Trump and Price Meet to Discuss Opioid Abuse (CQ HEALTHBEAT NEWS)

President Donald Trump will hold off on declaring a national emergency on opioid abuse, the administration's top health official said Tuesday. While an emergency declaration could make it easier to spend money on the crisis, Health and Human Services Secretary Tom Price told reporters that the administration thinks it has the resources it needs to address the issue at the moment.

While Price said that Trump considers the situation an emergency and that the formal declaration was still an option, he said the situation "can be addressed without a declaration of an emergency, although all things are on the table for the President."

The presidential commission led by New Jersey GOP Gov. Chris Christie suggested last week that Trump declare a national emergency on opioid abuse, which could allow Price to use his department’s money in a more flexible way to address the crisis.
Price made these comments shortly after meeting with Trump in Bedminster, N.J. and came as the Centers for Disease Control and Prevention released data indicating that the drug overdose death rate continued to climb in the first nine months of 2016. While it will still be a long time before the effects of Trump’s policies are known, experts don’t think the administration has done much yet to improve the situation.

Critics also point out that the administration has only recently filled key positions. New CDC Director Brenda Fitzgerald was appointed in July and Elinore F. McCance-Katz, who will lead the Substance Abuse and Mental Health Services Administration, was confirmed by the Senate just last week.

The commission also said HHS should grant waivers to states allowing them to spend more on residential treatment services, and that the administration should increase education requirements for the prescribers of opioid painkillers.

A White House spokesman on Tuesday said “the administration is still completing the review process of the recently submitted interim report.”

Experts were encouraged by the recommendations, which also won praise from Democrats in states where overdose deaths are a big problem.

“They feel like they represent continuity with the bipartisan efforts of the last few years,” said Daniel Raymond, the policy director for the Harm Reduction Coalition, a nonprofit that supports overdose prevention programs. However, he asked: “How does this align with the other actions of this administration?”

Specifically, Raymond and others point out that proposed Republican health care overhauls (HR 1628) endorsed by the administration could make it harder for people to afford insurance that includes coverage for drug treatment. It would also phase out increased federal funding for Medicaid, cap Medicaid spending and potentially push states to limit enrollment in the program.

Leana Wen, the health commissioner for the city of Baltimore, Maryland, said she couldn’t overstate how much of a problem it was for the health care law to face such uncertainty.

“Somebody who is kicked off of their insurance and is being treated for the disease of addiction often has no other choice but to go out and overdose,” she said.

She said she also worried about signals from the administration that it considers drug abuse more of a law enforcement issue than a health issue.

While Price focused on the health aspects of the crisis, Trump on Tuesday suggested that prosecutions and sentencing for drug crimes needed to be tougher.

"At the end of 2016, there were 23 percent fewer federal prosecutions than in 2011, so they looked at this surge and they let it go by. We're not letting it go by. The average sentence for a drug offender decreased 20 percent from 2009 to 2016," Trump said, according to a pool report.

Even though Trump last Thursday visited West Virginia, which has the highest rate of drug overdose deaths in the country, the issue seemed to be an afterthought during a speech that focused on topics like the Russia scandal and job creation. Trump briefly alluded to West Virginia’s struggles with opioid addiction in the context of border security.

“One by one we are finding the drug dealers, the gang members, the predators, thieves, criminals and killers and we are throwing them out of our country, and once they are gone, we will not let them back in. We are stopping drugs from pouring into our country and poisoning our youth, and you have a big problem in West Virginia, and we are going to solve that problem,” he said.

Trump also drew attention to the issue last week in a less positive way, when The Washington Post published leaked transcripts of the president's call earlier this year with Mexican President Enrique Pena Nieto. During the call, Trump described New Hampshire, which has the country’s second-highest rate of drug overdose, as a “drug-infested den.”

Lindsay Walters, the White House deputy press secretary, told reporters last week that “he was talking about the opioid epidemic up there which has affected a lot of lives in New Hampshire. I can tell you that's an important focus of his.”

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