On March 18, the White House announced President Trump’s Initiative to Stop Opioid Abuse and Reduce Drug Supply and Demand, a three-pronged strategy to address the nation’s ongoing opioid epidemic. The initiative will focus on reducing demand and over-prescription of opioids; cutting off the supply of illicit drugs; and expanding treatment options for individuals struggling with addiction.
The administration’s announcement follows up on a November 2017 report of policy recommendations issued by the White House’s opioid commission, which featured multiple proposals aimed at addiction prevention, addiction treatment and drug interdiction. The commission was established by President Trump shortly after his inauguration and was led by former New Jersey Governor Chris Christie.
In the White House’s new initiative, which incorporates many of the recommendations put forth by the opioid commission, specific steps are listed for each of the initiative’s three overarching goals. A county-focused summary of these steps is listed below, and you can read a full outline of the initiative here.
- Reducing demand and over-prescription: To educate Americans about the dangers of opioids and other drug use and to curb over-prescription of addictive painkillers, the president’s initiative calls for the launch of a nationwide media campaign to raise public awareness about the dangers of prescription and illicit opioid use, as well as other drug use. The initiative also calls for the implementation of a “Safer Prescribing Plan” that would cut nationwide opioid prescription fills by one-third within three years, and would also support a nationally interoperable Prescription Drug Monitoring Program network.
- Cutting off the supply of illicit drugs: The initiative calls for a crack-down on international and domestic illicit drug supply chains, in part by securing land borders, ports of entry and international mail shipments against illegal smuggling. The initiative also calls for increased enforcement by the U.S. Department of Justice (DOJ) against corrupt or criminally negligent doctors, pharmacies and distributors, and calls for use of the death penalty against drug traffickers, where appropriate under current law.
- Helping those struggling with addiction: To help individuals with substance use disorders, the initiative calls for increased supply of naloxone to first responders, expanded access to evidence-based treatment (including Medication-Assisted Treatment), on-demand access to evidence-based treatment for veterans and funding opportunities to states and counties to improve nationwide overdose tracking systems that will help facilitate rapid deployment of resources to hard-hit areas.
Notably, the initiative also calls for legislative changes to the law prohibiting federal Medicaid reimbursement for residential treatment at certain facilities with more than 16 beds, and states that the administration will continue to approve state Medicaid waivers on this issue. NACo has long supported and prioritized federal legislative or regulatory changes that would alleviate this prohibition on Medicaid reimbursement, which is commonly referred to as the Institution for Mental Disease (IMD) exclusion.
Finally, the initiative calls for increased support for state and local drug courts that provide offenders struggling with addiction access to treatments as an alternative to, or in conjunction with incarceration, or as a condition of supervised release.
As the Trump Administration works to implement this initiative over the next several months, NACo will work in close conjunction with the White House and federal agencies to ensure that federal actions are carried out in a manner that reflects the critical and wide-ranging role of county governments in the nation’s response to the opioid epidemic.
The administration’s proposals closely parallel recommendations issued in NACo and the National League of Cities’ (NLC) joint task force report issued in November 2016, A Prescription for Action: Local Leadership in Ending the Opioid Crisis. The report offers recommendations to help local, state and federal jurisdictions reduce rates of opioid misuse, overdose and fatality, and highlights changes to the Medicaid program, establishment of drug courts and strengthening of Prescription Drug Monitoring Programs as important steps needed in our nation’s fight against the opioid epidemic.