President Donald Trump declared war on drugs today.
However, he did it with a different kind of arsenal than originally planned.
And critics say his battlefield strategy will not have enough firepower to defeat an epidemic that is killing tens of thousands of Americans every year.
At the White House on Thursday, President Trump announced a “public health emergency” over the nation’s opioid epidemic.
The declaration falls short of the “national emergency” that had been discussed by the president and others this summer.
On Thursday, the president said the public health emergency will address the “national shame” and “human tragedy” of the opioid crisis.
Trump said the federal government would help develop nonaddictive painkillers and consider lawsuits against “bad actors” that fuel the opioid crisis.
“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,” the president said.
The declaration lasts for 90 days and can be renewed every 90 days as long as the president feels it’s needed.
Among other things, the health emergency declaration allows patients to get medically assisted treatment for opioid addiction through telemedicine instead of in-person visits with doctors, according to USA Today.
It also gives federal and state governments more flexibility in temporarily hiring substance abuse specialists.
The pharmaceutical industry praised the president’s action, saying “the problem is too complex for a single person or policy to solve alone.”
“We commend the Trump Administration for its leadership in tackling the opioid and heroin addiction crisis,” a statement from the Pharmaceutical Research and Manufacturers of America (PhRMA). “We agree that this is a nationwide public health emergency and believe today’s announcement will provide the federal government with more tools and resources to end a tragic epidemic that is being deeply felt by individuals, families and communities across the country.”
However, critics said the “public health emergency” status limits the scope of what the federal government can do.
They point out that under a “national emergency” status the federal government could have tapped into funds from the Federal Emergency Management Agency’s Disaster Relief Fund.
White House officials said using the Disaster Relief Fund wasn’t appropriate because the money is meant for natural disasters, not health crises.
CNN reported that under the public health emergency no additional funding will be directed immediately to the opioid epidemic. Instead, federal agencies will be able to use more grant money already in their budget for the epidemic.
Critics said more needs to be done.
“What’s important for Americans is not declaring an emergency but acting on the emergency,” Peter Maybarduk, director of Public Citizen’s Access to Medicines program, said in a statement. “Declarations and tweets will do little to curb the deadly opioid push into our communities spurred by Big Pharma.”
A difficult crisis to solve
More than in the United States die every year from opioid-related causes.
In addition, nearly half of all opioid overdose deaths involve a prescription opioid, according to the Centers for Disease Control and Prevention (CDC).
Earlier this week, Scott Gottlieb, commissioner of the U.S. Food and Drug Administration (FDA), testified before a House panel about the opioid crisis.
Gottlieb said the task at hand is mighty.
“We have a crisis of such massive proportion that the actions we need to take are going to be hard,” he told panel members.
Gottlieb said his agency will “double our efforts” to help develop new, less addictive pain remedies.
He added that the FDA will also update its “risk-benefit framework” when making decisions about prescription opioids.
The commissioner also laid out three steps his agency will take to help those addicted to the painkillers.
Among them is expanding access to treatment programs.
What a declaration can mean
Declaring an opioid “national emergency” would have had its benefits.
As Healthline reported in August, such a declaration can make it easier for federal agencies to receive additional funding to combat the problem.
It could also allow the federal government to grant waivers in certain situations, such as increasing treatment options for people on Medicaid.
The idea of declaring a national emergency on opioids was first publically suggested in late July by a commission the president had empaneled to look at the crisis.
On August 10, the president said the opioid crisis was a “national emergency” and promised to make that declaration official in the coming days.
Since then, White House officials have said the delay in the proclamation was due to bureaucratic paperwork and receiving input from experts.
Who’s to blame?
A “60 Minutes” report broadcast earlier this month on CBS focused on the distributors of opioids in the United States.
Whistleblowers told “60 Minutes” that the companies that distribute opioids from manufacturers to pharmacies had knowingly flooded communities with pills even though they were aware of illegal opioid operations there.
The report also stated that pharmaceutical industry lobbyists pushed Congress to reduce the power of the Drug Enforcement Agency (DEA) to investigate opioid abuses.
Rep. Tom Marino (R-Pennsylvania) was one of the primary sponsors of this legislation. After the “60 Minutes” report, he withdrew from consideration for the role of drug czar, a position for which he was nominated by President Trump.
One expert interviewed by Healthline feels the emphasis may be on the wrong group.
Dr. Indra Cidambi, an addiction medicine expert and the medical director at the Center for Network Therapy in New Jersey, said the focus should be on the doctors who are prescribing the opioid painkillers.
“They’re looking in the wrong place,” Cidambi told Healthline. “I bring it back to the prescribers. Someone has to write the prescriptions.”
She said declaring a national emergency is fine, but the proclamation alone doesn’t solve the problem.
“We all know this is an opioid epidemic. It’s not a secret,” she said.
She also thinks efforts to punish people who abuse opioids aren’t effective.
“It’s missing the point,” she said. “This is not going to help this problem.”
The group Public Citizen also feels the spotlight needs to be shifted.
However, their focus is on the pharmaceutical industry.
In his statement, Maybarduk said pharmaceutical companies have “hooked millions of Americans on opioids through illegal marketing, greed and undermining safety standards.”
He urged President Trump to ramp up enforcement and penalties against illegal opioid marketing.
He also urged the president to toughen FDA safety standards.
“Big Pharma created this epidemic. Ending Big Pharma’s corruption is a necessary part of the solution,” Maybarduk said.
Another expert told Healthline a proactive approach is needed rather than a reactive approach.
Dr. Nicholas Kardaras, executive director at the Dunes East Hampton addiction treatment residence in New York, said education is one of the keys.
“Government funding needs to be allocated to education and training to generate awareness of addiction,” said Kardaras.
He also said spending more in the appropriate locations is important.
“I firmly believe that the long-term solution is a redistribution in the budgets,” Kardaras said. “Programs that help addicts in low-income populations and states where addiction is at its highest is where we should start. It is well documented that addiction thrives in environments of high stress and low support. Programs that create jobs, improve living conditions and improve access to low-cost healthcare are what will make the greatest difference. In other words, get to the source — right now we are in reactive mode.”
Agencies have been taking action in the war on opioids for the past several months.
On Thursday, federal prosecutors announced they have filed a fraud and racketeering case against John Kapoor, the founder of opioid manufacturer Therapeutics.
The charges center on allegations that the former chief executive officer and other officials at Therapeutics provided kickbacks to doctors to prescribe the opioid Subsys.
During the summer, federal officials took other action on the opioid crisis.
The CDC released a report that noted the amount of opioids had peaked in 2010 and decreased every year through 2015.
However, CDC officials said prescription levels remain at a “high level,” and the average supply of prescription opioids had increased from 13 days to 18 days between 2006 and 2015.
At the time of that report in July, officials at Endo International announced they were taking their popular prescription painkiller, Opana ER, off the market.
The FDA had requested the recall in June, saying the reformulated drug was being abused by people who injected it.
A few weeks later, Attorney General Jeff Sessions announced that 412 defendants had been charged in healthcare fraud and opioid scams.
Officials at the state level have been tackling the opioid crisis on their own.
In all, 41 state attorneys general have subpoenaed drug companies for information on how opioid medications are manufactured, marketed, and distributed, according to a CBS News report.
In addition, the opioid epidemic reached the shelves of Walgreens this week.
The retail drug store chain announced on Tuesday that the nasal spray Narcan will now be available without a prescription at all of Walgreen’s 8,000 pharmacies nationwide.
The product contains the drug naloxone, which can be used to save people suffering from drug overdoses.
Last month, it was reported that CVS is offering prescription-free naloxone products in 43 states.