While President Donald Trump directed HHS to declare the nation's opioid crisis a public health emergency in October, the administration has yet to enact a specific strategy for a solution, according to a report from The New York Times.
To shed light on what a hypothetical solution might look like, the Times asked 30 people with expertise in politics, public health and law enforcement how they would spend $100 billion to address the crisis over five years. The $100 billion figure is less than current federal spending to address HIV and AIDS domestically.
Here are five things to know.
1. Consensus among the experts suggested funding should be spread across four major areas: treatment, demand, harm reduction and supply. Overall, the expert panel spent more money on treatment than anything else.
2. In aggregate, experts spent 47 percent of the budget on treatment. The 15 panelists who emphasized treatment as the most important area to devote funds collectively placed the highest priority on money for medication-assisted treatments for opioid addiction like methadone. These panelists also placed an emphasis on Medicaid expansion, as it is a primary source for addiction treatment funding. This subverts claims made by some Republican lawmakers that Medicaid may have exacerbated the opioid crisis. In fact, Jay Unick, an associate professor in social work from the University of Maryland in College Park, said Medicaid expansion is "the most important intervention for improving outcomes" linked to the opioid crisis.
3. As a whole, the 30 panelists allotted 27 percent of the budget for addressing issues related to demand. The eight experts who placed emphasis on demand prioritized community development efforts such as family services, job training and post-incarceration social programs.
"Until we provide people with an alternative source of dopamine, in the form of family connections, meaningful work and a sense of purpose in their lives, the problem of addiction will continue to grow," Anna Lembke, MD, the medical director of addiction medicine at Stanford (Calif.) University, told the Times.
4. In aggregate, panelists devoted 15 percent of the hypothetical $100 billion to harm reduction strategies, including expanding the availability of naloxone and safe needle exchanges. Four panelists placed a heavy emphasis on harm reduction, and only three of the 30 panelists allocated no additional funds for naloxone.
5. As a group, the 30 experts devoted 11 percent of the funds to supply issues, including prescription drug monitoring, increased funding for local police and reducing drug diversion. While President Trump has repeatedly stated building a wall on the Mexican border would help solve the crisis, none of the 30 panelists allocated any money for such a project.
"For any parent that has experienced the unimaginable pain of burying a child that has overdosed, a wall would not have prevented your tragedy," J. Scott Thomson, the Camden County, N.J., chief of police and president of the Police Executive Research Forum, told the Times. "The No. 1 entry point for fentanyl into this country is J.F.K. Airport via U.S. Mail, postmarked from China."
To read the full report, click here.
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