Assessing Trump’s Promises About Opioids - Pacific Standard

Assessing Trump’s Promises About Opioids

At a recent conference on prescription pill and heroin addiction, a parade of federal agency heads promised new projects—and support from the president.
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The ads show actors going to scary lengths to get prescription opioids.

President Donald Trump cares.

That was the message from an array of officials who spoke at a major conference this week about prescription painkiller and heroin addiction in America. In addition, a couple of top leaders promised progress on projects such as making naloxone, the opioid overdose-reversing drug, available over the counter.

More than 50,000 Americans died of drug overdoses in 2015, including more than 33,000 who died with prescription painkillers or heroin in their systems, according to the Centers for Disease Control and Prevention’s latest numbers. Drug overdose rates in America have increased by 33 percent since 2010, and still appear to be rising. Since Trump’s election, researchers and public-health workers have been watching anxiously to see what the federal government will do to try to stem the tide.

How will administration officials keep all these promises?

“I want to state very clearly that this is a pro-treatment administration,” Richard Baum, the acting director of the Office of National Drug Control Policy, said during his speech at the National Rx Abuse & Heroin Summit. This is a turnaround: Traditionally, American policy has been to incarcerate those charged with drug-use crimes, and about one in five Americans who think they need treatment for a substance-use disorder report that they don’t get it.

“He opened up with treatment. We’re on the same page here. Trump agrees,” says conference-goer Dan Ciccarone, a physician and researcher at the University of California–San Francisco with self-described “Democratic, liberal” leanings. “That was great. That alone made me relax.”

“There’s been some indication that progress might be reversed through Trump,” says Lisa Roberts, a public-health nurse for Scioto County in Ohio and a Republican who — like many experts, regardless of politics — liked the Obama administration’s approach to drug policy and worried about a change in administration. But, after the conference, Roberts says, “I felt like Trump had some advisors who may be able to point him in the right direction.”

Now in its sixth year, the National Rx Abuse & Heroin Summit isn’t a political meeting. The attendees this year seem mostly to be researchers and local government employees, and the sessions have focused on teaching them skills that they can take home to their own drug-court, drug-interdiction, and public-health programs. At the same time, many of the top speakers were leaders of federal government agencies, which makes the summit, unofficially, a place to divine the attitude of the feds on drug issues. Last year, Barack Obama even made a surprise visit.

This year, in addition to Baum, the surgeon general and the leaders of the Food and Drug Administration, Department of Health and Human Services, and National Institutes of Health all spoke. Not all of these speakers addressed the White House’s intentions, but many did.

Secretary of Health and Human Services Tom Price said the White House supported overdose-reducing efforts and that the opioid epidemic would be one of his department’s top three priorities.

National Institutes of Health director Francis Collins said his agency wants to develop public-private partnerships to move its science faster, an aim he said both Trump and Price support. Francis showed a slide that read, “The goal is to cut in half the time needed to develop safe, effective opioid alternatives” — in other words, painkillers that would not be addictive in the way opioids like oxycodone and hydrocodone are. Scientifically speaking, developing powerful, non-addictive pain relievers is very difficult, and it’s unclear what “half the time” needed to do so would be; there is no standard timeframe.

Baum told the conference that a new national drug-control strategy is on the way. Stephen Ostroff, acting head of the FDA, said his agency is examining labeling that would make naloxone over-the-counter, a remark met with applause.

How will officials keep all these promises? Trump has called for steep cuts to the NIH and HHS. The White House’s blueprint budget did, however, keep $500 million in funding over each of the next two years for states to implement their own anti-addiction projects. HHS is now ready to deliver $485 million of that to states, Price announced at the conference.

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