Opioid Crisis: Declared Emergency Without Funding, Commission Recommendations Ignored
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The Christie Commission had explicitly recommended declaring a national emergency under the Stafford Act or the Public Health Service Act, which would have freed up billions in emergency funding and allowed waiver of normal bureaucratic requirements. Trump instead declared a 'public health emergency' under a different statute (the Public Health Service Act § 319), which allowed no new money unless Congress appropriated it. Congress had not appropriated it. The declaration was described by public health experts as largely symbolic. Drug overdose deaths continued to rise throughout Trump's term.
Overview
70,237 Americans died of drug overdoses in 2017. The presidential commission charged with responding to the opioid crisis submitted 56 recommendations, starting with: declare a national emergency to unlock emergency funding.
Trump declared a lesser emergency that unlocked no new money.
What the Declaration Did and Didn't Do
The distinction between "national emergency" under the Stafford Act and "public health emergency" under PHSA Section 319 is the difference between money and no money. Stafford Act emergencies release federal emergency funds; Section 319 emergencies allow administrative waivers but provide no new funding unless Congress separately appropriates it.
Congress had not appropriated emergency opioid funds. The declaration was symbolic.
The Commission Recommendations
The Christie Commission's 56 recommendations included: mandatory prescriber education, expanded access to naloxone, funding for treatment programs, expansion of medication-assisted treatment, and removal of bureaucratic barriers to accessing care. These were evidence-based interventions with documented effectiveness.
The administration's 2018 budget proposed cutting $800 million from mental health and substance abuse programs.
The Death Toll
Overdose deaths continued rising throughout Trump's first term. The 70,237 deaths in 2017 became the baseline; subsequent years saw higher numbers. By 2020, overdose deaths exceeded 90,000 annually.
The administration's signature proposal was the death penalty for drug dealers. It was never implemented.
Timeline
Sequence of events
July 31, 2017
Christie Commission calls for national emergency declaration
The President's Commission on Combating Drug Addiction and the Opioid Crisis releases its interim report, explicitly calling on Trump to declare a national emergency under the Stafford Act to unlock emergency federal funding.
October 26, 2017
Trump declares public health emergency — no new money
Trump declares the opioid crisis a public health emergency under PHSA Section 319. Public health experts note the declaration unlocks no new funding; Congress had not appropriated emergency funds for opioid response.
November 1, 2017
Christie Commission final report — 56 recommendations
The Christie Commission issues its full final report with 56 recommendations, most of which are not acted upon. The commission noted that current treatment capacity serves only one in ten people with opioid use disorder who need treatment.
March 26, 2018
Trump proposes death penalty for drug dealers
Trump releases a plan that includes seeking the death penalty for major drug traffickers — a proposal experts say has no evidence base for effectiveness and that is not implemented.
Sources
- ↑ Trump Declares Opioid Crisis a 'Public Health Emergency' — The New York Times
- ↑ Christie Commission: Declare national emergency on opioids — The Washington Post
- ↑ Trump's opioid emergency carries no new money — The Associated Press
- ↑ Facing Addiction in America: The Surgeon General's Report on Opioids — U.S. Surgeon General
Verification