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Detroit News: Trump: Opioid crisis a public health emergency

October 27, 2017
Tim In The News

Washington — President Donald Trump on Thursday ordered his Department of Health and Human Services to declare the opioid crisis a national public health emergency.

The move stops short of Trump's pledge to declare a national emergency, which would have allowed officials to tap the federal disaster relief fund. But senior administration officials said an emergency under the Public Health Services Act is most appropriate given the needs of responding to the epidemic.

Trump called it the “worst drug crisis in American history” with drug overdoses claiming at least 64,000 lives in 2016, which is the largest number ever recorded in the United States, according to preliminary federal data. Drug overdoses are now the leading cause of death for Americans under 50.

“No part of our society – not young or old, rich or poor, urban or rural – has been spared this plague of drug addiction and this horrible, horrible situation that’s taken place with opioids,” the president said at a Thursday White House event.

“We can be the generation that ends the opioid epidemic. We can do it.”

In Michigan, overdose deaths from opioids and heroin increased 104 percent from 2005 to 2015 – the most recent data available from the Michigan Department of Health and Human Services.

Roughly 1,980 Michigan residents died in 2015 from an overdose of opioids or heroin – the seventh most deaths of any state, according to the Centers for Disease Control and Prevention.

Hospitalizations for overdoses are also up in Michigan – nearly 38 percent increase for opioids and 192 percent for heroin over the same period, according to Michigan’s health department. Some of the hospitalizations are for overdoses involving both heroin and opioids.

The declaration alone will not direct additional funding to the opioid crisis, but federal agencies will be prioritize available grant money for addressing the crisis, White House officials said.

Detroit U.S. Rep. John Conyers Jr., ranking Democrat on the House Judiciary Committee, said Trump’s declaration was inadequate and “essentially meaningless” without any new funding to fight the crisis.

“This is not the way to fight an epidemic of this magnitude,” Conyers said in a statement with New Jersey Rep. Frank Pallone Jr., the top Democrat on the House Energy and Commerce Committee.

But Attorney General Bill Schuette, who attended Thursday’s event at the White House, praised Trump for mobilizing his administration to address drug abuse and overdoses.

“The numbers are shocking. I would encourage us all not to just look at these as statistics on a piece of paper. These are families who are struggling,” said Schuette, a Republican.

He noted the state has four prosecutors assigned to an opioid task force currently working 50 cases.

“The point is we want to crack down on the pill-mill docs and the over-prescribers, and these dealers who pedal this,” Schuette said in an interview. “These guys are just merchants of death.”

Schuette, a Republican, is running for governor in 2018 and has been endorsed by Trump. Last month, he joined an investigation with 40 other state attorneys general to examine opioid manufacturers and distributors.

Republican Reps. Fred Upton of St. Joseph and Tim Walberg of Tipton also attended Trump’s address in the East Room.

The White House said Thursday’s order will allow for expanded access to telemedicine services, including the remote prescribing of medicine commonly used for substance abuse or mental health treatment.

Officials also said the action will permit the shifting of resources within HIV/AIDS programs to help people eligible for those programs receive substance abuse treatment, which was mentioned because of the connection between HIV transmission and substance abuse.

Trump also said the administration will announce a new policy to overcome a 1970s-era rule that prevents states from using Medicaid to pay for addiction treatment at residential treatment facilities with more than 16 beds.

“Our current addiction crisis will get worse before it gets better, but it will get better,” Trump said adding it could take years, even decades, to fix the problem.

Democrats, including Sens. Debbie Stabenow of Lansing and Gary Peters of Bloomfield Township, have called on Trump to allow the government to negotiate lower prices for the drug naloxone, which can reverse the effects of an opioid overdose and save lives.

The price of naloxone has risen in recent years as the opioid epidemic worsened. Narcan, a naloxone nasal spray, costs $150 for a two-pack, and Evzio, an auto-injector, has gone from $690 in 2014 to $4,500 for a two-pack in 2017, according to a letter the senators sent Trump on Wednesday.

The senators said declaring a national emergency would allow the Health and Human Services secretary to negotiate reduced pricing for all units of the federal government. Trump’s opioid commission made the same recommendation this summer in a draft report.

Michigan Reps. Walberg and Debbie Dingell, D-Dearborn, are pushing for Congress to adopt Jessie’s Law, a bill that would direct the government to develop guidelines for including a patient’s history of addiction treatment in their electronic health records, with the patient’s consent.

“This information helps to better inform, I believe, a provider and avoids risks for relapse or dangerous side effects when a patient seeks treatment for a condition or illness separate from their addiction,” Walberg said Tuesday at a committee hearing.

“That was the genesis of this piece of legislation because of a very unfortunate outcome where things were missed.”

The legislation, which the Senate approved in August, was drafted in response to the death of Jessica Grubb, an Ann Arbor woman who moved to Michigan for long-term treatment of her heroin addiction.

Grubb was clean seven months before she had surgery for a running injury in February 2016. Even though her parents had warned hospital staff that she was a recovering addict, the doctor who discharged her prescribed Oxycodone pills for her recovery. She overdosed that night and died.

At Wednesday’s hearing, Dingell urged the administrator of the Food & Drug Administration to revise federal guidelines to help drug companies and innovators develop new forms of treating pain that are not addictive.

She is also concerned that people who have “legitimate” pain needs can continue receiving treatment as officials move to respond to the crisis.

“We have to make sure the pendulum doesn’t swing too far the other way. ... I’m married to man who is not going to be happy I’m talking publicly about this, who this room is named after, who has a legitimate pain need,” Dingell said, referring to retired Rep. John Dingell, who has chronic shoulder pain.

“And I’ve learned more about pain drugs that I ever wanted to do. And it’s becoming an even more serious problem for people with chronic disease.”

She has also had family experience with addiction, noting her sister died of a drug overdose and her father was addicted to prescription drugs “before anyone talked about it or knew what it was.”

This article originally appeared in the October 27 edition of the Detroit News.