August 1, 2017

Opioid misuse is a 'national emergency,' White House commission says

Daily Briefing

    The White House Commission on Combating Drug Addiction and the Opioid Crisis in an interim report released Monday urged President Trump to declare the U.S. opioid misuse epidemic a national emergency.

    Reduce opioid misuse and abuse with our new report

    The commission, which was established in March under an executive order, is tasked with studying the opioid misuse epidemic and developing strategies to combat opioid and substance misuse. New Jersey Gov. Chris Christie (R) leads the commission.

    Opioid-related deaths

    The commission in the report cited CDC data that showed an average of 142 people die in the United States each day because of opioid misuse. The White House said more than 50,000 deaths were tied to drug misuse and addiction in 2015, and nearly two-thirds of those deaths were linked with opioids.

    Recommendations

    The commission in the report called the U.S. opioid misuse epidemic "unparalleled," adding, "We must act boldly to stop it."

    The panel wrote that Trump "first and most urgent[ly]" should declare the epidemic a national emergency because such a declaration would "empower" the Trump administration and Congress to take action. In addition, the commission wrote that declaring the epidemic a national emergency would "awaken every American to this simple fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon will."

    The panel also recommended that policymakers take steps to:

    • Bolster resources for law enforcement agencies to combat the distribution and trafficking of fentanyl;
    • Encourage the development of non-opioid painkillers;
    • Ensure health care insurers cover treatment for mental health conditions and substance use disorders to the same extent they cover treatments for physical health conditions;
    • Establish a national model to increase access to medications that can reverse overdoses, such as naloxone, and ensure such medications are prescribed along with opioids in certain situations;
    • Expanding so-called "good Samaritan" laws to protect from prosecution individuals who report drug overdoses;
    • Have NIH partner work with drugmakers to create new medication-assisted substance use disorder treatments;
    • Increase access to treatment for substance use disorders;
    • Provide federal resources for state prescription drug monitoring programs;
    • Require prescribers to receive education on opioids; and
    • Waive a federal rule that limits the number of Medicaid beneficiaries who can receive coverage for residential substance use disorder treatment.

    The commission also recommended that dental and medical schools should improve health care providers' prescribing habits with an aim toward reducing overprescribing opioids.

    According to the New York Times, the commission is scheduled to release a full report in October.

    Reaction

    Observers expressed mixed reactions to the report, according to the Los Angeles Times.

    Michael Fraser, executive director of the Association of State and Territorial Health Officials, said calling on Trump to declare the opioid misuse epidemic a national emergency is "really about drawing attention to the issue and pushing for all hands on deck." He continued, "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."

    Gary Mendell—founder and CEO of Shatterproof, an anti-addiction advocacy group—said declaring the epidemic a national emergency would be "a significant first step towards 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."

    Grant Smith, deputy director of national affairs at the Drug Policy Alliances, said commission's recommendations "offer a welcome departure from the ... administration's overall approach to drug policy so far." However, he cited several "glaring omissions" from the report. For instance, he said, "The reality is that law enforcement, in a number of places around the country, are increasingly turning toward measures that re-criminalize overdose." Smith added, "This is the elephant in the room that needs to be addressed if we're really going to make lasting progress in reducing demand for substances and reducing barriers to treatment and other services and ending the opioid crisis."

    Andrew Kolodny, executive director and co-founder of Physicians for Responsible Opioid Prescribing, said the commission should have placed a greater emphasis on federal funding that would help states address opioid misuse. "I would have liked to have seen them call on the federal government to make an enormous investment expanding access to the most effective treatment for opioid addiction," he said (Simmons, Los Angeles Times, 7/31; Goodnough, New York Times, 7/31; Ross Johnson, Modern Healthcare, 7/31; Ingraham, "Wonkblog," Washington Post, 7/31; Lopez, Vox, 7/31).

    Reduce opioid misuse and abuse with our new report

    Opioid misuse and abuse is one of the most pressing public health issues in the U.S., and hospitals and health systems are on the front lines. Currently, most health systems focus their opioid management efforts on select medical specialties.

    This report outlines three imperatives to guide hospitals and health systems in their efforts to reduce the impact of inappropriate opioid prescribing and misuse.

    Read the Report

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