Trump Announces Actions on Opioids Crisis

The president on Oct. 26 declared a National Public Health Emergency and outlined several actions his administration is taking and will take to address the opioids crisis, including new requirements from the Food and Drug Administration on the manufacturers of prescription opioids to help reverse over-prescribing.

President Donald J. Trump on Oct. 26 declared a public health emergency and outlined several actions his administration is taking and will take to address the opioids crisis, including new requirements from the Food and Drug Administration on the manufacturers of prescription opioids to help reverse over-prescribing.

Dr.Patrice A. Harris, M.D., who chairs the AMA Opioid Task Force and is the immediate past chair of the American Medical Association, released a statement saying the declaration is "a move that will offer needed flexibility and help direct attention to opioid-ravaged communities.

"This alone won't solve a complicated problem," Harris continued. "Ending the epidemic will require physicians, insurers, drug manufacturers, and the government to follow through with resources, evidence-based treatment plans, and smart public policies at the national and state levels. As physicians, we must be leaders in continuing to make judicious prescribing decisions and by considering the full range of effective therapies for pain, including non-opioid and non-pharmacologic options, co-prescribing naloxone, helping patients access medication-assisted treatment for opioid use disorder, and removing stigma. At the same time, insurers must be willing to cover pain treatments beyond opioid analgesics as well as long-term comprehensive treatment for opioid use disorder to promote recovery. The number of prescription opioids in the country is declining while the numbers of people dying from heroin and illicit fentanyl are increasing at a staggering rate. As it stands, it's easier for patients to access heroin than to access evidence-based treatment and non-opioid pain care. There is plenty of work ahead, and the emergency declaration adds further urgency to this epidemic."

FDA Commissioner Dr. Scott Gottlieb issued a statement about the administration's actions, calling them "a historic step to direct additional resources to help address the staggering human and economic toll created by the epidemic of opioid addiction. We thank President Trump for his leadership in further empowering public and private parties around the country to do everything possible to more forcefully address this complex public health crisis. We are committed to taking additional steps under the new declaration of a public health emergency to more forcefully confront this immense national tragedy. This includes taking aggressive steps to prevent new addictions and opioid-related deaths and help those currently addicted regain control and restore them to their communities," Gottlieb said. "Since becoming FDA commissioner, I've made it one of my highest priorities to work on multiple fronts to reduce the scope of the opioid epidemic that’s devastating our nation and destroying individual lives and families. In particular, we believe the FDA has a vital role to play in curbing new addiction, reframing how we look at the benefits and risks of opioids as part of our pre- and post-market efforts, and keeping as many people as possible from experiencing the serious adverse effects associated with these medications. The agency is also focused on promoting the development of opioids that are harder to manipulate and abuse, and non-opioid pain treatments; supporting important efforts to increase the use of and access to the potentially life-saving antidote naloxone; encouraging the safe adoption and more widespread use of FDA-approved medically assisted treatments to help combat addiction; and working with federal and international partners to stop the flow of heroin and extremely potent, and often deadly, synthetic drugs like illicitly made fentanyl. I also announced this week that the FDA will use our platform to join efforts to break the stigma associated with addiction and the use of medications that can help people live lives of sobriety."

The White House's description of the actions notes that drug overdoses are now the leading cause of injury death in the United States, outnumbering both traffic crashes and gun-related deaths, and the estimated 64,000 drug overdose deaths in 2016 represent a rate of 175 deaths per day and exceed the number of Americans killed during the Vietnam War.

His declaration of a Nationwide Public Health Emergency allows for expanded access to telemedicine services, including services involving remote prescribing of medicine commonly used for substance abuse or mental health treatment, and allows HHS to more quickly make temporary appointments of specialists with the tools and talent needed to respond effectively to the emergency and the Department of Labor to issue dislocated worker grants to help workers who have been displaced from the workforce because of the opioid crisis, subject to available funding.

He said he is awaiting the final report from the President's Commission on Combating Drug Addiction and the Opioid Crisis, which the president established in March 2017.

The National Safety Council issued a statement of its own that commends the president for declaring the opioid epidemic a public health emergency but saying his strategy "is still vague at a time when a clear path forward is critical.

"Today's announcement fell short of the draft recommendations from the President's Commission on Combating Drug Addiction and the Opioid Crisis, which called for declaring a national emergency under the Public Health Service Act or the Stafford Act, both of which would have unlocked critically needed funds," the council said. "While an effort to find non-addictive alternatives to opioid is a step in the right direction, the federal response must include adequate funding for implementing other evidence-based strategies as well, a move the president himself said is necessary. If we are serious about ending opioid misuse, we should deploy and fund a robust set of plans that include mandatory prescriber education for all prescribers, regulating pain clinics, allowing delegates to access Prescription Drug Monitoring Programs, and expanding access to naloxone – not just for first responders but for every American."

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