence Act by allowing addiction treatment providers to recruit qualified staff and improve access to care in rural and underserved areas that are hard hit by the opioid epidemic. “This bill could go a long way in helping curb these problems by providing needed support and improve both quality and access to care,” said Sen. Lisa Murkowski (R-Alaska), one of the bill’s sponsors.
Emergency declarations help us sit up and take notice. But we don’t need one to know that we are facing a disaster of unprecedented proportions. As the president’s opioid and addiction commission made clear, “If this scourge has not found you or your family yet, without bold action by everyone, it soon will.”
Declaring the opioid epidemic a public health emergency is a bold step, but it is only a first step. We call on Congress and HHS to offer an equally bold response. People are literally dying for their help.
Chuck Ingoglia is senior vice president of public policy and practice improvement at the National Council for Behavioral Health.