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Opioid crisis a national emergency, federal drug commission suggests

By RUSTY MARKS

The State Journal

CHARLESTON, W.Va. — President Donald Trump should “declare a national emergency” and increase tools and funding to states to combat a growing opioid drug epidemic, an interim draft report by the President’s Commission on Combating Drug Addiction and the Opioid Crisis suggests.

The report, released Monday, July 31, cities federal Centers for Disease Control and Prevention estimates that 142 Americans die every day from drug overdoses, and says more than 560,000 people died from drug overdoses between 1999 and 2015.

According to the CDC, more people now die of drug overdoses in the United States than by gun crimes and car crashes combined, the report cites.

“Our citizen are dying,” the report said. “We must act boldly to stop it.”

Trump established the commission by executive order in March.

The commission suggests the president “declare a national emergency under either the Public Health Service Act or the Stafford Act.” Doing so “could empower your cabinet to take bold steps and would force Congress to focus on funding and empowering the executive branch even further to deal with this loss of life. It would also awaken every American to this simple fact: if this scourge has not found you or your family yet, without bold action by everyone, it soon will.

“You, Mr. President, are the only person who can bring this type of intensity to the emergency and we believe you have the will to do so and to do so immediately,” the report suggests.

Among other recommendations made by the drug addiction commission are to:

• Rapidly increase treatment capacity. Grant waiver approvals for all 50 states to quickly eliminate barriers to treatment resulting from the federal Institutes for Mental Diseases (IMD) exclusion within the Medicaid program. This will immediately open treatment to thousands of Americans in existing facilities in all 50 states.

• Immediately establish and fund a federal incentive to enhance access to Medication-Assisted Treatment (MAT). Require that all modes of MAT are offered at every licensed MAT facility and that those decisions are based on what is best for the patient. Partner with the National Institutes of Health (NIH) and the industry to facilitate testing and development of new MAT treatments.

• Provide model legislation for states to allow naloxone dispensing via standing orders, as well as requiring the prescribing of naloxone with high-risk opioid prescriptions; we must equip all law enforcement in the United States with naloxone to save lives.

• Mandate prescriber education initiatives with the assistance of medical and dental schools across the country to enhance prevention efforts. Mandate medical education training in opioid prescribing and risks of developing an SUD by amending the Controlled Substance Act to require all Drug Enforcement Administration (DEA) registrants to take a course in proper treatment of pain. HHS should work with partners to ensure additional training opportunities, including continuing education courses for professionals.

• Immediately establish and fund a federal incentive to enhance access to Medication-Assisted Treatment (MAT). Require that all modes of MAT are offered at every licensed MAT facility and that those decisions are based on what is best for the patient. Partner with the National Institutes of Health (NIH) and the industry to facilitate testing and development of new MAT treatments.

• Provide model legislation for states to allow naloxone dispensing via standing orders, as well as requiring the prescribing of naloxone with high-risk opioid prescriptions; we must equip all law enforcement in the United States with naloxone to save lives.

• Prioritize funding and manpower to the Department of Homeland Security’s (DHS) Customs and Border Protection, the DOJ Federal Bureau of Investigation (FBI), and the DEA to quickly develop fentanyl detection sensors and disseminate them to federal, state, local, and tribal law enforcement agencies. Support federal legislation to staunch the flow of deadly synthetic opioids through the U.S. Postal Service (USPS).

• Provide federal funding and technical support to states to enhance interstate data sharing among state-based prescription drug monitoring programs (PDMPs) to better track patient-specific prescription data and support regional law enforcement in cases of controlled substance diversion. Ensure federal health care systems, including Veteran’s Hospitals, participate in state-based data sharing.

• Better align, through regulation, patient privacy laws specific to addiction with the Health Insurance Portability and Accountability Act (HIPAA) to ensure that information about SUDs be made available to medical professionals treating and prescribing medication to a patient. This could be done through the bipartisan Overdose Prevention and Patient Safety Act/Jessie’s Law.

• Enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) with a standardized parity compliance tool to ensure health plans cannot impose less favorable benefits for mental health and substance use diagnoses verses physical health diagnoses.

U.S. Sen. Shelley Moore Capito, R-W.Va., who introduced Jessie’s Law with U.S. Sen. Joe Manchin, D-W.Va., welcomed the report’s findings. Jessie’s Law would allow health care providers to share information about patients who are addicted to drugs.

“The opioid epidemic that is devastating West Virginia and other communities deserves the attention of the entire nation,” Capito said. “I was particularly pleased to see the commission’s report cite Jessie’s Law as a way to ensure medical professionals have full knowledge of their patient’s previous opioid addiction when consent is given. I support this bill because it will save lives by helping medical professionals make better decisions when treating patients and prescribing medication.

“While we have made progress in combating this epidemic, there is still more work to be done. This report demonstrates the severity of this problem and offers solutions that can help us build on the momentum we have created,” she said. “I applaud the president for forming the commission and look forward to continuing our work together to end this epidemic.”

“I’m encouraged to see the commission’s interim report and recommendations,” said Richard Baum, Acting White House Drug Czar. “Addressing the opioid epidemic is a top priority for the president and the White House Office of National Drug Control Policy. The good news is that the administration is already working on several of these recommendations, including improving our abilities to detect fentanyl, increasing access to medication-assisted treatment, and looking at ways to improve prescriber education. The president and I both appreciate the commission’s hard work on this interim report and are eagerly awaiting the final report.”

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