On July 31, the White House’s Commission on Combating Drug Addiction and the Opioid Crisis released an interim report of policy recommendations for addressing the country’s opioid epidemic. The commission, which was established via executive order in March and is led by Gov. Chris Christie (R-N.J.), is tasked with identifying methods to combat and prevent opioid addiction. Opioid overdoses accounted for 33,000 deaths in 2015 – more than any other year on record, according to data from the Centers for Disease Control and Prevention (CDC).
The commission’s first report includes several short-term action items and largely reflects the guidance of public health advocates in its focus on expanding treatment options through maximizing the authority of relevant federal agencies and programs. The commission is expected to issue a more comprehensive set of policy proposals in October 2017.
The interim report’s recommendations include:
- Increase treatment capacity by allowing states to grant Medicaid waivers to treat substance use disorders;
- Mandate prescriber education initiatives in medical and dental schools aimed at preventing patient addiction;
- Enhance patient access to Medication-Assisted Treatment (MAT) to reduce the risk of relapse and overdose death;
- Provide states with model legislation to dispense the overdose antidote naloxone; and equip U.S. law enforcement officials with naloxone kits;
- Prioritize funding and resources to federal agencies to develop fentanyl (synthetic opioid) detection sensors to halt the flow of drugs from overseas and through the U.S. Postal Service;
- Streamline federal privacy laws to allow health professionals to share information across different providers and with patients’ family members;
- Deliver federal backing and technical support to states to improve data sharing to track patient prescription data; and
- Declare a federal state of emergency over the opioid epidemic
The last of these recommendations – declaring a national emergency – is unique in its urgency. Although this measure is typically reserved for natural disasters, it would empower the U.S. Department of Health and Human Services and other federal agencies to take immediate action on the deployment of treatment resources such as Medicaid waivers. For several of these short-term measures, a state of emergency may represent the best opportunity to implement the commission’s proposals – several of which would normally require congressional approval.
The other recommendations contained in the interim report hit close to home for counties, who increasingly find themselves on the front lines of responding to the opioid epidemic. County law enforcement officials, firefighters, and even librarians are now learning to recognize overdose symptoms and administer treatment drugs, since they are sometimes among the first to encounter a drug overdose in public.
Whether Congress will adopt the commission’s recommendations remains to be seen. For the past seven months, congressional Republicans and the White House have been engaged in efforts to repeal and/or replace the Affordable Care Act (ACA). The legislation, which proposed cuts to federal funding for Medicaid and public health, failed narrowly in the U.S. Senate last month. NACo opposed the bill’s potential cost shift to counties as it pertains to behavioral and public health care providers’ ability to address opioid addiction cases.
Lawmakers face a busy legislative calendar going into Fall. With just weeks left until the end of Fiscal Year (FY) 2017 on September 30, Congress is under pressure to take action on several big-ticket items, including reauthorization of the Children’s Health Insurance Program (CHIP), major reforms to the National Flood Insurance Program (NFIP) and finalizing FY 2018 appropriations bills.
Given the urgency of the epidemic, NACo is eager to work with Congress on measures that would help counties respond to the rising tide of opioid overdose cases. Over the last several months, NACo has been engaged in a joint effort with the National League of Cities (NLC) to comprehensively assess the local response to the opioid epidemic. In November 2016, the organizations published a joint report titled "A Prescription for Action," offering recommendations for reducing rates of opioid misuse, overdose and fatality through local, state and federal action.
Between now and the end of the year, federal lawmakers will spend several weeks back in their home districts and states. These district or state work periods offer county officials a unique opportunity to educate members of Congress, advocate for issues important to your county and stress the need for strong federal-state-local partnerships in combatting this urgent public health issue.
For more NACo resources on the opioid epidemic, please see the following links: