On Thursday, the President announced a declaration of a national health care emergency. The declaration is intended to make it easier to use current programs and funds to better address the opioids situation.  The declaration (which lasts for 90 days unless extended) came one day after the House Energy and Commerce Committee held their second hearing on the same topic in the past month. The President said, “The best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place. If they don’t start, they won’t have a problem.”

The White House event highlighted some of the grim statistics:

  • In 2016, more than two million Americans had an addiction to prescription or illicit opioids.
  • Since 2000, over 300,000 Americans have died from overdoses involving opioids.
  • Drug overdoses are now the leading cause of injury death in the United States, outnumbering both traffic crashes and gun-related deaths.
  • In 2015, there were 52,404 drug overdose deaths—33,091 of those deaths, almost two-thirds, involved the use of opioids.
  • Center for Disease Control and Prevention’s (CDC) statistics; indicate the national age-adjusted rate of opioid overdose deaths in 2015 was 10.4 deaths per 100,000 Americans.
  • The situation has only gotten worse, with drug overdose deaths in 2016 expected to exceed 64,000 which represents a rate of 175 deaths a day.
  • In 2016, more than 11.5 million Americans ages 12 and older reported misuse of prescription opioids in the past year, and nearly 950,000 Americans reported heroin use in the past year.
  • In 2014, the number of babies born drug-dependent had increased by 500 percent since 2000, and children being placed in foster care due in part to parental drug abuse is going up—now it is almost a third of all child removals.

Some advocates and policy experts were disappointed in that it limited the action to a health emergency and not a national emergency. The expected difference is that a national emergency would have brought more funding for treatment and other measures something the President’s declaration did not do.

The health emergency does allow all states to suspend the IMD Medicaid restrictions on residential drug treatment. For the 19 states that did not expand Medicaid under the ACA, this may not have as far as reach. There is also concern that the current appropriations debate does not increase funding for the key mental health and substance abuse treatment block grants.

Last year’s CURES Act provided states with $500 million in drug treatment funding for 2017 and in the current year but those funds are limited to the two years and some advocates project needed drug treatment total closer to the $5 to $6 billion range.

The declaration: allows for expanded access to telemedicine services, including services involving remote prescribing of medicine commonly used for substance abuse or mental health treatment; helps overcome bureaucratic delays and inefficiencies in the hiring process, by allowing the HHS to more quickly make temporary appointments of specialists to respond more; it allows the Labor Department to issue dislocated worker grants to help workers who have been displaced from the workforce because of the opioid crisis, subject to available funding; and it allows for shifting funds within HIV/AIDS programs to help people eligible for those programs receive substance abuse treatment.

There is concern about the potential shift in HIV/AIDS funding by some advocates although this provision is still being assessed for impact.

The President’s Commission is expected to make its final recommendations this week and it is likely to expand on these actions.

On Wednesday the House Energy and Commerce Committee heard from a number of leaders from key government agencies and the implementation of CARA, the Comprehensive Addiction and Recovery Act (CARA), and all have additional legislation. The testimony mirrored much of what had taken place earlier last month by the Senate HELP Committee.

Witnesses included Neil Doherty, Deputy Assistant Administrator, Drug Enforcement Administration, Dr. Scott Gottlieb, Commissioner, Food and Drug Administration (FDA), Dr. Elinore McCance-Katz ,Assistant Secretary for Mental Health and Substance Use, Substance Abuse and Mental Health Services Administration (SAMHSA), Dr. Anne Schuchat, Principal Deputy Director, Centers for Disease Control and Prevention (CDC), Dr. Nora Volkow, Director, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH).