More than three months after President Trump declared the nation's opioid crisis a public health emergency, activists and health care providers say they're still waiting for some other action.
The Trump administration quietly renewed the declaration recently. But it has given no signs it's developing a comprehensive strategy to address an epidemic that claims more than 115 lives every day. The president now says that to combat opioids, he's focused on enforcement, not treatment.
Trump spent just over a minute of his 80-minute State of the Union address talking about opioids. In a speech this week in Cincinnati, he had a few more comments. The opioid epidemic, he said, "has never been worse. People form blue ribbon committees. They do everything they can. And frankly, I have a different take on it. My take is you have to get really, really tough, really mean with the drug pushers and the drug dealers."
The president's mention of "blue ribbon committees" sounds like a slam on one he convened last year, chaired by former New Jersey Gov. Chris Christie — the President's Commission on Combating Drug Addiction and the Opioid Crisis. The commission issued more than 50 recommendations. The administration has so far followed up on just a few of those recommendations.
Some officials and care providers who work on the frontlines of the opioid crisis, however, are scathing about what they see as a lack of action from the White House. Former Congressman Patrick Kennedy, who served on the White House opioid commission, says he's "incredulous" that, after declaring a public health emergency in October, the president still hasn't requested any money from Congress to combat the epidemic.
"I mean this is just a mental health crisis of the first order," Kennedy says, "and this administration has done nothing."
Here's what the administration has done so far:
Here are things critics point out the administration hasn't done:
Roughly 64,000 people died from drug overdoses in 2016, and data from the CDC indicates deaths are rising. Kennedy says what's needed is a coordinated federal response similar to the one in the mid-1990s — when the U.S. spent $24 billion a year to address the HIV/AIDS crisis.
"We're talking about a major league crisis and they're taking credit for little things, while the whole country is burning down," Kennedy says.
Instead of a big boost in funding, the Trump administration is focused, in many cases, on cutting spending.
In the 2018 budget, the president recommended cutting the Office of National Drug Control Policy budget by 95 percent, and may do so again this year.
"It's very hard to make sense of," says Keith Humphreys, a professor of psychiatry at Stanford and former policy adviser to the drug czar's office in the Obama administration. "I mean, it's like closing a fire station in the middle of a wildfire."
A law signed by President Barack Obama that designated a billion dollars to help states combat opioids runs out of money this year. Humphreys has seen no sign President Trump intends to ask Congress to renew that funding.
"The 2018 budget had a $400 million cut to the Substance Abuse and Mental Health Services Administration, which is the lead agency that funds treatment in the United States," Humphreys says. "So, the administration's impulse seems to be not to spend more — in fact to spend less."
The White House is preparing to act on one of the recommendations of its opioid commission—that it launch a campaign to educate the public, especially young people, on the dangers of opioids. The campaign is being developed not by the Office of National Drug Control Policy, but by a team in the White House led by Kellyanne Conway.
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