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President Donald Trump finally made a formal declaration that the opioid crisis is, in fact, a national public health emergency. He made the declaration via the Public Health Services Act. He signed an executive order and gave a fluffy speech; but what does it really mean? A national public health emergency requires resources, money, and a lot of effort. With all of the hard talk from Trump for months now about the crisis and his forming of a federal opioid task force, you’d think that this executive order would provide more than enough resources. Unfortunately, for now, it doesn’t look like much will change.

The President made very clear we will end this crisis but did not make many concrete statements about plans of action or what exactly will be done. He didn’t mention treatment funding, the mental health and substance abuse requirements for insurance companies made under Obamacare, nor harm reduction methods like naloxone funding or the legalization of needle exchange programs. For now, it seems the president is just all talk. This crisis is the result of years of bad laws, manipulation by drug manufacturers, and fundamental misunderstandings of the dangers of prescription opioids. It is going to take A LOT to really make an impact of one of the worst public health emergencies this country has ever seen.

Overdose deaths are skyrocketing and are now one of the leading causes of deaths, surpassing automobile accidents. This public health emergency is even taking more lives than at the height of AIDS transmissions. It is far worse than the crack epidemic of the 80’s and 90’s. Many lives can be saved from proven methods that work, like harm reduction centers that provide clean syringes and naloxone, the overdose reversal drug. These centers reduce death and the spread of disease. Simply legalizing these programs on a federal level would save countless lives alone. Still, it is going to take a lot more than legalizing needle exchange programs to tackle this problem.

How Much Will A Public Health Emergency Cost?

A study published by the Centers for Disease Control and Prevention (CDC) estimated that the total economic burden of the opioid public health emergency to be roughly $78.5 BILLION. $28.9 billion of these costs comes from increased health care and substance abuse treatment costs. The Trump declaration immediately provides a measly $57,000. The price of a new car or a fancy engagement ring simply will not be close to enough to do, well, anything.

The founder and CEO of Shatterproof, an organization advocating for policy change in regards to addiction treatment, reacted to Trump with this quote:

“President Trump can call the opioid crisis whatever he wants. The most important thing will be how this declaration is implemented and how quickly he takes action. It will require laser-like, business execution by the Administration to take the necessary actions to save lives. We obviously need more funding to fully address the epidemic. But there are many things that can be done without funding, including implementing the CDC guidelines, setting higher standards for treatment and changing FDA labeling of prescription opioids.”

What’s even worse is Trump’s proposed 2018 budget, which will likely make public health one of the least priorities. So, it is unlikely we will see any more than this $57,000 joke. Trump’s proposed budget would cut billions from public health programs and biomedical research. The CDC will suffer a 17% cut, the Food and Drug Administration (FDA) a 31% cut, and an 18% cut to the National Institutes of Health (NIH). Medicaid will suffer a $610 billion cut over the next decade. For many suffering from this public health emergency, Medicaid may be their online line of hope.


It seems that the President’s plan is to re-enact the failed and laughable idea of “just say no,” made popular under the Reagan administration to tackle the crack cocaine epidemic. Trump proposed the idea of teaching children that “drugs are bad.” He said that children need to know that drugs will lead to failure. This outdated rhetoric even made a major contribution to this start public health emergency. It certainly won’t help stop it…

Trump also talked about his wall. The wall dividing the US and Mexico is what he claims will stop the drugs from entering the country in the first place, which will stop the spread of addiction on its own. The problem with this idea is that this opioid crisis started in doctor’s offices in the United States. Fraudulent or reckless prescription rates combined with “pill mills” lead the staggering rates of opioid addiction we see today, so Mexico has very little to do with this problem.

This public health emergency is going to cost billions. It will require progressive changes to health care. It will require progressive laws in regards to harm reduction. Hopefully, the President wakes up this reality.