President Trump declares opioid epidemic a public health crisis

The addiction to opioids tearing through Montgomery County and many other communities across the nation is a public health emergency worthy of national attention, President Trump declared Thursday.

Local officials applauded Trump's offering of "relief" for state governments looking to access Medicaid funding for drug treatment centers with more than 16 beds.

Helen Jones-Kelley, executive director of the Montgomery County Alcohol Drug Addiction & Mental Health Services, said loosening that regulation is "the one thing that can make a difference in this community."

"That was one of the major impediments,” Jones-Kelley said. “The good news for us is that we can then stop using local dollars on residential beds and redirect those dollars into increased services.”

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State Rep. Niraj Antani, R-Miamisburg, said the move will provide more access to treatment.

"The 16-bed issue is one that affects us all in Ohio," Antani said. "We can't deliver drugs to addicts in jail, so we can't help them until they get out of jail."

Trump said his Thursday afternoon announcement at the White House "marks a critical step in confronting the extraordinary challenge we face."

"It is time to liberate our communities from the scourge of drug addiction," Trump said, referring to the situation as "a worldwide problem" and "national shame."

“Addressing it will require all of our effort and it will require us to confront the crisis in all of its real complexity,” the president said.

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Public health emergencies – which have been designated for the H1N1 flu outbreak in 2009, the Zika outbreak in 2016 and, more recently, hurricanes in Texas, Florida and Puerto Rico – allow the Secretary of Health and Human Services additional flexibility, such as waiving some Medicare, Medicaid, health insurance privacy and Children’s Health Insurance Program requirements, appointing personnel to respond the emergency and give states flexibility in how they use existing federal dollars.

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Trump did not, however, declare a national state of emergency, of which there are currently 29, including the proliferation of weapons of mass destruction and restrictions surrounding North Korea. Nor did he designate it a Stafford Act Emergency - one that would have allowed states to access funding from the federal Disaster Relief Fund – an account typically used to pay for the response to tornadoes and hurricanes. In a briefing with reporters early Thursday, Trump administration officials said that such a designation would not have been appropriate for the crisis, which has already spanned years. Such disasters – usually managed by the Federal Emergency Management Agency – are short-term and geographically specific.

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While that type of emergency “doesn’t really offer authorities that are essentially helpful here,” the official said, “if our legal analysis uncovers an authority really needed that could be helpful that we don’t already have, we would consider additional declarations.”

A public health emergency – such as the one Trump will sign later today – typically lasts 90 days, but can be extended.

The designation comes two after Trump’s Aug. 10 announcement that the opioid epidemic was a “national emergency” “the likes of which we’ve never had.” The delay, administration officials said, was because it needed to do a legal review.

But that delay was frustrating to everyone from the Partnership for Drug-Free Kids to New Jersey Gov. Chris Christie, a Republican who is leading Trump’s commission on opioid abuse.

There are multiple ways that a president can designate an emergency. Under the 1976 National Emergencies Act, formally imposes a procedure for a president to declare a national emergency.

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A public health emergency occurs when the secretary of Health and Human Services determines that a disease or disorder presents a public health emergency or that a public health emergency exists.

Finally, Trump could invoke the Stafford Act, a 1998 law that is used for most federal disaster response activities, particularly those requiring the help of the Federal Emergency Management Agency.

Trump has not invoked the 1976 law since he became president, but since Aug. 25, he’s declared major disasters through the Stafford Act covering Hurricanes Harvey, Irma, Maria and Nate and as well as for wildfires in California. The secretary of Health and Human Services has declared public health emergencies for the four hurricanes as well as renewing a determination for the Zika virus in January and April. In all, 122 disasters have been declared this year to date through the Stafford Act.

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Local impact

Opioids such as fentanyl, oxycodone and others took more than 34,500 lives last year, according to a Centers for Disease Control and Prevention estimate. This summer, Montgomery County Sheriff Phil Plummer said the county was on track to see some 800 people killed in overdoses this year.

As the president made his announcment, a new report outlines just how expensive that crisis in Ohio is — in more ways than one.

Opioid addiction, abuse and overdose deaths cost Ohio from $6.6 billion to $8.8 billion, according to a new report from the C. William Swank Program in Rural-Urban Policy at Ohio State University.

“To put this in perspective, Ohio spent $8.2 billion of general revenue funds and lottery profits money on K-12 public education in 2015,” the report says. “Thus, the opioid crisis was likely as costly as the state’s spending on K-12 education.”

The report estimates that between 92,000 and 170,000 Ohioans were abusing or dependent on opioids in 2015.

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