Public Health Emergency--What Does it Mean?

Public Health Emergency--What Does it Mean?

                President Trump has declared the Opioid Epidemic a public health emergency. This is in contrast to the national emergency that his own appointed panel recommended, which he promised to make in August and referenced as recently as Wednesday. What does this mean for treatment centers like START, and for those who have recognized the severity of this crisis and who wish to combat it?

                First, this declaration will make a difference. While there will be no additional federal funding, more of the money already budgeted to involved federal agencies will be allotted to the research and treatment of opioid use disorder. As an organization unique in our dual engagement in both the treatment and research of this deadly disorder, we look forward to the potential for new grants to be offered in our field.

                Second, the publicity that will come with this announcement will continue to raise awareness about opioids in our country. While it’s nearly impossible now to be unaware of a scourge that takes as many lives as 9/11 every three weeks, or 142 Americans every day, many still stubbornly view this as a “character flaw epidemic”. The federal government, in declaring this, by law, a public health emergency, has delivered a resounding and final response to such flawed rhetoric.

                Still, the fact remains that this is not the measure that was promised. Its scope is not nearly as broad as what experts agree is necessary. Currently, this epidemic costs our country nearly $80 billion, dwarfing the $36 billion spent. The re-allotment of existing public health funding cannot bridge that gap.

                One of the major issues is access to Medication-Assisted Treatment (MAT) programs like START. One recent analysis found that if every doctor who is licensed to prescribe buprenorphine did so at the maximum allowable rate, less than half of those living with opioid use disorder in America could receive that treatment. This comes as a result of stigma, lack of awareness, bureaucratic obstacles, and simple physical and economic access challenges. Many potential patients in rural states are required to travel hundreds of miles for treatment they struggle to afford. Increasing access to buprenorphine and methadone is a critical need that this declaration falls short of addressing.

                 Sadly, this is merely scratching the surface of how this crisis will not be sufficiently addressed by the declaration of a public health emergency. Further complicating matters, President Trump appears to favor a law enforcement approach to combating this epidemic, which history, and his own commission, tell us is ineffective. His repeated attacks on the Affordable Care Act (ACA) and proposed cuts to Medicaid will also directly harm the majority of our patients—indeed, the threats alone have impacted the insurance market already.

                So instead START will redouble its efforts to seek grant funding and support from the philanthropic community to help us make up as much ground as we can and bridge the treatment gap that is destroying entire swaths of our country. While we can’t treat everyone, we will continue to save hundreds of lives here in our own city, and our research will continue to inform practices nationwide. We will continue to create breakthroughs and do everything in our power to do what this declaration fails to do.