By Duke London

President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis was due to submit their initial report on June 27, but committee chair Chris Christie requested multiple delays to ensure the onslaught of public input was properly analyzed.

“We said we need time to go through this, and the president’s senior staff agreed,” Christie said of the delays.

This afternoon, Christie and the rest of the Commission held a public teleconference to announce their initial findings as part of the “draft interim report” so that President Trump can take immediate action on some of the commission’s more pressing recommendations ahead of their final report in October.

Though Christie mentioned that the commission received and reviewed comments from over 8,000 members of the public, not one mention was made of medical marijuana or its potential benefit in the suppression of pain associated with withdrawal symptoms. Christie spoke at length about finding non-addictive alternatives to opioid painkillers, but never discussed what is arguably the most effective alternative to harmful pharmaceuticals in the world today.

The commission’s initial report included the following recommendations:

The commission is calling on President Trump to declare a national emergency first and foremost, either using his power under the Public Health Service Act or Stafford Act. Declaring a state of emergency in reaction to the opioid epidemic would give the Executive Branch an additional set of resources to accomplish many of the goals the commission is aiming to achieve.
The draft interim report calls for an increase in available beds for treatment nationwide, as many patients without insurance are left at risk. The commission recommends using insurance waivers in all 50 states to bypass an exclusion in Medicaid that prevents hospitals from getting reimbursed when they treat patients with certain mental disorders, including substance addiction. According to the commission, making these Medicaid waivers readily available to hospitals and treatment facilities is the “single fastest way to increase treatment availability across the nation.”
An increase in education for new prescribers while in medical or dental school, including training that covers the risks of opioid addiction. The commission acknowledges that “this crisis began in our nation’s healthcare system,” as four out of every five heroin addicts began with prescription painkillers, according to the Substance Abuse and Mental Health Services Administration. However, they believe that while some of this activity is rooted in the black market, the vast majority of gross overprescribing can be credited to a lack of training by our nation’s doctors during their schooling. The commission is calling on the Food and Drug Administration to assist in developing and coordinating educational standards across the industry.
A new fund to be immediately formed to increase access to Medication-Assisted Treatment (MAT) for addicts looking to get off their drug of abuse. The fund would ensure that all MATs are available at all clinics so that patients may get the right solution for their case rather than the preferred medication issued at any one given facility. The fund would also assist with research by the National Institute of Health as they develop and test new methods of MAT.
Equip all law enforcement officers with naloxone, the life-saving medication that can quickly reverse an opioid overdose. The recommendation also aims to provide legislation that would create naloxone dispensary stations as well as distribute the drug alongside “high-risk opioid prescriptions.” Christie also reminded listeners that one of the main hurdles in naloxone utilization is the fear of bystanders that they will face some sort of legal ramifications, urging them that “Good Samaritan” laws are in place to protect us from that scenario.
Allocate additional resources to the Department of Homeland Security, Federal Bureau of Investigation, and the Drug Enforcement Agency so that these agencies may increase efforts in fentanyl detection. The commission is also calling for a ramp up in detection efforts through the mail by the United States Postal Service.
Increased funding for the purpose of developing data sharing channels between state-based prescription drug monitoring programs (PDMPs). These programs track opioid prescriptions to prevent misuse by patients and overprescribing by doctors. However, this data is not always readily available nationwide and an addict may be at risk if their physician cannot see their entire history. Currently, 49 states use a PDMP system but less than half share that data with other states. The commission is calling for the nationwide adoption of PDMPs and mandatory data sharing by July 1, 2018.
Amending some portions of the Health Insurance Portability and Accountability Act (HIPAA) to better allow for assistance from a patient’s family in the case of a substance use disorder. Many times, physicians are helpless in treatment because they are required to garner a written approval from the patient before making decisions or disclosing information.
Increase enforcement of the Mental Health Parity and Addiction Equity Act, which protects patients with substance abuse disorders or mental health issues from receiving inferior health benefits from their insurance provider in comparison to a patient suffering from a physical condition. This law was passed in 2008 to eliminate many of the “fail-first protocols” being used around the country that limit treatment until a patient’s issue becomes worse.