Trump’s Opioid Commission Recently Recommended Health-Based Response, While Attorney General Sessions Pushes for More Criminalization and Incarceration; Advocates: Opioid Overdose Crisis is a Health Issue, Not Criminal Issue
Washington, DC—(ENEWSPF)—August 8, 2017. President Trump is expected to be briefed on the opioid crisis today by Tom Price, Secretary of Health and Human Services. Today’s briefing comes a little more than a week after President Trump’s bipartisan opioid commission released interim recommendations calling for the declaration of a national emergency that would prioritize a federal government response to the crisis and greater access to medication-assisted treatment and naloxone.
“We need to be cautious about the intentions of this administration,” said Grant Smith, deputy director of national affairs for the Drug Policy Alliance. “An emergency declaration can be used for good. It can help free up federal resources, help prioritize responses by the federal government, help give the administration leverage to request legislation from Congress.”
“On the other hand, declaring a national emergency could be used to further the war on drugs,” said Smith. “It could give the administration leverage to push for new sentencing legislation, or legislation that enhances drug penalties or a law enforcement response. It could give Jeff Sessions ammunition to push the agenda that he has been pursuing.”
Officially there has been no reaction from the White House about the opioid commission’s recommendations, although advocates say they contrast sharply from the Trump administration’s overall response to the opioid crisis to date. For instance, President Trump made repeal of the Affordable Care Act a top priority, which would threaten healthcare and access to treatment and mental health services for millions of people living with substance use disorder.
Trump’s Attorney General, Jeff Sessions, has repeatedly dismissed the value of treatment and pursued a hardline agenda that has escalated the war on drugs. Sessions declared that the opioid crisis is a “winnable war” and urged law enforcement to pursue prosecutions for illegal possession of prescriptions just two days after the opioid commission released its interim report that called for a health-based response.
“President Trump’s bipartisan opioid commission makes clear that this crisis demands a health-based response,” said Smith. “So far, Attorney General Sessions’s escalation of the war on drugs and President Trump’s attempts to take away healthcare and treatment from millions of people is extremely worrisome. To date, the Trump Administration’s response to the opioid crisis is an epic fail.”
Advocates say that the opioid commission’s recommendations reflect a dire need to treat the opioid overdose crisis as a health issue and not a criminal issue. The Trump Administration and Congress should prioritize scaling up access to the overdose-reversal drug naloxone and medication-assisted treatment, like methadone and buprenorphine, and resist efforts to expand the use of mandatory minimum sentences and criminalization.
Here’s what happens if Trump declares opioid abuse a national emergency, By: Christopher Ingraham, August 8, 2017
President Trump announced on Tuesday that he would hold “a major briefing on the Opioid crisis” this afternoon at his private New Jersey golf club. While the White House has not yet released any details about the event, the president could take the opportunity to declare a state of national emergency over the drug overdose epidemic, following a recommendation issued at the end of July by a White House commission on opioids he convened earlier this year.
That commission, chaired by New Jersey Gov. Chris Christie, wrote that its “first and most urgent recommendation” was for the president to “declare a national emergency under either the Public Health Service Act or the Stafford Act.”
Such a declaration would “empower your cabinet to take bold steps and would force Congress to focus on funding and empowering the Executive Branch even further to deal with this loss of life,” the commission wrote.
From a strictly practical standpoint the emergency declaration would have two main effects, according to Keith Humphreys, an addiction specialist at Stanford University (and frequent Wonkblog contributor) who worked in the federal Office of National Drug Control Policy under President Barack Obama.
“First, it lets states and localities that are designated disaster zones to access money in the federal Disaster Relief Fund, just like they could if they had a tornado or hurricane,” Humphreys said. States and cities would be able to request disaster zone declarations from the White House, which would enable them to use federal funds for drug treatment, overdose-reversal medication and more.
“Second, declaring an emergency allows temporary waivers of many rules regarding federal programs,” Humphreys said. “For example, currently Medicaid can’t reimburse drug treatment in large residential facilities (16 or more beds). That could be waived in an emergency.”
Humphreys points out that Congress could have addressed any of these issues legislatively in recent years, and it could have allocated billions in funding for the opioid crisis as well. But, he said, “the reality is that they have spent this entire year trying to cut spending on the opioid epidemic” via drastic cuts to Medicaid contained within the various GOP-supported Obamacare repeal bills that nearly became law.
In 2016 Congress did approve $1 billion in funding over two years for state grants to fight the opiate epidemic as part of the 21st Century Cures Act. But the epidemic shows no sign of relenting. The latest federal estimates released this week suggest the pace of drug overdose deaths accelerated last year.
Groups advocating for a public health-centered approach to the epidemic are worried about what powers an emergency declaration would grant an administration with a fondness for “tough on crime” law enforcement tactics.
“We need to be cautious about the intentions of this administration,” said Grant Smith of the Drug Policy Alliance. “An emergency declaration can be used for good. It can help free up federal resources, help prioritize responses by the federal gov, help give the administration leverage to request legislation from Congress.”
On the other hand, Smith said, “all of those things I just mentioned could be used to further the war on drugs. It could give the administration leverage to push for new sentencing legislation. Or legislation that enhances [drug] penalties or law enforcement response. It could give [Attorney General Jeff] Sessions more leverage to push the agenda that he has been pushing.”
With the release of the opiate commission report in July, the Trump administration finds itself at something of a crossroads on how it deals with the opiate crisis. The White House could pursue the law enforcement-centric approach favored by Attorney General Jeff Sessions, involving more mandatory minimum sentencing, expanded use of asset forfeiture to target suspected criminals, and the construction of a Mexican border wall.
Or, the White House could pivot to the more public health-oriented approach outlined in the opiate commission’s recommendations, involving expanded drug treatment options and increasing the availability of anti-overdose drugs.
The president’s briefing today should offer clarity on which direction the administration plans to pursue.