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October 26, 2017

Prez Trump to declare opioid epidemic a "public health" emergency

As reported in this piece from The Hill, "President Trump on Thursday will instruct the acting director of the Department of Health and Human Services to declare the opioid epidemic a public health emergency, White House officials said." Here is more about this notable news:

It's a move that won't free up additional federal funding and is a more narrow option recommended by the president's opioid commission.  The announcement has been months in the making and avoids declaring a more sweeping national emergency under the Stafford Act, which was one option the administration's opioid commission had previously recommended.  The commission recommended either a public health emergency or a Stafford Act emergency.

The Stafford Act “doesn't offer authority that is helpful here," a senior administration official said. "There has been some false reporting about this." A Stafford Act emergency is typically reserved for a terror attack or natural disaster in a more localized area.

Trump will formally make the announcement during a White House event Thursday.... On Aug. 10, Trump said his administration was drafting paperwork to officially declare the epidemic a national emergency, which was the “first and most urgent” recommendation in an interim report from his commission to combat the crisis. Two months later, some advocates and lawmakers were frustrated that the declaration still hadn’t come. At a press conference last week, Trump said he’d make the announcement this week, calling a declaration “a very important step” and saying “to get to that step, a lot of work has to be done and it’s time-consuming work.”

Administration officials said they felt that a public health emergency was a better use of resources.  It will allow acting HHS Secretary Eric Hargan to loosen certain regulations and issue grants and spend money that he otherwise would not be able to.  A public health emergency needs to be renewed every 90 days until the declaration is no longer needed.

Three agencies that play a role in the federal response to the opioid epidemic have acting directors instead of Senate-confirmed leaders: the White House Office of National Drug Control Policy, the Department of Health and Human Services and the Drug Enforcement Administration.  Rep. Tom Marino (R-Pa.) — an early backer of Trump — withdrew as the ONDCP nominee last week following a Washington Post-"60 Minutes” joint investigative report on a bill he sponsored that weakened the DEA's ability to enforce the nation’s drug laws.  Marino has vigorously defended himself. White House officials said Trump will be submitting names to lead HHS and ONDCP soon but pointed to “obstructionists” in the Senate for slowing down confirmation of lower level agency appointees who could help implement the action.

The declaration could spark a funding feud in Washington, as some say more cash is needed to make a declaration effective. The amount of money left in the public health emergency fund is paltry — just $57,000.  Administration officials said there have been ongoing discussions with Congress about securing more money for the fund as part of the year-end spending bill, but would not discuss specific dollar amounts.

Though I am sure there will criticism and debate as to whether the Trump Administration is doing enough with this latest move and other actions, I cannot help but note and praise the labeling and symbolism here.  Today's announcement involves a declaration of a "public health" emergency rather than a declaration of a "war on opioids" or advocacy for increased punishments for opioid activity.  (Although until we hear what Prez Trump actually says this afternoon, it may be premature to praise what it would seem he plans to say and I recall that last month AG Sessions talked about winning the war against opioids.)

In prior generations, such as when crack was the drug of great concern in the 1980s, the response at the federal level was to increase and emphasize the criminal justice fight in various ways.  A "public health" focus for drug problems is one that has been long urged by researchers and advocates; today's announcement suggests some rhetoric of late is shifting to embracing a "public health" model — although on-the-ground realities demonstrate that the criminal justice system is still playing a huge part of the public response to opioid and other drug issues.

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October 26, 2017 at 11:18 AM | Permalink


Some will suggest more white people have problems with opoids and argue that there is some inconsistency regarding the public health v. crime model. But, this blog is about optimism. Let's be optimistic that AG Sessions will not overuse the crime model as a whole.

Posted by: Joe | Oct 26, 2017 12:07:58 PM

I can't figure out whether I agree with @joe's comment or not. It has some good points and some bad points. It is really really important that we look at all the details and understand America today is in a complicated situation where we have to balance theoretical imperatives with real world consequences. So I don't know--a tough call--lots of people will second guess the solutions proposed by those in authority but we shouldn't rush to second guess them. Take our time. Ease into it. Could be some racial considerations here. Maybe not. Difficult to tell in advance.

Posted by: Daniel | Oct 26, 2017 2:41:45 PM

Drops in crime, ahead, by the millions. Then, drops in employment in criminal justice, by the thousands.

Drops in health care costs by the $billions. Then, drops in employment in health care by the millions.

Improvements of performance everywhere. Then, a richer economy for everyone.

Posted by: David Behar | Oct 26, 2017 11:22:51 PM

"It has some good points and some bad points."

Oh...my...God. It is spreading. The Weasel Bug.

Posted by: David Behar | Oct 27, 2017 12:21:38 AM

As alcohol and cigarette taxes increase so do the opioid overdoses. And yet no one suggests outlawing excise taxes . . .

Posted by: Stop taxing the poor | Oct 27, 2017 11:32:20 AM

I am interested in charging the DEA with crimes against humanity. When they say, they dropped Vicodin scripts 40%, it implies that millions of pain patients are left to suffer with inadequate pain control. If a dictator caused the torture of countless people, he would be arrested by Interpol, put on trial, and imprisoned for crimes against humanity at the International Court.

Posted by: David Behar | Oct 27, 2017 12:49:07 PM

Drug dependence is a public health issue. This has taken an interesting turn. Many sentencing reform advocates seem to be torn by this development.

I believe that it is because so many reform advocates are now interested in being involved in reentry and recovery programs. If the law enforcement piece is removed there will not be court referrals to the many programs that are now being funded. That will severely limit those who seek these services.

Posted by: beth | Oct 30, 2017 3:21:27 PM

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