Substance Use Events and What Declaring a Public Health Emergency Over the Opioid Crisis Means

Prescription opoids

Recent events at George Washington University on substance use include a forum held on November 1, “Opioid Use: An Epidemic of Addiction, Not Abuse,” which featured panelists, including Milken Institute SPH Dean Lynn Goldman and best-selling author J.D. Vance, discussing the underlying issues that complicate America's ability to mitigate addiction. The event was hosted by the George Washington University and ICF, a strategic consulting and communications firm.  The school’s Health Policy and Management department is holding another event next week; learn more here.

A recent interview of GW Health Policy and Management Professor Jeffrey Levi sheds light on exactly what President Donald Trump’s declaration on October 26 that our nation’s opioid crisis is a public health emergency means. 

Here are some of the questions and answers from that interview:

What does a public health emergency allow the government to do?
A public health emergency gives agencies in the U.S. Department of Health and Human Services flexibility in how current funds and personnel are allocated. A public health emergency lasts for only 90 days—so these are very temporary shifts in resources. This authority was designed for a short-term crisis (e.g., the aftermath of a natural disaster or in response to a pandemic flu), not for a sustained problem like substance use disorder. An emergency declaration would also free up money in the Public Health Emergency Fund, but that only has $57,000 in it since Congress hasn’t replenished it.

What is the difference between a public health emergency and a national emergency?
A national emergency is declared under the Stafford Act. This applies to the entire federal government. This can mobilize multiple agencies. More importantly, it also permits the government to tap emergency response funds in the same way that was done after the hurricanesand that fund is replenished regularly. However, most of what is done under the Stafford Act is also meant to be short term.

In terms of the opioid crisis, what will be able to happen under a public health emergency declaration?
Very little that wouldn’t be possible without a declaration. The principal issues with the opioid response are associated with fundingfor prevention, for treatment, for social support, for harm reduction (syringe exchange, naloxone to reverse overdose).  Perhaps most important, is preserving access to substance use treatment under the Affordable Care Act, in particular through the Medicaid expansion.

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