03.27.2019 0

The Trump administration takes on the opioid epidemic

By Richard McCarty

Starting at the top, the Trump administration has made fighting the opioid epidemic a priority. To this end, President Trump appointed a commission, declared an emergency, and has signed two pieces of legislation relating to the opioid crisis. The President has also discussed the issue of illicit fentanyl with Chinese President Xi Jinping, who has agreed to crack down on it. Meanwhile, First Lady Melania Trump has been speaking about opioid addiction and urging people to help those struggling with it; and the administration has been implementing the study commission’s recommendations. Thanks, in part, to these efforts, we are seeing results.

In March of 2017, Trump issued an executive order establishing the President’s Commission on Combating Drug Addiction and the Opioid Crisis. He subsequently appointed three governors, a state attorney general, a Member of Congress, and a professor to the bipartisan commission. In August of 2017, the commission issued an interim report with several recommendations, including the following:

  • Declare the opioid crisis a national public health emergency.
  • Grant state waiver requests that allow them to use federal funds to provide in-patient drug treatment for Medicaid recipients at psychiatric facilities with more than 16 beds. (A longstanding rule has been in place that prohibited this, meaning that states were solely responsible for paying for this care.)
  • Take steps to increase access to medication assisted treatment, such as methadone.
  • Require prescribers to be trained on risks of opioid addiction and how to properly treat pain.

The final commission report was released in early November. It made more recommendations, which included the following:

  • More drug courts, which are courts that offer defendants an opportunity for drug treatment and less incarceration time.
  • A multimedia campaign warning people, especially kids, about opioids and addiction and fighting the stigma of addiction.

The administration has been addressing the issues raised in these reports. For example, prescribers are getting more education on opioids; funding for drug courts is up 53 percent; and the White House partnered with the Ad Council and the Truth Initiative on an ad campaign. These ads have been viewed hundreds of millions of times, and they have reached 58 percent of young Americans.

Trump signed two bills dealing with the opioid crisis into law last year. In January of last year, he signed the INTERDICT Act, which provided funds to Customs and Border Patrol to increase the number of chemical screening devices to detect fentanyl and other drugs that are imported illegally. Last fall, Trump signed the SUPPORT for Patients and Communities Act into law. The sweeping law included many provisions, the following are just a few.

  • The law allows states to apply for Medicaid funding to cover the treatment of opioid addiction at psychiatric hospitals and facilities.
  • It also expands Medicare coverage of treatment for opioid abuse, including coverage of methadone.
  • The law also increases the number of medical professionals authorized to prescribe or dispense methadone and other drugs to fight opioid addiction.

Law enforcement agents are also doing their part to fight the opioid epidemic. Over the past two years, more than 35,000 pounds of heroin and close to 11,000 pounds of fentanyl have been seized in this country. Last fiscal year, Customs and Border Protection seized enough fentanyl on the southern border, between ports of entry, to kill close to 90 million people.

In the first year of the Trump administration, the number of adolescents who began misusing prescription painkillers declined by more than 100,000, and the number of American adults 26 or older who started using heroin fell by 68 percent. In addition, the number of opioid misusers declined in 2017, and more people with opioid use disorder received treatment in 2017. Obviously, much work remains to be done before we end the opioid epidemic, but important progress is being made.

Richard McCarty is the Director of Research at Americans for Limited Government Foundation.

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