Pubdate: Tue, 08 Aug 2017
Source: Los Angeles Times (CA)
Copyright: 2017 Los Angeles Times
Contact:  http://www.latimes.com/
Details: http://www.mapinc.org/media/248
Author: Noah Bierman and Noam N. Levey

TRUMP EMPHASIZES TOUGH LAW ENFORCEMENT IN COMMENTS ON OPIOID
EPIDEMIC

President Trump emphasized the need for stepped-up law enforcement to
combat the nation's opioid problem Tuesday, an approach that is at
odds with a report released last week by the special commission he
appointed to address abuse.

"Strong law enforcement is absolutely vital to having a drug-free
society," Trump told reporters from the clubhouse of his golf club
here.

"I have had the opportunity to hear from many on the front lines of
the opioid epidemic, and I'm confidant that by working with our
healthcare and law enforcement experts we will fight this deadly
epidemic and the United States will win."

He also sought to cast blame on the previous administration for the
worsening of the opioid problem.

"At the end of 2016, there were 23% fewer federal prosecutions than in
2011, so they looked at this surge and they let it go by," he said.
"We're not letting it go by."

Eager to convey a sense that he is working during his two-week stay in
New Jersey, the president and First Lady Melania Trump met with Health
and Human Services Secretary Tom Price and other top aides to discuss
the opioid crisis.

Trump spoke often on the campaign trail about the devastation that
opioid addiction has caused in communities, particularly rural,
lower-income and working-class areas. Trump tended to do well in the
regions hit hardest, a reflection of the issue's importance to many
voters.

The commission Trump appointed to study the epidemic, headed by New
Jersey Gov. Chris Christie, recommended last week that Trump declare a
national emergency, but its report emphasized medical solutions, not
law enforcement.

"We must act boldly to stop it," the commission wrote. "The opioid
epidemic we are facing is unparalleled."

The interim report, which the authors said would be updated in the
fall, included several recommendations to lift restrictions on the use
of federal funds. Current rules limit states' use of Medicaid money
for residential addiction treatment.

In a sign that Christie's commission favored a treatment over an
enforcement role for police, the report recommended equipping law
enforcement officials around the country with naloxone, a drug
designed to reverse drug overdoses.

The authors lamented that "an impediment to naloxone usage and people
seeking help in the event of an overdose is the perceived threat of
law enforcement involvement" and that "overly restrictive or punitive
laws may prevent the uptake of naloxone or the seeking of aid in an
emergency."

Trump declined the report's recommendation about a national emergency.
Price, briefing reporters at a hotel about 15 minutes away from
Trump's golf course, said many of the report's recommendations for
increased funding and attention can be accomplished without such a
declaration, which is normally reserved for a natural disaster such as
a hurricane or for a more focused public health problem such as an
infectious disease outbreak. But he added that "all things are on the
table for the president."

Price said the administration, among other efforts, may seek to relax
some medical privacy laws to allow for more family members to be
notified of overdoses. He also pointed to research efforts, including
a potential vaccine for addiction.

"The president certainly believes that it is, that we will treat it as
an emergency -- and it is an emergency," Price said. "When you have
the capacity of Yankee Stadium or Dodger Stadium dying every single
year in this nation, that's a crisis that has to be given incredible
attention, and the president is giving it that attention."

Though concern over the addiction crisis resonates strongly with
Trump's core supporters, it could be a rare opportunity for bipartisan
cooperation, given its widespread impact.

"No state has been spared, and no demographic group has gone
untouched," said Kellyanne Conway, a White House counselor who had
been active in the opioid effort and joined Price in briefing
reporters and the president. "It really has affected all of our
communities in varying degrees."

Despite repeated promises from the president to take on the opioid
crisis, the Trump administration has taken steps that are likely to
undermine efforts to control the epidemic, according to many
physicians and other healthcare leaders.

Trump has pushed for deep cuts in federal aid to states for their
Medicaid programs even as Medicaid has emerged as one of the most
important tools in combating the crisis.

Medicaid, which now insures some 70 million low-income Americans,
historically covered primarily poor children, pregnant mothers and the
low-income elderly. But in recent years, funding made available
through the Affordable Care Act has allowed states on the front lines
of the epidemic, including Ohio, West Virginia and Kentucky, to open
Medicaid to poor, working-age adults, a population traditionally not
eligible for coverage but among the most likely to face substance
abuse issues.

In Ohio, for example, more than a third of the approximately 700,000
people who enrolled in Medicaid after the expansion began in 2014
reported some drug or alcohol dependence, according to a recent study
by the state. The vast majority did not previously have health insurance.