WV needs money for fight against opioid emergency, health experts say

Other health experts said the president’s declaration regarding opioids likely will provide only limited help to West Virginia — unless federal funding is made available to combat the epidemic that led to a record 886 fatal drug overdoses statewide last year.

West Virginia has the highest drug overdose death rate in the nation.

“That [funding] seems to be missing from this particular declaration,” said Dr. Rahul Gupta, West Virginia’s public health commissioner. “It seems to be waiting for Congress to act. That’s the piece we’re hoping for, that this will allow Congress to take leadership and direct funds to address the challenges of this particular crisis.”

In a conference call with reporters Thursday, White House officials said they hope Congress will provide more funding in a spending bill later this year, but those officials would not say how much money the Trump administration will ask for.

Trump consistently has supported dramatic cuts to the federal Medicaid program, which covers about a third of West Virginia and is the single-largest payer of substance-abuse and mental-health care in the country.

Gupta predicted that Trump’s declaration would raise awareness about the opioid epidemic and, perhaps, reduce the stigma associated with drug abuse and lessen regulations that hinder the response to the crisis.

“It represents a commitment at the highest level of government,” Gupta said. “The president is sending a message of commitment.”

States like West Virginia already are doing “more with less” to deal with the crisis.

“We know where the resources are needed,” Gupta said.

Sen. Shelley Moore Capito, who joined the president at the announcement, sent a statement afterward, saying: “As a leader on the Appropriations Committee, I have worked hard to secure funding to fight the opioid epidemic on all fronts, and I will continue pushing and advocating for much-needed resources.”

Capito, R-W.Va, also said that, while the declaration “makes fighting the opioid epidemic a true national priority, it is just part of what must be a larger and broader national effort.”

During his speech, the president mentioned loosening Medicaid restrictions for substance abuse treatment. The U.S. Department of Health and Human Services granted West Virginia that ability earlier this month.

However, Trump’s proposed budget would have cut $800 billion from the Medicaid program over 10 years.

“The most important thing they could do would be to make sure Medicaid stayed in effect for people under 138 percent of [the federal poverty level] and that the Medicaid program paid for the cost of opioid addiction treatment,” said Craig Robinson, executive director of Cabin Creek Health Systems.

Trump has supported efforts to repeal the Affordable Care Act — efforts that would have kicked at least 170,000 West Virginians, including 50,000 with substance-abuse diagnoses, off of the Medicaid program.

Trump’s proposed changes to a few programs could have been done without declaring a national emergency, said Keith Humphreys, a Stanford University professor and West Virginia native who advised former Presidents Barack Obama and George W. Bush on drug policy.

Trump’s declaration adds no new funds to combat the drug crisis, while the 2018 budget includes treatment-funding cuts, Humphreys said. Trump has supported recent Republican efforts to pass a budget through the reconciliation process, without Democratic support, to clear the way for tax reform, including tax cuts for corporations.

“This is a complete failure of leadership.” Humphreys said. “In short, it’s dereliction of his duty as president.”

Matt Boggs, executive director of the Recovery Point drug treatment center, said he appreciated hearing first lady Melania Trump denounce the stigma surrounding drug addiction, and the president talk about prevention.

“The only thing I would encourage him to look at — we’ve got to continue talking about addiction as a disease,” Boggs said. Trump has said he had listened to his older brother, Fred, who encouraged him not to drink.

“It’s one thing for him to ask all of his various Cabinet members to deploy all the resources,” Boggs said. “It’s another thing to actually follow through and deploy those resources.

“I’m hopeful that they will deploy additional resources to West Virginia because, when you look at the other 49 states, we’ve been affected the hardest.”

Boggs noted that, last month, the DHHS announced $144 million in opioid prevention and treatment grants. West Virginia received none.

“I don’t think it was for lack of trying,” Boggs said. “Recovery Point applied.”

The state DHHR also applied and was denied.

Trump referred to Lily’s Place, a Huntington facility for babies born with neonatal abstinence syndrome, during his speech.

Cece Brown, whose son, Ryan, died of an overdose in Charleston in 2014, was standing behind the president during his announcement.

The emergency declaration is expected to expand the use of telemedicine, in which doctors treat and consult with patients remotely via video teleconferencing. Gupta noted that the West Virginia Legislature has passed laws that promote telemedicine, but hurdles remain.

“What we don’t have in rural areas is access to adequate broadband,” Gupta said. “There are technological challenges.”

He said much of the declaration strives to make the response to the crisis more efficient, by reducing regulatory burdens.

“Unfortunately, this isn’t a crisis easily solved by making systems more efficient,” Gupta said. “I wish it was. It is going to take a lot more effort and resources. The word ‘comprehensive’ is key.”

Gupta said addiction treatment for people who overdose but survive — and are taken to hospital emergency rooms — should start immediately at hospitals.

“Not just referring them to another agency, where they get lost,” he said. “We need a spectrum of care.”

Gupta had said he hopes the declaration will spur more federal funding to purchase naloxone — an overdose-reversing drug that saves lives.

“Health departments and other agencies in West Virginia are literally counting the number of doses they have left on the shelf,” he said, “because they’re afraid they’re going to run out.”