Trump and Tom Price are making it harder to combat opioid epidemic

Earlier this month, President Trump pronounced that the opioid epidemic was "a national emergency” and promised to, “spend a lot of time, a lot of effort, and a lot of money on the opioid crisis.”

Grand gestures, absent of the best science and meaningful budgetary policy, will not change the path of the opioid epidemic.

While Trump, Health and Human Services Secretary Dr. Tom PriceThomas (Tom) Edmunds PriceDems look to gain ground in Va. House of Delegates Pruitt to address trade group at luxury resort Spring promises of partnership on health-care reform are growing cold for states MORE and the administration express distress about the opioid epidemic and make many pledges to combat it, they continue to push policies and federal budget proposals that would gut treatment and slash our ability to fight the epidemic.

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President Trump continues to advocate for the repeal of the Affordable Care Act (ACA), which would cut hundreds of millions of dollars over the coming decade from Medicaid’s funding of opioid treatment and purchases of the opioid overdose reversal drug naloxone. It would also restore the ability of insurers to exclude coverage for substance use disorder treatment from health insurance plans.

 

In West Virginia, a state that has so far been hit the hardest by the opioid epidemic, nearly 45 percent of the state’s funding to combat opioid abuse comes from Medicaid. It is a critical tool for fighting this epidemic.

The policy moves of the Trump administration represent a retreat from existing U.S. government efforts to stem the opioid epidemic. The president continues to chide Congress for failing to repeal and replace the ACA, a move that would drastically impair our nation’s ability to curb the opioid crisis.

The president’s budget compounds these problems by reducing spending on the HHS opioid initiative by $84.5 million next year. This spending cut is far larger than the funds that would be made available through declaration of a public health emergency.

The scientific retreat is equally disturbing. The president’s budget ignores the findings of addiction treatment research. Recently Price suggested that Medication Assisted Treatment (MAT) was not the best way to treat opioid use disorder by saying, “if we just simply substitute buprenorphine or methadone or some other opioid-type medication for the opioid addiction, then we haven't moved the dial much…”

These remarks were made on a listening tour in West Virginia. Price apparently did not listen to the evidence from his own National Institute on Drug Abuse that clearly shows that MAT is the first line treatment for opioid use disorders.

Unfortunately, Price’s divorce from evidence is reflected in the HHS budget proposal where 37 percent of the cut to the opioids program or $31.3 million comes from reduced support for MAT.

Opioid mortality has been rising at an average rate of 9 percent per year since 1979. The epidemic is evolving in unexpected and deadly ways. Changing the course of opioid addiction in this country requires a concerted, multi-pronged effort that applies the best science and makes serious and sustained financial commitments to equip our health care, public safety and human services institutions with the tools they need to turn the tide on this vexing public health challenge.

Richard G. Frank, Ph.D., is the Margaret T. Morris Professor of Health Economics in the Department of Health Care Policy at Harvard Medical School, and Keith Humphreys, Ph.D., is the Esther Ting Memorial Professor at Stanford University School of Medicine.


The views expressed by contributors are their own and are not the views of The Hill.