Update 8/10: On Thursday, President Trump said he would declare the opioid crisis a national emergency.
We are writing today urging President Trump to heed the advice of the bipartisan White House Commission on Combating Drug Addiction and the Opioid Crisis and declare the opioid epidemic a National Emergency.
The declaration of a National Emergency would give this epidemic the full attention it deserves and allow states to access federal resources to act swiftly and definitively to save the lives of more than 33,000 Americans annually through evidence-based treatments and programs that have been proven to work.
Each day, 142 people die in our country from a drug overdose. The number of opioid overdoses has quadrupled, along with the number of opioid prescriptions, over the last two decades. Today more people die from drug overdoses than from car accidents, guns or falls. More broadly, the addiction epidemic affects 1 in 3 American families in every town and city across the country and does not discriminate based on race or political affiliations. This critical public health situation demands extraordinary measures.
For example, we have an antidote for overdose called Naloxone. Rapid administration of this drug reverses opioid overdose and prevents death. Unfortunately, the cost of Naloxone has increased dramatically and has proven a barrier to access. One product skyrocketed from $690 to $4500. In a hurricane we don’t allow stores to gouge consumers for gas or water and the same should be true for life-saving drugs in this opioid emergency. Although Naloxone needs to be in the kits of every first responder, our government is not allowed to negotiate national prices that would make this possible. A National Emergency declaration would allow the secretary of Department of Health and Human Services to pursue solutions and ensure the medication is affordable and accessible.
“Too many barriers exist to getting people the treatment required to overcome addiction.”
What is slowing down a rapid embrace of this option? Many still believe addiction is a moral failing, rather than a chronic and often lethal disease. We have learned from our collective experiences that recovery is real and that people suffering addiction can rejoin society as productive members. For too long our nation has asked law enforcement to wage war on people addicted to drugs, instead of getting them the help they need. Like other chronic disease, such as hypertension and diabetes, we have effective medical treatments that work (known as medication assisted treatment or MAT), but too many barriers exist to getting people the treatment required to overcome addiction.
Declaring a national emergency on opioids would help ensure that every person ready for help can get treated. Imagine if you went to the ER because you were having a heart attack. The doctors were able to open up your blood vessels and save your life, but weren’t able to prescribe the blood pressure and cholesterol lowering medications, as well as the dietary counseling and exercises, you needed to prevent another heart attack from happening. This scenario essentially occurs every day throughout the nation for people trying to get help with addiction because we have caps on the number of patients for whom a doctor can prescribe MAT and only about 10 percent of conventional treatment facilities even provide this type of therapy for people addicted to opioids. Equally concerning, there are exclusions in the Medicaid program that essentially block providers from being reimbursed from addiction services in a facility that has more than 16 beds.
A national emergency declaration would also free up funding to add staff to emergency rooms who can intervene with people rescued from overdose. Patients surviving an overdose are at their greatest risk of dying when the Naloxone wears off and the cravings start with a fury. That is exactly the point that treatment services and medical management of withdrawal symptoms can save thousands of lives. Certain states like Task Force Chair Governor Christie’s home state of New Jersey have implemented this program successfully but not all states have the funding, the know-how or the political willpower. The Emergency Powers Act was designed to eliminate exactly these types of logistical hurdles.
Laws designed to help patients must also be updated. For example, there are rules requiring that mental health issues are covered in the same way as physical health issues (known as “Parity”), but these policies have been inadequately enforced, allowing insurance companies to erect barriers to the treatment of opioid disorders.
“This isn’t just good policy, it’s our moral imperative.”
Equally frustrating is the enforcement of laws that hinder comprehensive care. Federal HIPAA regulations designed to protect patient privacy can impinge on patients getting the timely support from family who are unable to get information from their doctors about their condition. We agree with the Commission that this regulation needs to be amended to protect the lives of people at risk for overdose, while still protecting their privacy given there is still so much stigma associated with this illness.
One thing we’ve learned from dealing with natural disasters is the value of preparedness. Unfortunately, the medical community has not been prepared for this epidemic and tragically many addictions unfortunately start in a doctor’s office. According to the Centers for Disease Control and Prevention, in 2015 enough opioids were prescribed for every American to be medicated around the clock for three weeks. Shockingly, only 20 percent of the health care providers licensed to prescribe opioids have the training to prescribe them safely. Many physicians also have little education in treating chronic pain and few realize that few long-term studies support that opioids effectively manage this condition, perhaps explaining why America consumes 80 percent of opioids in the world while comprising five percent of the population. A declaration of a national emergency would galvanize the medical community to prepare current and future doctors to deal with this crisis.
As critical as response, treatment and recovery efforts are, nothing is more important than preventing the flow of illicit drugs into our country. As the President’s Commission declares, we are massively losing this fight. Local, state and federal agencies must have the technology, resources and manpower for effective drug interdiction.
Let’s act swiftly to correct the system that has allowed drugs to become the number one killer of young adults. This epidemic represents a true national emergency and President Trump should heed the advice of his bipartisan commission and empower our states, patients and health care community accordingly.
In closing, these recommendations are a critical starting point to addressing the opioid epidemic, but we must also acknowledge the cultural and institutional failures that have contributed to this crisis and work to reverse them. This starts by recognizing our society has developed an over-reliance on prescription drugs in ways that far exceed the usage challenges other countries face. Preventing drug abuse, curbing addiction and increasing the number of successfully rehabilitated individuals requires a focus on education, criminal justice reform, and family and community engagement.
This isn’t just good policy, it’s our moral imperative to aggressively combat this dangerous epidemic before it threatens another generation of Americans.
Facing Addiction, a national non-profit organization, is collecting comments in support of President Trump taking action on the Commission’s Emergency Declaration recommendation. To add your name in support of this life-saving federal action, click here.