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Trump declares opioid emergency

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First lady Melania Trump speaks before the president's address on the opioid crisis. (CNN) First lady Melania Trump speaks before the president's address on the opioid crisis. (CNN)

By JILL COLVIN and CARLA K. JOHNSON
Associated Press

WASHINGTON (AP) -- In ringing and personal terms, President Donald Trump on Thursday pledged to "overcome addiction in America," declaring the opioid crisis a nationwide public health emergency and announcing new steps to combat what he described as the worst drug crisis in U.S. history.

Trump's declaration, which will be effective for 90 days and can be renewed, will allow the government to redirect resources, including toward expanded access to medical services in rural areas. But it won't bring new dollars to fight a scourge that kills nearly 100 Americans a day.

"As Americans we cannot allow this to continue," Trump said in a speech at the White House, where he bemoaned an epidemic he said had spared no segment of American society, affecting rural areas and cities, the rich and the poor and both the elderly and newborns.

Officials said they also would urge Congress, during end-of-the year budget negotiations, to add new cash to a public health emergency fund that Congress hasn't replenished for years. The Public Health Emergency Fund currently contains just $57,000, according to the Department of Health and Human Services, a negligible amount. Officials would not disclose how much they were seeking.


Watch the president's statement


But critics said Thursday's words weren't enough.

"How can you say it's an emergency if we're not going to put a new nickel in it?" said Dr. Joseph Parks, medical director of the nonprofit National Council for Behavioral Health, which advocates for addiction treatment providers. "As far as moving the money around," he added, "that's like robbing Peter to pay Paul."

Democratic House leader Nancy Pelosi called the new declaration "words without the money."

Trump's audience Thursday included parents who have lost children to drug overdoses, people who have struggled with addiction, and first responders whose have used overdose reversal drugs to save lives.

Trump also spoke personally about his own family's experience with addiction: His older brother, Fred Jr., died after struggling with alcoholism. It's the reason the president does not drink.

Trump described his brother as a "great guy, best looking guy," with a personality "much better than mine"

"But he had a problem, he had a problem with alcohol," the president said. "I learned because of Fred."

Trump said he hoped a massive advertising campaign, which sounded reminiscent of the 1980s "Just Say No" campaign, might have a similar impact.

"If we can teach young people, and people generally, not to start, it's really, really easy not to take 'em," he said.

As a presidential candidate, Trump had pledged to make fighting addiction a priority.

"When I won the New Hampshire primary, I promised the people of New Hampshire that I would stop drugs from pouring into your communities. I am now doubling down on that promise, and can guarantee you we will not only stop the drugs from pouring in, but we will help all of those people so seriously addicted get the assistance they need to unchain themselves," Trump told a crowd in Maine weeks before last November's election.

Once in office, Trump assembled a commission, led by Gov. Chris Christie of New Jersey, to study the problem. The commission's interim report argued an emergency declaration would free additional money and resources, but some in Trump's administration disagreed.

Christie, in a statement, said Trump was taking "bold action" that shows "an unprecedented commitment to fighting this epidemic and placing the weight of the presidency behind saving lives across the country."

Officials said the administration had considered a bolder emergency declaration, under the Stafford Act, which is typically used for natural disasters like hurricanes. But they decided that measure was better suited to more short-term, location-specific crises than the opioid problem. Drug overdoses of all kinds kill an estimated 142 Americans every day.

As a result of Trump's declaration, officials will be able to expand access to telemedicine services, include substance abuse treatment for people living in rural and remote areas. Officials will also be able to more easily deploy state and federal workers, secure Department of Labor grants for the unemployed, and shift funding for HIV and AIDs programs to provide more substance abuse treatment for people already eligible for those programs.

Trump said his administration would also be working to reduce regulatory barriers, such as one that bars Medicaid from paying for addiction treatment in residential rehab facilities larger than 16 beds. He also spoke of efforts to require federally employed opioid prescribers to undergo special training, talked about the Postal Service and Homeland Security Department's ramped-up inspection of packages, the Justice Department's targeting of opioid dealers and efforts to develop a non-addictive painkiller.

But Sen. Richard Blumenthal (D-CT), said the effort falls far short of what is needed and will diverts staff and resources from other vital public health initiatives.

"Families in Connecticut suffering from the opioid epidemic deserve better than half measures and empty rhetoric offered seemingly as an afterthought," he said in a statement. He argued, "An emergency of this magnitude must be met with sustained, robust funding and comprehensive treatment programs."

Democrats also criticize Trump's efforts to repeal and replace the "Obamacare" health law. Its Medicaid expansion has been crucial in confronting the opioid epidemic.

Adopted by 31 states, the Medicaid expansion provides coverage to low-income adults previously not eligible. Many are in their 20s and 30s, a demographic hit hard by the epidemic. Medicaid pays for detox and long-term treatment.

Rep. Seth Moulton, D-Mass., said in a statement that many people addicted to opioids don't have insurance and more must be done to expand coverage.

"We cannot keep having conversations about gutting the ACA while simultaneously talking about the opioid epidemic. And we cannot declare a public health emergency without actually allocating resources to help combat it," he said.

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AP Medical Writer Carla K. Johnson reported from Chicago. Follow Colvin and Johnson on Twitter at https://twitter.com/colvinj and https://twitter.com/CarlaKJohnson.

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This story has been corrected to change first paragraph to say 'nearly' 100 opioid deaths a day, not 'more than.'

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This story has been corrected to delete 4th paragraph quote, which was from Melania Trump, not the president.

Copyright 2017 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

By JILL COLVIN and CARLA K. JOHNSON
Associated Press

WASHINGTON (AP) --  President Donald Trump is declaring the opioid crisis a national public health emergency, and says it's sparing "no part" of the United States.

Trump has made that announcement at the White House -- and he says the scourge affects rural areas and cities, rich people and the poor, and the elderly and newborns.

Trump says it all amounts to "a national health emergency" that's ripping "the nation apart."

The president had campaigned on an effort to combat the crisis and has taken criticism for being slow to act. Overdose deaths involving prescription opioids have quadrupled since 1999.

Speaking in the East Room of the White House, Trump said he was directing federal agencies to do everything in their power to combat the crisis. He said that includes a "massive advertising campaign" reaching out to young people to avoid prescription drugs.

The president said his administration will soon provide "relief" for state governments seeking to access Medicaid funding for drug treatment centers with more than 16 beds.

He also promised more research funding for opioid alternatives, saying the administration will be "spending lots of money coming up with a nonaddictive solution."

"We will overcome addiction in America," Trump pledged.

Melania Trump says drug addiction "can happen to any of us."

The first lady offered opening remarks Thursday before President  Trump gave a speech on opioid addiction. 

Melania Trump said she has recently taken a "larger interest in what I can do to fight this epidemic." She said she has been participating in meetings and listening sessions.

She acknowledged the audience, which included parents whose children died and people who have struggled with addiction.

The first lady says: "We are here today because of your courage."

Officials made clear that the declaration, which lasts for 90 days and can be renewed, comes with no dedicated dollars. But they said it will allow them to use existing money to better fight the crisis. Officials also said they would urge Congress, during end-of-the year budget negotiations, to add new cash to a public health emergency fund that Congress hasn't replenished for years.

The Public Health Emergency Fund currently contains just $57,000, according to the Department of Health and Human Services, a negligible amount. Officials would not disclose how much they were seeking.

But critics said that wasn't enough.

"How can you say it's an emergency if we're not going to put a new nickel in it?" said Dr. Joseph Parks, medical director of the nonprofit National Council for Behavioral Health, which advocates for addiction treatment providers. "As far as moving the money around," he added, "that's like robbing Peter to pay Paul."

Democratic House leader Nancy Pelosi also was critical, calling the new declaration "words without the money."

Trump's audience Thursday included parents who have lost children to drug overdoses, people who have struggled with addiction, and first responders whose have used overdose reversal drugs to save lives. The president spoke personally about his own experience with addiction: His older brother, Fred Jr., died of alcoholism. It's the reason the president does not drink.

Leading up to the announcement, Trump had said he wanted to give his administration the "power to do things that you can't do right now." As a candidate, he had pledged to make fighting addiction a priority, and pressed the issue in some of the states hardest hit.

"When I won the New Hampshire primary, I promised the people of New Hampshire that I would stop drugs from pouring into your communities. I am now doubling down on that promise, and can guarantee you we will not only stop the drugs from pouring in, but we will help all of those people so seriously addicted get the assistance they need to unchain themselves," Trump told a crowd in Maine weeks before last November's election.

Once in office, Trump assembled a commission, led by Gov. Chris Christie of New Jersey, to study the problem. The commission's interim report argued an emergency declaration would free additional money and resources, but some in Trump's administration disagreed.

Christie, in a statement, said Trump was taking "bold action" that shows "an unprecedented commitment to fighting this epidemic and placing the weight of the presidency behind saving lives across the country."

Officials said the administration had considered a bolder emergency declaration, under the Stafford Act, which is typically used for natural disasters like hurricanes. But they decided that measure was better suited to more short-term, location-specific crises than the opioid problem. Drug overdoses of all kinds kill an estimated 142 Americans every day.

As a result of the public health emergency declaration, officials will be able to expand access to telemedicine services, include substance abuse treatment for people living in rural and remote areas. Officials will also be able to more easily deploy state and federal workers, secure Department of Labor grants for the unemployed, and shift funding for HIV and AIDs programs to provide more substance abuse treatment for people already eligible for those programs.

Trump was also expected to direct other departments and agencies to exercise their own available emergency authorities to address the crisis.

But Sen. Richard Blumenthal (D-CT), said the effort falls far short of what is needed and will diverts staff and resources from other vital public health initiatives.

"Families in Connecticut suffering from the opioid epidemic deserve better than half measures and empty rhetoric offered seemingly as an afterthought," he said in a statement. He argued, "An emergency of this magnitude must be met with sustained, robust funding and comprehensive treatment programs."

Democrats also criticize Trump's efforts to repeal and replace the "Obamacare" health law. Its Medicaid expansion has been crucial in confronting the opioid epidemic.

Adopted by 31 states, the Medicaid expansion provides coverage to low-income adults previously not eligible. Many are in their 20s and 30s, a demographic hit hard by the epidemic. Medicaid pays for detox and long-term treatment.

Nearly a year ago, Congress also approved $1 billion to tackle addiction as part of the 21st Century Cures Act. States got half their Cures Act grants in April and will get the rest next year.

Places such as Fellowship House in Birmingham, Alabama, are using drugs like Suboxone, a combination of buprenorphine and naloxone, with patients for the first time.

"When I took Suboxone, it was like a miracle," said one Fellowship House patient, 43-year-old John Montesano, a former long-haul truck driver with a 20-year pill addiction, chronic pain and no health insurance. "I'd be dead now" without it, he said. "Or worse, not dead" and still using.

Montesano recently marked six months without a relapse. He attends daily recovery meetings, works at a sandwich shop and plans to reunite with his wife. As long as the money goes for treatment "the way Fellowship House does it," he said, Congress "should release all the money they can spare."

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AP Medical Writer Carla K. Johnson reported from Chicago. Follow Colvin and Johnson on Twitter at https://twitter.com/colvinj and https://twitter.com/CarlaKJohnson.

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This story has been corrected to change first paragraph to say 'nearly' 100 opioid deaths a day, not 'more than.'

Copyright 2017 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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