Opioid Epidemic Prompts Public Health Emergency: What is Next?

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American Society of Anesthesiologists

On October 26, 2017 President Donald Trump declared the opioid crisis a public health emergency, following previous remarks he made in August that action would be taken to recognize the magnitude of the opioid epidemic. The President’s Commission on Combating Drug Addiction and the Opioid Crisis, led by New Jersey Governor Chris Christie, recommended that the president declare a national emergency to rapidly increase substance abuse treatment capacity and increase access to naloxone, the overdose reversal drug. As the Administration has grappled with how to best address the crisis, the President ultimately decided to take a different approach. A president may declare a national disaster or emergency under the Public Health Service Act or the Stafford Act, but in this case President Trump did neither, leaving many asking, what’s next?
Following the White House press briefing where President Trump made the announcement, it was clear additional steps were necessary before the public health emergency was official. A Presidential Memorandum signed by the president directs the Secretary of the Department of Health and Human Services (HHS) “to consider that the drug demand and opioid crisis…constitutes a Public Health Emergency. Additionally, the heads of executive departments and agencies…shall exercise all appropriate emergency authorities…to reduce the number of deaths and minimize the devastation the drug demand and opioid crisis inflicts upon American communities.” Shortly after President Trump’s announcement, Acting Secretary of HHS Eric Hargan, signed the declaration.

Although the declaration does not provide for any new or additional funding, it will allow for the shifting of resources in existing programs to help address the opioid epidemic. A White House press release explains:

  • The action allows for expanded access to telemedicine services, including services involving remote prescribing of medicine commonly used for substance abuse or mental health treatment.
  • The action helps overcome bureaucratic delays and inefficiencies in the hiring process, by allowing the Department of Health and Human Services to more quickly make temporary appointments of specialists with the tools and talent needed to respond effectively to our Nation’s ongoing public health emergency.
  • The actions allow 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.
  • The action allows for shifting of resources within HIV/AIDS programs to help people eligible for those programs receive substance abuse treatment, which is important given the connection between HIV transmission and substance abuse.

Media reports indicate that the president’s action will place additional pressure on Congress to allocate new funding to fight the opioid crisis, potentially as part of a year-end spending agreement.

In response to the declaration, several federal agencies released their own statements, supporting President Trump’s declaration. For example, a statement by NIH indicated that in support of the Administration’s efforts, “NIH is pursuing formal partnerships with more than 30 biopharmaceutical companies and academic research centers to develop safe, effective, non-addictive strategies to manage chronic pain; new, innovative medications and technologies to treat opioid use disorders; and improved overdose prevention and reversal interventions to save lives and support recovery.” ASA has long advocated for additional research on non-opioid therapies to treat pain and is pleased to hear this.

ASA has been at the forefront of the issue, working with numerous regulatory agencies, health care organizations, and other stakeholders to address the opioid crisis. ASA is partnering with Premier Inc., and its network of hospitals, on a national opioid safety pilot to reduce patient harm from opioid misuse, dependence and addiction. The six-month pilot is geared at addressing opioid misuse and abuse, through implementation of evidence-based practices and education provided by ASA physician members, aimed at improving pain management and reducing opioid prescriptions after surgery. This is one way to reduce the number of medications in America’s households and prevent them from getting into the wrong hands, a large contributing factor to this epidemic.

Statement from the NIH Director on Combating the Opioid Crisis with Scientific Solutions

Statement from FDA Commissioner Scott Gottlieb, M.D., on the Trump Administration’s important efforts to address the opioid crisis

Statement from HHS

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Written by Stephanie Summers