Preparedness & Recovery

As Island Drug Crisis Rages, Trump Weighs Declaring State of Emergency

The Commission on Combating Drug Addiction and the Opioid Crisis, which was set up by President Trump, is calling on him to take action by declaring the opioid epidemic a state of emergency.

by Kristin F. Dalton, Staten Island Advance, N.Y. / August 8, 2017
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(TNS) - President Donald Trump promised the American people that he would take action "to keep drugs from pouring into our country and help those who have been so badly affected by them."

Now, the Commission on Combating Drug Addiction and the Opioid Crisis, which was set up by President Trump, is calling on him to take action by declaring the opioid epidemic a state of emergency.

"According to the Centers for Disease Control (CDC), the most recent data estimates that 142 Americans die every day from a drug overdose," the report states, adding, "... drug overdoses now kill more people than gun homicides and car crashed combined."

Chaired by New Jersey Gov. Chris Christie, the commission released a preliminary report of recommendations to the president on how to combat some of the biggest barriers between addicted Americans and treatment, as well as ways to stop drugs from coming into the country.

According to FEMA, "The President can declare an emergency for any occasion or instance where the president determines federal assistance in needed. Emergency declarations supplements State and local or Indian tribal government efforts in providing emergency services, such as the protection of lives, property, public health, and safety, or to lessen or avert the threat of a catastrophe in any part of the United States."

Should the president declare a state of emergency, he would most likely do so under the Public Health Service Act, as suggested by the commission, or the Stafford Act, which FEMA operates under.

Helping addicts get access to treatment


The report's first recommendation is that a federal incentive to enhance access to Medication Assisted Treatment (MAT) be immediately established and funded, citing that MAT has been proven to reduce overdose deaths, retain people in treatment, reduce relapse and decrease the use of heroin.

The panel also is asking that the Centers for Medicare and Medicaid Services should grant all federally qualified health centers waivers to prescribe buprenorphine, one of the primary medications now used to treat addiction.

Naloxone expansion

The commission suggests that naloxone be prescribed to people who are given a high-risk opioid prescription, as well as equipping all law enforcement agencies in the country with the life-saving drug.

"The Federal Government should ensure that naloxone is made available when there is the greatest chance for an overdose," the report states.

The panel also recommends legislation that informs and expands the ''Good Samaritan,'' or 911 drug immunity law, which is currently enacted in 40 states and the District of Columbia.

While they vary from state-to-state, they all offer some form of criminal and civil prosecution protection for people seeking assistance at the scene of an overdose.

Expansion of I-Stop data sharing

Spearheaded by state Attorney General Eric Schneiderman, Assemblyman Michael Cusick and Sen. Andrew Lanza, I-STOP -- short for the Internet System for Tracking Over-Prescribing Act -- gives physicians and pharmacists access to their patients' up-to-the-minute prescription history, so they can determine if said patients are "doctor shopping."

Similar data-sharing databases have been created in other states since I-STOP's initiation in 2014.

The Commission is asking Trump to allocate federal funds, as well as technical support, to states to enhance interstate data sharing among state-based prescription drug monitoring programs (PDMPs), which they have been told are being "significantly underutilized in the vast majority of our states."

They are also asking that additional information, like if a patient has previously overdosed, be added to better determine if a patient is considered low- or high-risk.

Eliminate barriers to Medicaid

Federal funding cannot be used to reimburse services from inpatient facilities that treat a number of mental diseases, including addiction, that have more than 16 beds as regulated by the Social Security Act.

The commission is asking Trump to grant waiver approvals for every state  that would eliminate the "red tape" in the Medicaid program.

"This is the single fastest way to increase treatment availability across the nation," according to the report.

Local politicians and advocates have been trying to increase the number of inpatient treatment beds on Staten Island.

While there has been a modest expansion in the number of in-patient and other addiction services on Staten Island recently, the success of The Warm Handoff illustrates there are not enough treatment beds available in the borough.

Other recommendations:

Mandating prescriber education initiatives with the guidance of medical and dental schools to enhance prevention efforts; mandate medical education training in opioid prescribing.

Develop fentanyl detection sensors and disseminate them to federal, state, local, and tribal law enforcement agencies.

Regulate patient privacy laws specific to addiction so physicians across the board have access to a patient's complete history, making treatment more accessible. 

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©2017 Staten Island Advance, N.Y.

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