Trump calls opioids crisis an emergency
Designation as ‘public’ rather than ‘national’ prevents release of funds
Families affected by opioid abuse were among the attendees at the ceremony on Thursday.Jeanne Moser of East Kingston, N.H., whose son Adam died from an overdose, carried his photo at the White House. (Alex Wong/Getty ImagesPablo Martinez Monsivais/associated press)
By Julie Hirschfeld Davis
and New York Times

WASHINGTON — President Trump announced Thursday that he is directing his Department of Health and Human Services to declare the opioid crisis a public health emergency, taking long-anticipated action to address a rapidly escalating epidemic of drug use in the United States.

The move falls short of Trump’s sweeping promise to declare a national emergency on opioids, which would have prompted the rapid allocation of federal funding to address the issue. The directive does not on its own release any money to deal with a drug crisis that has become a grim reality across the country, claiming more than 59,000 lives in 2016.

But it would allow some grant money to be used for an array of efforts to combat opioid abuse and would ease certain laws and regulations to address it.

“No part of our society — not young or old, rich or poor, urban or rural — has been spared this plague of drug addiction and this horrible, horrible situation that’s taken place with opioids,’’ Trump said at a ceremony in the White House East Room attended by families affected by opioid abuse, members of Congress, and administration officials. “This epidemic is a national health emergency.’’

“We cannot allow this to continue,’’ Trump added. “It is time to liberate our communities from this scourge of drug addiction.’’

The announcement was intended to fulfill a vow that the president made when he assumed office to make tackling opioid abuse one of his top priorities. But he has taken limited action to carry it out.

Administration officials argued Thursday that a national emergency declaration was not necessary or helpful in the case of the opioid crisis, and that the powers associated with a public health emergency were better suited to address the issue. The Trump administration, they said, would work with Congress to secure money to combat opioids in a year-end spending package, including through the Public Health Emergency Fund.

They outlined Trump’s announcement on the condition of anonymity to avoid preempting his speech.

Trump said his plan would include bypassing a rule that bars Medicaid funding from being used for many drug rehabilitation facilities; requiring federally employed prescribers to be trained in safe practices for opioid prescriptions; and a new federal initiative to develop nonaddictive painkillers. He also said the government would produce “really tough, really big, really great advertising’’ aimed at persuading Americans not to start using opioids in the first place.

“This was an idea that I had, where if we can teach young people not to take drugs,’’ Trump said, “it’s really, really easy not to take them.’’ He shared the story of his brother Fred, who he said had struggled with alcohol addiction throughout his life and implored Trump never to take a drink — advice the president said he heeded.

“We are going to overcome addiction in America,’’ the president said.

In August, Trump called the opioid crisis a “national emergency.’’ But he did not sign a formal declaration designating it as such, allowing the prospect to languish amid resistance in his administration about making an open-ended commitment of federal funds to deal with an issue that has shown no signs of abating. The crisis has claimed tens of thousands of lives.

Beyond the lack of funding, it is unclear how much impact the public health declaration will have in the short term, given that Trump has yet to name central players who would carry it out. That includes a drug czar to steer a broader strategy on opioids and a secretary of Health and Human Services who would tailor policies and identify sources of funding.

Representative Tom Marino, a Pennsylvania Republican whom Trump had named to lead the Office of National Drug Control Policy, withdrew last week after reports that he did the bidding of the pharmaceutical industry in weakening law enforcement’s ability to curb drug sales in efforts to block black-market sales of opioids. The White House has yet to announce a new candidate.

And Tom Price resigned last month as health secretary after it was revealed he was flying on private jets paid for with taxpayer dollars; a nominee has not been named for that post either.

But proponents, including some antiaddiction groups and physicians, contend Trump’s action is an important symbolic step that would raise awareness and elicit a new sense of urgency to deal with the opioid scourge.

The administration officials said a public health emergency declaration would quickly lead to crucial changes, including the potential to secure federal grant money and the expansion of access to telemedicine services, which would broaden the reach of treatment to rural areas ravaged by opioid use and where doctors are often in short supply.

Trump’s promises to focus on the opioid crisis helped propel him to victory in New Hampshire’s primary last year.

As president, he formed an opioid commission in March and installed at the helm Governor Chris Christie of New Jersey, a rival for the Republican nomination who had championed the issue during the 2016 race. In July, the commission recommended that the president declare a national emergency — either under the Stafford Act, which would have prompted the allocation of Federal Emergency Management Agency funds, or the Public Health Service Act, the option Trump has chosen.

Price had ruled out the idea of a national emergency, in part because of concerns about the potentially exorbitant costs to the federal government. Still, Trump surprised his advisers by telling reporters soon after his commission’s report that he was ready to take just such a step.

There have been few major actions to match those words, even as administration officials have worked feverishly behind the scenes to come to an agreement on an opioid policy that would reflect the president’s position.

In the meantime, members of Trump’s opioid commission and lawmakers in both parties had grown impatient for action. On Wednesday, a group of Democrats led by Senator Debbie Stabenow of Michigan released a letter they wrote to the president asking him to allow the government to negotiate lower prices for naloxone, a drug that quickly counteracts the effects of opioid overdoses. Declaring a state of emergency would give the secretary of Health and Human Services the power to seek such price reductions, they said.

Christie commended the president Thursday and said the commission would put forth a comprehensive plan next week.