In a final report released Nov. 1, President Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis revealed 56 recommendations for curbing the opioid epidemic, ranging from improving opioid prescribing practices to expanding access to medication-assisted therapy for people battling addiction.
The commission issued the report six days after Trump declared the opioid crisis a public health emergency.
In a letter to Trump, New Jersey Gov. Chris Christie, chairman of the opioid commission, said that the intent of the suggestions is to increase support for programs designed to reduce opioid abuse and to reduce federal barriers to substance abuse treatment.
“The commission is confident that, if enacted quickly, these recommendations will strengthen the federal government, state and local response to this crisis,” Christie wrote.
The expansion of drug courts was one of the most noteworthy recommendations listed in the report. These programs allow nonviolent drug offenders with substance abuse problems to avoid incarceration and enter drug treatment.
As of 2017, more than 3,140 drug courts operate in the United States. The commission suggested the Department of Justice establish drug courts in all 93 federal judicial districts. It also encouraged local, state and Indian tribal governments to apply for drug court grants.
“Individuals with [a substance use disorder] who violate probation terms with substance use should be diverted into drug court rather than prison,” the report stated.
Other recommendations in the report include:
- The Department of Education should work with states on student evaluation programs such as Screening, Brief Intervention, and Referral to Treatment, an initiative that identifies at-risk youth battling substance abuse problems.
- All law enforcement officers should receive access to naloxone, an overdose reversal medication that rapidly blocks the effects of opioids.
- The Department of Health and Human Services should organize the creation of a national curriculum and standard of care for prescribing opioids.
- The HHS, Department of Justice, the Office of National Drug Control Policy and pharmacy groups should train pharmacists to recognize reliable opioid prescriptions, and pharmacists should not be reprimanded for denying improper prescriptions.
- The government should set stricter federal sentencing punishments for those who traffic fentanyl and fentanyl analogues.
The commission also urged the White House to pass the Prescription Drug Monitoring Act, a law that would create and implement an electronic database that tracks prescribing and dispensing data submitted by pharmacies and dispensing practitioners.
The number of prescription opioids sold to hospitals, practitioners and pharmacies nearly quadrupled from 1999 to 2010. According to the Centers for Disease Control and Prevention, 91 people in the United States die from an opioid overdose every day.
Mixed Reactions from Treatment Advocates
Regina LaBelle, who was chief of staff in the White House Office of National Drug Control Policy under former President Barack Obama, praised the report for highlighting the importance of addiction treatment. But she noted that more funding will be needed to fulfill these recommendations.
Dr. Mitchell Rosenthal, founder of the nonprofit addiction treatment facility Phoenix House, expressed a similar sentiment: He said more money must be allocated to states to fight the opioid crisis.
“We need significantly more funding to the states on the front lines of this crisis, otherwise they won’t be able to implement the prevention and treatment programs that can save so many lives,” Rosenthal told ABC News.
Dr. Andrew Kolodny, executive director of the nonprofit Physicians for Responsible Opioid Prescribing, praised many of the recommendations. But he also expressed concerns.
“The overall problem here is we’ve got a commission making recommendations when we need an administration putting out a plan and seeking out appropriations,” said Kolodny.
According to Christie, the opioid commission is not responsible for quantifying the costs of fulfilling these suggestions. But he also noted the importance of getting federal funding to state governments quickly.
“Saving time and resources, in this instance, will literally save lives,” said Christie.
Christie: ‘Addiction Is a Disease’
In his letter to Trump, Christie mentioned opioid overdose statistics and other consequences of opioid misuse to underscore the importance of defeating the opioid epidemic.
He said that those affected by opioid abuse represent all ages and backgrounds. They are student athletes, sons, daughters and newborn babies. The epidemic has also caused more children to enter foster care and more grandparents to raise their grandchildren.
“It is time we all say what we know is true: Addiction is a disease,” wrote Christie.
This disease has ravaged many communities in the United States, and drug overdose is the leading cause of unintentional death in the country. But Christie says that the country still does not treat substance use disorders like it does other diseases.
Addiction often co-occurs with other mental health problems such as depression. The opioid commission recommended that health insurance plans should not provide less favorable benefits for mental health and addiction diagnoses than it does for physical health problems.
“People need to be aware of the health risks associated with opioid use, and they must stop being afraid or ashamed of seeking help when facing their addiction,” said Christie.
After the opioid commission released its final report, the White House issued a statement saying that it would review the recommendations.