What the Next Administration Needs to Know About the Opioid Crisis

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City leaders are taking actions to stem the tide of overdoses and deaths resulting from the opioid crisis. Across the country, cities are expanding prevention and treatment programs and providing flexibility to the public safety personnel who interact daily with individuals suffering from addiction. However, cities cannot end this epidemic alone – they need support from the federal government to expand treatment programs and strategies that challenge old conventions about the stigma of addiction.

It’s important to examine the presidential candidates’ positions on the issue to determine whether cities will get that support from the coming administration. We’ve analyzed the two leading candidates’ positions, and it’s good to see that both have addressed the opioid crisis to some degree – but cities need to ensure that each candidate is armed with the tools and knowledge they need to fully address the issue and support city efforts to fight the epidemic.

Prevention and Treatment, Not Incarceration

Secretary Clinton’s plan would provide $7.5 billion in new funding to the federal government to:

  • empower communities to prevent drug use among teenagers
  • ensure every person suffering from addiction can obtain comprehensive treatment
  • ensure that all first responders carry the overdose antidote Naloxone
  • require health care providers to receive training in recognizing substance use disorders and to consult a prescription drug monitoring program before prescribing controlled substances, and
  • prioritize treatment over prison for low-level and nonviolent drug offenders

The funding provided by Secretary Clinton’s plan would likely go a long way to helping cities fight the opioid epidemic. But her administration’s efforts to help would be bolstered by having a strong, informed framework to guide the distribution of such funds – and cities need guidance as well when it comes to implementing the above plan.

The National League of Cities and National Association of Counties came together earlier this year to convene a joint task force focused on identifying the local policies and practices that reduce rates of opioid abuse and related fatalities. The Task Force met twice to discuss and observe effective local policies and practices relating to the prevention, treatment, and enforcement needed to contain and address this epidemic. These meetings enabled the Task Force to produce a report with recommendations for city and county officials that will be released at NLC’s City Summit in November.

The recommendations are divided into four “pillars”: leadership, education and prevention, treatment and community wellness, and public safety and law enforcement. The report also highlights local practices from cities and counties across the country. In addition, the report includes recommendations aimed at state and federal officials, who are pivotal partners in local efforts to combat opioid abuse. Should Hillary Clinton win the presidential election, it’s our hope that her administration would take into account this report when it comes time to implement the plan outlined above.

A Public Health Crisis, Not A War on Drugs

Mr. Trump’s plan would:

  • expand incentives for states and local governments to use drug courts and mandated treatment
  • expand access to treatment slots and end Medicaid policies that obstruct inpatient treatment and
  • expand first responders’ and caregivers’ access to the overdose antidote Narcan

Although Congress couldn’t agree on much this year, they did complete their work on legislation to combat the rise in opioid abuse – and on July 22, 2016, President Obama signed in to law the Comprehensive Addiction and Recovery Act (PL 114-198). The bill establishes programs in the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) to improve the treatment of individuals with substance abuse disorders by authorizing grants to expand drug treatment and recovery programs, including:

  • Enhancing collaboration between criminal justice and substance abuse agencies
  • Developing, implementing, or expanding programs to prevent, treat, or respond to opioid abuse
  • Training first responders to administer opioid overdose reversal drugs
  • Establishing drug take-back programs
  • Investigating unlawful opioid distribution activities
  • Supporting drug courts and veteran treatment courts
  • Expanding medication assisted treatment programs
  • Providing rehabilitation programs
  • Implementing prescription monitoring programs

This bill essentially provides a legislative framework for Donald Trump’s plan – and should he win the presidential election, it’s our hope that his administration would expand the grants and programs authorized by the above legislation.

Passage of the bill authorizing the grant funds is good news – but regardless of who should win the election on November 8, NLC urges the federal government to finish the job and provide the necessary funding to:

  • significantly expand medically assisted treatment programs
  • increase grant funding to local governments to expand drug abuse prevention and education efforts, purchase sufficient quantities of Naloxone, and implement useful drug take-back programs
  • partner with local law enforcement to stem the influx for fentanyl and carfentanil laced heroin
  • allow individuals in custody to continue to receive Medicaid benefits until sentenced and ensure the benefits are reinstated before they are release from incarceration