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Experts share how the declaration could affect how the opioid epidemic is managed.
On August 10, President Trump announced that he is drafting paperwork to declare the country’s opioid crisis a national emergency. His statement was made on the heels of a report by the President's Commission on Combating Drug Addiction and the Opioid Crisis, which urged Trump to do so. “With approximately 142 Americans dying every day, America is enduring a death toll equal to September 11th every three weeks,” the report states.
"We're going to spend a lot of time, a lot of effort, and a lot of money on the opioid crisis. It is a serious problem the likes of which we have never had,” Trump stated at his golf club in Bedminster, New Jersey, during an impromptu press briefing.
“Declaring the opioid epidemic a national emergency more closely resembles a public health emergency, except that those emergencies typically are in effect for 90 days and relate to infectious diseases or bioterrorist attacks,” explains Janice G. Jacobs, managing director in Berkeley Research Group’s Health Analytics practice, a healthcare consultancy. “The opioid epidemic is a long-term problem that relates to behavioral health issues and will be difficult to eradicate since it involves psychological as well as physical therapies.”
An example of a national emergency and public health crisis occurred in Puerto Rico with the Zika virus and the widespread concern of a potential pandemic. “The crucial part of this declaration is that it mobilizes resources and brings noteworthy attention to the problem,” says Sherry Ellis, LICSW, ACSW, chief operating officer, Spectrum Health Systems, Inc., Worcester, Massachusetts.
Doug Tieman, president and CEO, Caron Treatment Centers in Wernersville, Pennsylvania, points out that the President’s Commission on Combating Drug Addiction and the Opioid Crisis included a variety of recommendations that the Trump Administration would be able to immediately enact as a result of declaring a national emergency.
The federal government should learn from states that have already implemented public health emergencies to address the opioid crisis, including Maryland, Massachusetts, Alaska, Arizona, Virginia, and Florida, he says. “These states provide a model for using public health emergency declarations to implement new prescription guidelines for healthcare professionals and expand educational programs about addiction. They also increased access to treatment including medications for addiction treatment and broadened availability of emergency tools such as naloxone, a medication used to revive someone who has overdosed. These combined efforts can make a significant impact in saving lives.”
So what exactly are the implications of such a declaration, and how would it affect healthcare?
1. More resources for funding would become available. Once a national emergency is declared, the president could use resources reserved for natural disasters such as Federal Emergency Management Agency funds. State governors would be able to apply for relief and receive funding for local governments to use in the fight against this epidemic, Jacobs says.
Much needed funding would be provided for patients seeking treatment for addiction through therapy and anti-opioid medications, Jacobs says. Additional funding to programs treating the addiction would provide benefits to more patients seeking help.
2. Funds from Medicare and Medicaid could be used. Since Medicare and Medicaid are federally-funded programs, declaring the opioid epidemic a national emergency would most likely require both of these programs to expand their benefits to cover treatment, medications, and ongoing therapy for patients suffering from substance abuse, Jacobs says. From a compliance perspective, treatment programs receiving federal funds would be subject to closer scrutiny.
A declaration of an emergency under the Social Security Act could allow waivers for Medicaid funding. This would let the HHS secretary bypass regulatory hurdles that normally apply to the public health program. For example, under the Social Security Act, federal Medicaid funds can’t reimburse services from inpatient facilities with more than 16 beds that treat mental diseases, including addiction. “Eliminating this barrier through waivers would let states open more treatment options,” Ellis says. “Additionally, a national emergency would allow the HHS secretary to negotiate lower prices on naloxone through Medicare under emergency conditions.”
A national emergency would also allow Medicaid funds to be used for access to experimental medications in addition to the traditional medication assisted treatment options including, but not limited to methadone, naltrexone, and buprenorphine, Ellis adds.
3. Funds could be allotted for education. Tieman says the declaration is an opportunity to raise awareness and help the public better understand the complexities of addiction as a chronic disease. Prevention programs for families, students, teachers, and other general consumers are essential for a long-term solution to this crisis.
Tieman also emphasizes that funding can improve access to quality, evidence-based treatment programs for individuals and their families.
Karen Appold is a medical writer in Lehigh Valley, Pennsylvania.