Philadelphia Medicine Winter 2017-18x - 28

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FEATURE

What Impact Will the Federal Government's
Declaration of a Public Health Emergency
Have on the Opioid Crisis?
By: Robert Miyamoto, B.A.

n October 26, the Secretary of the U.S. Department of
Health and Human Services, Eric Hargan, under the
direction of President Trump, declared that the opioid
crisis was a public health emergency. This was clearly a long time
in coming. We have all seen and felt the effects of the epidemic
on both the people around us and on our nation as a whole. What
impact will this announcement have on the battle against opioid
addiction?

Trump suggested in August that he would call the opioid epidemic
a national emergency. This would have opened up immediate aid
and significant funding for communities affected by the crisis.
More resources are devoted to national emergencies than public
health emergencies.
Historically, national emergencies have been issued primarily
for the purpose of imposing sanctions on other countries. Despite this, it would not have been unprecedented for the opioid
epidemic to have been designated as a national emergency, as one
currently exists that is focused on narcotics traffickers. Critics have
argued that Trump should have been consistent with his remarks
and should have declared the epidemic a national emergency.

Regardless, the designation of a public health emergency is an
appropriate one. While the label has been typically reserved for
natural disasters and infectious disease or virus outbreaks, it can
encompass any widespread outbreak such as the opioid crisis.
This status gives the Department of Health and Human Services
more freedom to act on the epidemic, allowing for temporary
appointments of specialists to respond to the health emergency,
and permitting it to reallocate existing assets within HIV/AIDS
programs to help participants receive substance abuse treatment.
One of the major focuses that has arisen as a result of this declaration is access to addiction treatment. The department plans to
work with the Drug Enforcement Administration to expand access
for patients to telemedicine for addiction treatment, particularly in
rural areas. Forty-five percent of rural U.S. counties lack substance
abuse disorder treatment facilities, compared to 10 percent in
metropolitan counties.
An advertising campaign is also in the works, which will warn
of the dangers of opioid addiction. As part of Trump's promise to
decline his presidential salary of $400,000 a year, he will donate
his third-quarter salary towards funding this campaign.
The government will continue working with pharmaceutical companies to develop innovative addiction treatments as well as develop
non-addictive approaches to treating chronic pain. The government
is also emphasizing the importance of educating physicians and
other health care professionals on pain management, destigmatizing
addiction, and pushing for full enforcement of health plan parity
between mental and physical health. Recommendations on how
to resolve these issues were brought to the president in November
by the Office of National Drug Control Policy.
The Public Health Emergency status does not significantly increase
funding towards addressing the opioid crisis. The fund associated
with public health emergencies contains a meager $57,000. However, the national budget does set aside funding to combat both
the opioid and illicit drug crises, and is set to increase for 2018.
In 2017, the Department of Health and Human Services invested
$900 million in programs targeting the opioid crisis. The money
helped increase the availability of overdose-reversing drugs such
as naloxone, helped train first responders, and increased access to
prevention, treatment and recovery services.

28 Philadelphia Medicine : Winter 2018

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