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President Trump: 'I am directing all executive agencies to fight the opioid crisis.' US president Donald Trump has declared the country’s opioid crisis a ‘nationwide public health emergency’ and said that he is ‘mobilising his entire administration’ to address the situation, the White House has announced. Last year more than 2m Americans had an addiction to illicit or prescription opioids, with drug overdoses now the leading cause of ‘injury death’ in the US, outnumbering both traffic and gun fatalities. There were more than 52,000 drug overdose deaths in 2015, with the White House expecting 2016’s total to exceed 64,000 – a rate of 175 deaths per day. In 2016 more than 11.5m Americans reported misuse of prescription opioids and 950,000 reported heroin use, the administration says, with the rising death rate in part the result of ‘the proliferation of illegally made fentanyl’. An interim report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis urged him to declare a national emergency earlier this year (DDN, September, page 5). The emergency declaration will allow expanded access to substance misuse treatment and medication, including for people in HIV/Aids programmes, as well as the recruitment of more treatment professionals and provision of grants for people who have been ‘displaced from the workforce’ as a result of addiction. ‘Ending the epidemic will require mobilisation of government, local communities, and private organisations,’ said Trump. ‘It will require the resolve of our entire country. I am directing all executive agencies to use every appropriate emergency authority to fight the opioid crisis. This marks a critical step in confronting the extraordinary challenge that we face.’ DPA director Maria McFarland Sánchez-Moreno: President Trump is 'ignoring reality'. The US-based Drug Policy Alliance, however, accused the president of ‘ignoring reality’ and ‘sticking his head in the sand’. ‘While a couple of his proposals might help mitigate overdose, his speech revealed a profound and reckless disregard for the realities about drugs and drug use in the United States,’ said alliance director Maria McFarland Sánchez-Moreno. ‘Trump seemed to be saying that prevention boils down to ads encouraging young people to "just say no" to drugs, ignoring the utter failure of that strategy when the Reagan administration started it in the 1980s,’ she continued. ‘And he continued talking about criminal justice answers to a public health problem, even though the war on drugs is itself a major factor contributing to the overdose crisis. Trump had a chance to do something meaningful to help stem the tide of overdose deaths in the country – instead, he is condemning even more people to death, imprisonment, and deportation in the name of his war on drugs.’ A position paper from the Global Commission on Drug Policy has also urged that supplies of prescription opioids in the US and Canada should not be cut without ‘first putting supporting measures in place’. Harm reduction options need to be improved and expanded, alongside ‘de facto decriminalisation’ of possession and personal use, says The opioid crisis in North America. The extent of the public health crisis ‘cannot be overstated’, it warns. Position paper at www.globalcommissionondrugs.org

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Trump declares opioid crisis ‘a public health emergency’