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What Do Harvey and Irma Mean for America's Opioid Emergency?

Trump's commission on addiction recommended last month that he declare opioid overdoses a national emergency. With the U.S. sustaining two major hurricanes in just a few weeks, is that still a good idea?
A man walks through his neighborhood in Orange, Texas, on September 7th, 2017.

A man walks through his neighborhood in Orange, Texas, on September 7th, 2017.

President Donald Trump's own addiction commission recommended last month that he declare opioid overdoses in America a national emergency. Trump said he would. Then, Hurricanes Harvey and Irma hit the United States and its territories, displacing tens of thousands of people and wreaking damage that groups have estimated to cost in the hundreds of billions of dollars. Department of Health and Human Services head Tom Price declared public-health emergencies for the storms, while Trump declared states of emergency in four states, Puerto Rico, and the U.S. Virgin Islands in response to Irma.

What does all this mean for the designation of drug use and addiction as an emergency in America? Trump never made that official declaration. The White House is working on doing so, a spokesman told USA Today, but it's apparently turned out to be a more difficult task than the administration thought:

When the president's Commission on Combating Drug Addiction and the Opioid Crisis first recommended opioid overdoses be considered a national emergency, Pacific Standard talked to University of Michigan health-policy researcher Rebecca Haffajee to learn the benefits and drawbacks of such a declaration. She warned against keeping an emergency state on drugs open for too long; she argued doing so could drain special funds, create a status quo in which health-privacy laws are relaxed for an extended time, and undermine the point of emergency declarations, which is to respond to situations that need "extraordinary powers." Still, given the increasingly deadly heroin supply in some parts of the country, Haffajee said, "I think it [the opioid epidemic] has become more acute and it could be appropriate."

To see if Harvey and Irma altered the balance, we reached back out to Haffajee. She hadn't changed her mind. The hurricanes do, however, demonstrate the more traditional uses of emergency declarations and why they work so well for sudden, severe problems such as storms and infectious-disease outbreaks. The declarations have infused money and attention to the affected areas. They've suspended Medicare and Medicaid rules, so doctors and nurses can care for beneficiaries without requiring them to show documentation first. "That paperwork shouldn't hold up providing care," Haffajee says.

These changes aren't sustainable over the years it will take for the estimated 23 million Americans with addictions to recover, or even for the Gulf states and the Caribbean to rebuild.

As for when Trump ought to declare opioid overdoses an emergency, Haffajee thinks it might be valuable to wait a few weeks, "so our focus can shift a little bit, because that's a big purpose of the powers, is to get policymakers and the public's attention and right now I think we're at capacity."