Last week the President became the latest President to mark a top priority by declaring war on it. Mr. Trump declared a war on opioids saying,

“When confronting a crisis of this magnitude, the most important factor—and one where government too often falls short—is making sure that every dollar is used effectively. To this end, the Trump Administration’s aggressive and multifaceted response to opioid addiction can best be understood in terms of three categories: demand, supply, and treatment.”

This White House now joins other Presidents (Johnson’s War on Poverty, Nixon’s War on Cancer, Reagan’s War on Drugs, Bush’s War on Terrorism), in using a term that envisions an end or victory declaration in addressing a complex and ever-evolving challenge and problem.

The White House released the information in the context of a Thursday, March 1, all-day White House Summit. The White House outlined:

• Preventing drug use initiation and reducing demand: The Administration is promoting prevention efforts and enhanced overdose tracking, helping first responders handle opioid-related incidents, and encouraging safer prescribing practices to lower misuse.

• Cracking down on the bad actors fueling drug supply: The Administration is bringing its tough law-and-order approach to the drug trade by shutting down criminal websites that sell opioids, cracking down on fraudulent prescribers, stopping the production and sale of illicit fentanyl, and preventing illegal drugs from coming into the country in the first place.

• Expanding access to evidence-based, world-class care and treatment: The Trump Administration is supporting state and industry innovation to increase access to high-quality treatment, expand the availability of treatment and recovery services, and facilitate life-saving communication between healthcare providers and family members.

As noted, Congress is negotiating how $3 billion in opioid funding will be allocated between the areas the White House listed but that funding is based on Congressional action. Unlike the Administration’s 2019 budget proposal, Congressional funding is not based on deep cuts in human services funding such as SSBG. The White House event included remarks by the President and the participation of new “drug czar”, Jim Carroll, the Office of National Drug Control, (ONDC) Director-Designee, Senior Presidential Advisor Kelley Ann Conway, Attorney General Jeff Sessions, and Housing Secretary Ben Carson, among others.

At the same time, last week, the House Ways and Means Committee talked about Medicare and opioids while Senators released a new Comprehensive Addiction and Recovery Act (CARA), called “CARA 2.0.”

The new CARA bill once again partners some senators including bill sponsors Senator Rob Portman (R-OH) and Senator Sheldon Whitehouse (D-RI). The bill envisions some additional tighter restrictions on prescription medication, a major advertising campaign, and a new “National Youth Recovery Initiative” that would provide funding to be used, in the words of the Senator Portman’s office:

“ to develop, support, and maintain youth recovery support services, including maintaining a physical space for activities, staff, social activities, to establish a recovery high school, to coordinate recovery programs with other social service providers (mental health, primary care, criminal justice, substance use disorder treatment programs, housing, child welfare, and more), to develop peer support programs, and other activities that help youth and young adults achieve recovery from substance use disorders.”

The bill would add $1 billion that would provide: $300 million to medications for opioid addiction, $300 million to expand first responder training and access to the opioid overdose antidote naloxone, $200 million to better support people moving from treatment into long-term recovery, $100 million to expand treatment for pregnant and postpartum women, and another $100 million would go to a variety of treatment, criminal justice, and education programs.

It is not clear if the funds would be in addition to what Congress is dividing up now in 2018 and 2019 budgets. Other Senators cosponsoring the legislation include: Senator Shelley Moore Capito (R-WV), Senator Amy Klobuchar (D-MN), Senator Dan Sullivan (R-AK), Senator Maggie Hassan (D-NH), Senator Bill Cassidy (R-LA) and Senator Maria Cantwell (D-WA).
Authorizes $10 million annually (Program removed in CARA conference)

Several organizations sponsored briefings on Capitol Hill and next week additional congressional committees will be holding hearings including the Senate HELP Committee on Thursday.