Trump declares opioid epidemic a national public health emergency
Washington (CNN)President Donald Trump declared the opioid epidemic a national public health emergency on Thursday, telling an audience in the East Room of the White House that "we can be the generation that ends the opioid epidemic."
"This epidemic is a national health emergency," he said. "Nobody has seen anything like what is going on now."
He
added: "As Americans, we cannot allow this to continue. It is time to
liberate our communities from this scourge of drug addiction. Never been
this way. We can be the generation that ends the opioid epidemic. We
can do it."
Trump, in a
wide-ranging speech about opioids, stressed the need for further
enforcement and linked his planned wall along the US-Mexico border with
efforts to stem the tide of illegal drugs coming into the United States.
"An
astonishing 90% of the heroin in America comes from south of the border
-- where we will be building a wall -- which will greatly help in this
problem," he said.
Some
experts are skeptical about the wall's ability to fight the problem,
given its roots in painkillers prescribed by doctors in the United
States.
Trump also stressed the
need to crack down on those Americans who are buying illegal drugs,
stressing the need to link enforcement with stopping abuse in the first
place.
"Every person who buys
illicit drugs here in America should know that they are risking their
futures, their families and even their lives," he said. "Illegal drug
use is not a victimless crime. There is nothing admirable, positive or
socially desirable about it."
Trump's
move is different from the broad order the President previewed over the
last few months. On Thursday, the President directed acting Health
Secretary Eric Hargan to declare a public health emergency under the
Public Health Services Act -- which directs federal agencies to provide
more grant money to combat the epidemic -- not a national emergency
through the Stafford Disaster Relief and Emergency Assistance Act.
The
difference between the two orders is money and scope. If Trump had used
the Stafford Act, the federal government would have been able to tap
into funds from the Federal Emergency Management Agency's Disaster
Relief Fund to combat opioids. A senior administration official,
however, said the designation was not the right fit because the FEMA
money is meant for natural disasters, not health emergencies.
Under
the Public Health Services Act designation, no additional federal
funding will automatically be directed to the crisis, said an official,
but federal agencies will be directed to devote more grant money already
in their budget to the problem and take "action to overcome
bureaucratic delays and inefficiencies in the hiring process," according
to a fact sheet on Trump's order.
The
Trump administration will work with Congress to fund the Public Health
Emergency fund and to increase federal funding in year-end budget deals
currently being negotiated in Congress.
Trump
called for creativity in trying to fight the opioid epidemic, even
suggesting a "really tough, really big, really great" advertising
campaign that would aim to convince people never to do drugs in the
first place. That sort of strategy advocates for targeting kids and
young adults with anti-drug messaging, evocative of the "Just Say No" ad
campaign of the 1980s and early 1990s.
The
President also personalized his message, telling the audience of
Cabinet officials, lawmakers and families affected by the opioid
epidemic that his older brother Fred Trump Jr.'s struggle with
alcoholism taught him about curbing addiction.
"I
had someone who guided me and he had a very, very tough life because of
alcohol," he said, adding that reaching young people and urging them
never to start using drugs will make it "really, really easy" to fight
the scourge.
Administration
officials, pressed as to why Trump didn't declare a nation disaster to
combat the crisis, pushed back against the idea that Trump's order is
less sweeping than what he promised.
"Under
the Stafford Act, as unfortunately we have seen on multiple occasions
over the last several months, the Stafford Act is deigned to respond to
mostly natural disasters that are (of a) very short time duration and a
specific geographic region," one official said, adding that the Trump
administration believed the order under the Public Health Services Act
is "a better use."
Trump's order
will last 90 days and, according to another official, can be renewed
every 90 days until the President believes it is no longer needed.
Since
1999, the number of American overdose deaths involving opioids has
quadrupled. From 2000 to 2015, more than 500,000 people died of drug
overdoses, and opioids account for the majority of those. Recently
released numbers from the Centers for Disease Control and Prevention
found that around 64,000 people died from drug overdoses in 2016.
Trump, after campaigning for president in part on fighting the scourge of opioid addiction, has long teased sweeping action.
The
President told reporters in August that he would designate the epidemic
a "national emergency" but failed to follow through. The lack of
action, treatment advocates said, has deprived the fight against the
deadly drugs a designation that would offer states and federal agencies
more resources and power.
During an
impromptu press conference in the White House Rose Garden last week,
Trump said that he would officially declare the national emergency when
asked why he had not followed through with his initial pledge.
And
speaking with reporters on the South Lawn of the White House on
Wednesday, Trump said he would have a "very big meeting on opioids" on
Thursday and will be declaring the opioid epidemic a national emergency
"in the very near future."
Public health emergency vs. national emergency
The primary difference between the two designations is access to funding.
The
designation Trump will announce Thursday does not allow the federal
government to tap into FEMA's Disaster Relief Fund and it is an open
question whether Congress will offer more money to fund the Public
Health Emergency fund, which Congress has not funded in recent years.
But
multiple Obama administration health officials told CNN that they
believe using the Public Health Services Act is the more appropriate
avenue.
Using FEMA funds to combat
the opioid crisis would be "a little bit like asking an engineer to bake
a cake," said Rafael Lemaitre, the former communications director for
the White House Drug Policy Office under Obama.
"I
do think the public health service act is more appropriate route to
take than the Stafford Act designation," he said. "I worked at FEMA for
two years and dealt with multiple disasters. The Stafford Act is not
structured to deal with a long term, complicated public health crisis
like the opioid crisis."
Lemaitre added that FEMA's fund is "already running on fumes because of the three hurricanes" that hit this year.
Tom
Coderre, a former senior official under in Obama's Substance Abuse and
Mental Health Services Administration office at HHS, echoed that
sentiment.
"One of the things that I
think is most beneficial part of having a public health emergency is
you really can marshal public support and then you can bring all the
resources of the federal government to bear on it, bringing people from
all of the agencies to combat the issue," he said.
Though
both Lemaitre and Coderre said this step was important, both argued
that it was not a "silver bullet solution to the opioid crisis." That,
they said, would be additional funding from Congress.
"A
smarter play here would be for the administration to move beyond this
declaration and pass the billions in funding needed to address this
crisis. That is how you move the needle on this," Lemaitre said.
2016 election
Shortly
after taking office, Trump convened a White House commission to study
the problem and provide recommendations. Earlier this year, despite
then-Health and Human Services Secretary Tom Price saying it wasn't
needed, the commission recommended Trump declare a national emergency
using either the Public Health Services Act or the Stafford Act.
"I
commend the President on the bold action he is taking today by adopting
the first recommendation" the commission made, New Jersey Gov. Chris
Christie, the head of the panel, said Thursday.
The businessman-turned-politician made combating the opioid epidemic a top priority during the 2016 campaign.
The
issue was elevated to such importance that during the closing moments
of Trump's 2016 campaign -- when time is at its most precious -- the
Republican nominee headlined an opioid roundtable where he met
face-to-face with those directly impacted by the issue.
"I
just want to let the people of New Hampshire know that I'm with you
1,000%, you really taught me a lot," he said before promising to help
people who "are so seriously addicted."
His actions as president, though, have left even members of his own commission with concerns.
Former Rep. Patrick Kennedy, a member of the President's commission on opioid addiction, told CNN on Wednesday that he worries the President and his administration are using the opioid epidemic for photo ops.
"We
don't want any more photo-ops," the former Democratic congressman from
Rhode Island said. "I'm just speaking as an advocate, in this fight
every single day as someone who is in recovery and someone who is an
advocate. We don't want any more visits to rehab centers and photo-ops,
saying how courageous we are. Enough already. We want to save lives."
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