The most recent data shows that roughly 23.5 million Americans are struggling with addiction. This number has slowly grown over the last couple years. The White House seems to have made some progress in combatting this by putting in requests for more government spending. However, much of the public feels that the Trump administration’s impact on the opioid crisis has been minimal. The action that it has taken against the opioid crisis so far dates back to March of last year. This was near the end of Trump’s first 100 days as President of the United States. Here is what the Trump administration has accomplished— or at least set in motion— over the last few months.
On March 29th, Trump founded the Commission on Combating Drug Addiction and the Opioid Crisis, also called the Opioid and Drug Abuse Commission. Its purpose was to find ways to address drug addiction, especially the opioid crisis. This commission, comprised of Governor Chris Christie as the head and five other government officials, worked under its parent agency the Office of National Drug Control Policy. It also worked closely with the White House Office of American Innovation, chaired by Jared Kushner.
October and November
In late October of 2017, Trump declared a public health emergency in response to the increasingly rampant opioid addiction crisis. Just a few days later, Christie and the Opioid and Drug Abuse Commission announced their plans to combat the opioid crisis.
By the end of the year, the Affordable Health Care Act saw to the implementation of Medicaid in 32 states. Through Medicaid alone, roughly 1.2 million previously uninsured people in need of treatment were able to get it in 2017.
Despite this, the Trump administration began pushing for massive budget cuts to ACA and Medicaid toward the end of 2017. In fact, Trump proposed an enormous collective decrease of $1.3 trillion for Medicaid over the next decade.
Additionally, the Trump administration’s Opioid and Drug Abuse Commission disbanded in December, after having been active for less than a year.
In the first month of the New Year, the Trump administration suspended a widely-used SAMHSA database called The National Registry of Evidence-based Programs and Practices (NREPP). This program provided hundreds of scientifically-sound treatment resources for both medical professionals and individuals with substance abuse disorders. Trump administration officials announced that the contract that kept the database up and running was officially terminated.
Reportedly, a new database designed to battle the opioid crisis will replace the now dismantled NREPP program. No one has released any further details yet.
In his State of the Union address, Trump spent 80 minutes reviewing various issues and concerns of the American people. However, he spent less than one minute discussing his plans for the opioid crisis— a total of 49 seconds. During this short time, Trump discussed the potential benefits of focusing more on law enforcement to combat illicit opioid use.
Additionally, the Trump administration began shifting its focus away from funding for treatment options. After the State of the Union Address, they started focusing on various cuts for the 2019 budget. One of Trump’s proposals included cutting the budget for the Office of National Drug Control Policy, the parent agency of his failed Opioid and Drug Abuse Commission. The proposal involved a staggering 95% budget cut. This and other proposed budget cuts left many government officials and much of the public with a sense of unease.
By February 9th, Trump signed a bipartisan budget agreement after Congress approved the bill. The two-year deal will allow lawmakers to spend an additional $300 billion on top of their current budget.
Three days after the $300 billion bipartisan budget agreement, Trump and his administration released a blueprint of the 2019 U.S. Government Budget. In it, several federal agencies would see drastic budget cuts compared to their enacted funds of 2017. This includes the Environmental Protection Agency, the Interior Department, and even the State Department. The 2019 budget plan also calls for the complete elimination of certain agencies. The funding for dismantled agencies would most likely be repurposed for other departments.
Details About the Budget Proposal
The 2019 budget proposal affects funding for fighting the opioid crisis as well. In the 2019 budget plan, the Trump administration put in a request for more than $30 billion in drug control funding. This will supposedly combat the opioid crisis over the next five years. This includes a request for $13 billion and the designated $6 billion from the bipartisan budget agreement mentioned earlier. The 2019 budget plan outlines other parts of proposed drug control funding here:
[T]he Office of National Drug Control Policy estimates that more than $7 billion combats the opioid crisis, with efforts spanning prevention, treatment, interdiction, international operations, and law enforcement across 14 Executive Branch Departments, the Federal Judiciary, and the District of Columbia.
The Budget requests $5 billion in new resources for the Department of Health and Human Services (HHS) over the next five years, including $1 billion in 2019, to combat the opioid epidemic by preventing opioid abuse and helping those who are addicted get access to overdose reversal drugs, treatment, and recovery support services.
The HHS Secretary Alex Azar confirmed in a formal statement that “[the budget] supports our four priorities here at HHS: addressing the opioid crisis, bringing down the high price of prescription drugs, increasing the affordability and accessibility of health insurance, and improving Medicare in ways that push our health system toward paying for value rather than volume.”
Other Details to Consider
This seems like the step in the right direction. However, the Trump administration also proposed to cut 21% of funds from the HHS budget. A cut like this would leave the department with roughly $68 million in government spending. According to budgeting documents, this is almost $18 billion less than the HHS used in 2017.
Additionally, the Trump administration did not raise the $1 billion that the plan listed as a resource. President Barack Obama and his administration approved that bit of government spending and signed it into law for the 21st Century Cures Act.
The 2019 budget plan’s release garnered a lot of mixed responses from non-administrative government officials and the public. Afterward, the Trump administration went on to approve a national research effort to combat the opioid crisis. With this approval, the Centers for Disease Control and Prevention (CDC) dove into a slew of new studies.
This new line of research will set out to determine the most effective treatments for those who are struggling with opioid addiction. The study’s findings will help keep policymakers and healthcare providers informed as to whether or not specific drug-assisted therapies are appropriate on a case-by-case basis. The study will also determine which treatment methods are actually successful. As of now, the CDC reports that it has high hopes for the study’s results.
Concerns Over ACA and Medicaid Budget Cuts
The 2019 budget plan demonstrates that the administration is trying to combat the opioid crisis as Trump promised. The proposals in the plan regarding the opioid crisis do potentially provide more funding for opioid addiction treatment. However, the proposed cutbacks of other funding sources have the potential to harm people’s access to such treatment. The budget plans to repeal the Affordable Care Act and cut Medicaid funding, which will leave almost 20% of the U.S. population without coverage.
Concerns Over Treatment Accessibility
As of right now, the United States lacks widespread access to addiction treatment. Of the 23.5 million Americans that are struggling with addiction, only 10% ever get treatment. Vivek Murthy, the last Surgeon General of the Obama administration, theorized in his 2016 report that this number was due in large part to a lack of treatment accessibility.
Additionally, many addiction treatment experts believe that the $6 billion in opioid crisis spending that has been confirmed so far is not enough to make an impact. In fact, they say that opioid crisis funding would need to be in the tens of billions to be effective.
A study conducted in 2016 seems to support this. The study calculated the economic burden by taking prescription misuse, addiction, and overdose all into account. The total economic burden of the opioid crisis in 2013 was more than $78.5 billion. Healthcare and treatment costs made up about a third of the money spent. So, even if all the proposals for drug control funding from the 2019 budget plan were met, it wouldn’t even make up for half of the year’s projected economic burden. A further investment of tens of billions could save money in the long run before more costs have the chance to pile up.
What the Public Wants from the Trump Administration
In 2016, more than 64,000 people died of an opioid overdose. Based on their data, the CDC fears that this mortality rate will continue to rise over the next few years. Unfortunately, the death toll probably will continue to increase unless the White House follows through on generating enough funds to fight the crisis efficiently. This, of course, is the number one priority, but the general public has other concerns that the Trump administration should also address.
For example, there is still no head of the Office of National Drug Control Policy. Back in October, the Trump administration came close to appointing not long before the Opioid and Drug Abuse Commission was formed. However, Tom Marino, Trump’s nominee, turned down the position after news broke out of his involvement in a controversial bill regarding opioid manufacturing and distribution. This bill reportedly made it more difficult for the DEA to investigate potential prescription abuse. As of right now, James W. Carroll was appointed by the Trump administration to step in as Acting Director of the, but this likely won’t last long. And with no official director, the Office of National Drug Control Policy is in danger of being dismantled. This could spell disaster for the battle against the opioid crisis.
In addition to wanting a new Head of the Office of National Drug Control Policy, the general public also wants a more coordinated federal response to the opioid crisis. Professionals are calling on the Trump administration to employ a strategy similar to the one used during the HIV/AIDS crisis in the mid-1990s.
TTC Outpatient Services Offers Opioid Addiction Treatment
Change is coming. We could very well be the generation that ends the opioid crisis. Still, we are in desperate need of adequate treatment budgeting, improved health services, and more widespread access to care for those affected by the opioid crisis. Until those and other public demands are met, we can only use the resources we have.
At TTC Outpatient Services, our trained medical staff and team of counselors and therapists can help you overcome your addiction to opioids. We offer personalized treatment plans that fit both your needs and your schedule. For more information, please call 844-665-6834.