President Trump Declares National Emergency on Opioids

Yesterday, President Donald Trump declared a national state of emergency on the opioid epidemic. It is estimated that as many as 2.5 million people in the US are suffering from opioid addiction related to prescriptions, and an additional 467,000 are addicted to heroin. These numbers are especially intimidating given the unique challenges rural communities face. While all states have reported increases in opioid mortality and injury, the largest increases are reported in heavily rural states like Kentucky, West Virginia, Alaska, and Oklahoma. Rural areas have seen an enormous increase in both prescription opioids and illegal opiates like heroin.

In his declaration, President Trump ordered Acting Secretary of Health and Human Services (HHS) Eric Hargan to declare a nationwide public health emergency and direct federal agencies to use any emergency authorities they possess in an attempt to reduce the number of opioid overdose related deaths. While the declared emergency only remains in effect for 90 days, it can be renewed, continuing the engagement of federal, state, and local government agencies. The declaration allows the federal government to waive regulations constraining emergency responses, provides states flexibility in use of federal funds to treat the epidemic, and increases use of telemedicine treatment options. The plan does not, however, go so far as to allow states access to funds from the Disaster Relief Fund.

Legislation was introduced this week in the U.S. Senate by Senators Martin Heinrich (D-N.M.), Bob Casey (D-PA), Ed Markey (D-MA), Dianne Feinstein (D-CA), Bob Menendez (D-NJ), Sherrod Brown (D-OH), Amy Klobuchar (D-MN), Jeanne Shaheen (D-NH), Al Franken (D-MN), Tammy Baldwin (D-WI), Angus King (I-ME), Tim Kaine (D-VA), Elizabeth Warren (D-MA), Maggie Hassan (D-NH), and Kamala Harris (D-CA) to invest $45 billion in federal funds to prevent and treat opioid addiction.

For a better understanding of what this declaration may mean, we can look to examples from Governors that have declared a state of emergency at the state level:

  • Massachusetts: Declared June 2014 by Governor Deval Patrick (D)
    • Governor Patrick’s order banned what are known as “high-dosed opioids,” such as Zohydro and Zogenix. It developed a prescription drug monitoring program (PDMP); increased access to naloxone, a life saving drug also referred to as NARCAN; and provided additional funding for treatment and prevention services.
  • Maryland: Declared March 2017 by Governor Larry Hogan (R)
    • Governor Hogan’s declaration created an executive branch position to work under the Maryland Emergency Management Agency Act and coordinate agency responses to the epidemic. Maryland has since developed a tool that tracks overdoses in real time to aid emergency responders in identifying “hot spots” for synthetic, deadly opioids. It also allowed Maryland’s health secretary to issue a statewide order that allows Maryland-licensed pharmacists to provide naloxone without a prescription.
  • Florida: Declared May 2017 by Governor Rick Scott (R)
    • Governor Scott’s order allowed the state to utilize federal grant funds that were not supposed to be available until July. It also allowed the state to legally provide naloxone to first responders, and state agencies are now holding “community workshops” to find other possible solutions.
  • Arizona: Declared June 2017 by Governor Doug Ducey (R)
    • Governor Ducey’s also allowed local law enforcement to provide and administer naloxone to individuals. The Arizona State Health Department is now working with the State’s Attorney General to develop prescribing guidelines for health professionals and to provide real-time data on opioid related overdoses and deaths.
  • Alaska: Declared February 2017 by Governor Bill Walker (I)
    • Governor Walker’s declaration established an “Overdose Response Program” to study and address the epidemic. It also allows law enforcement officials and some members of the public to dispense and administer naloxone.

NRHA will continue to monitor the State of Emergency declaration and will provide updates as we know more about what this will mean for rural communities.