{"id":7807,"date":"2017-10-23T18:59:21","date_gmt":"2017-10-23T18:59:21","guid":{"rendered":"http:\/\/www.denverpost.com\/?p=2831538"},"modified":"2017-10-23T18:59:21","modified_gmt":"2017-10-23T18:59:21","slug":"opioid-commission-members-pessimistic-that-trump-congress-will-act","status":"publish","type":"post","link":"https:\/\/cannitrol.com\/blog\/opioid-commission-members-pessimistic-that-trump-congress-will-act\/","title":{"rendered":"Opioid commission members pessimistic that Trump, Congress will act"},"content":{"rendered":"<div id=\"wp_fb_like_button\" style=\"margin:5px 0 5px 5px;float:right;height:100px;\"><script src=\"http:\/\/connect.facebook.net\/en_US\/all.js#xfbml=1\"><\/script><fb:like href=\"https:\/\/cannitrol.com\/blog\/opioid-commission-members-pessimistic-that-trump-congress-will-act\/\" send=\"true\" layout=\"standard\" width=\"450\" show_faces=\"false\" font=\"arial\" action=\"like\" colorscheme=\"light\"><\/fb:like><\/div><div class=\"media_block\"><\/div>\n<div class=\"row\">\n<div class=\"large-10 large-centered small-12 columns\">\n<div class=\"entry-meta-date\">Published: Oct 23, 2017, 10:50 am \u2022 Updated: Oct 23, 2017, 10:50 am<span class=\"single-comments-link\" \/><\/div>\n<p class=\"byline\">By <strong>Greg Sargent<\/strong>, <em> The Washington Post<\/em><\/p>\n<p>As early as this week, President Donald Trump is set to declare the opioid crisis a \u201cnational emergency.\u201d Trump telegraphed this when he <a href=\"http:\/\/www.thecannabist.co\/2017\/10\/16\/marino-drug-czar-manchin-trump\/90163\/\">recently told reporters that he would soon have a \u201cmajor announcement\u201d<\/a> on the \u201cmassive opioid problem,\u201d and people inside the White House are now leaking word that this announcement will herald an all-hands-on-deck push to combat the epidemic.<\/p>\n<p>But members of Trump\u2019s own handpicked commission to combat the epidemic aren\u2019t nearly as confident, I\u2019m told. They are increasingly worried that the Trump administration will not actually follow through with a robust response, even if he does go before the cameras and declare the crisis a national emergency, and they are increasingly annoyed by the efforts of people inside the administration who are resistant to such a response, one member of the commission says.<\/p>\n<p>In a surprisingly blunt interview with me, Patrick Kennedy, the former congressman from Rhode Island who is a member of the President\u2019s Commission on Combating Drug Addiction and the Opioid Crisis, candidly described the mood on the commission as one racked by pessimism about the president\u2019s willingness and ability to follow through with a response that matches the scale of the human disaster that has unfolded.<\/p>\n<p>The commission is set to release a final report of recommendations for combating the crisis on Nov. 1, and \u201cthe worry is that it won\u2019t be adopted,\u201d Kennedy tells me.<\/p>\n<p>This apparently includes the head of Trump\u2019s commission: <a href=\"http:\/\/www.thecannabist.co\/2017\/06\/26\/new-jersey-legal-marijuana-christie\/82392\/\">New Jersey Gov. Chris Christie, R, whom Trump picked<\/a> for the role. Kennedy told me that Christie has confided to him that he thinks failure on the opioid crisis could deal a debilitating blow to Trump\u2019s presidency.<\/p>\n<p>\u201cChristie doesn\u2019t mince words,\u201d Kennedy said. \u201cHe said, \u2018If he doesn\u2019t recognize this as the issue of our time, his presidency is over.\u2019 \u201d Kennedy added that Christie, an early supporter of the president, said he had conveyed a variety of this sentiment to Trump himself.<\/p>\n<p>In August, the commission \u2013 which was created by Trump via executive order in March \u2013 released <a href=\"http:\/\/www.thecannabist.co\/2017\/08\/01\/white-house-opioid-commission-trump-national-emergency\/84986\/\">a preliminary report urging the president to declare the opioid crisis a \u201cnational emergency,\u201d<\/a> arguing that this would \u201cempower your cabinet to take bold steps and would force Congress to focus on funding\u201d a serious response to the epidemic. Such a declaration could also <a href=\"http:\/\/www.thecannabist.co\/2017\/08\/10\/trump-opioids-national-emergency-war-on-drugs\/85793\/\">give the executive branch more flexibility<\/a> to direct appropriated funds toward combating the crisis.<\/p>\n<p>Since then, <a href=\"http:\/\/www.thecannabist.co\/2017\/08\/11\/trump-opioid-epidemic-blame-obama-marijuana\/85830\/\">it has been unclear whether Trump would actually go through with the declaration<\/a> \u2013 that is, until last week, when he suddenly vowed that he would be doing just that. Politico reported that this blindsided members of the Trump administration, who are scrambling to figure out how a response commensurate with that declaration would be implemented. Politico also quoted unnamed officials saying that some in the administration, such as budget chief Mick Mulvaney, are wary that a declaration of national emergency could lock the administration into supporting overly large public expenditures to combat it.<\/p>\n<p>Kennedy confirmed this to me on the record and went even further, claiming that these differences had resulted in tensions between Christie and administration officials such as Mulvaney. \u201cThe tension is between the Mulvaney crowd, who is ideological about the numbers, and the Christie crowd, whose fidelity is towards the reality of what\u2019s most practical,\u201d Kennedy said, adding that there are \u201cinternal arguments\u201d underway that he defined this way: \u201cCan we do this on the cheap, or are we going to be serious about saving lives?\u201d<\/p>\n<p>The key distinction to understand here is this: While it is certainly desirable for Trump to declare a national emergency, it is not clear how meaningful that will prove in substantive terms, even if he does it. Axios reports that the administration is preparing a massive \u201cpublic relations\u201d effort that will include unspecified requests for funds and <a href=\"http:\/\/www.thecannabist.co\/2017\/09\/28\/melania-trump-opioid-crisis-listening\/88908\/\">a public role for Melania Trump<\/a>.<\/p>\n<p>But while such a general vow of seriousness will be welcome, what matters is the follow through. \u201cVisiting rehab centers . . . been there, done that,\u201d Kennedy said, by way of illustrating the difference between photo ops and an actual response.<\/p>\n<p>This is where the recommendations of the president\u2019s commission come in. Kennedy tells me that the commission members are converging on a fairly robust set of recommendations that include <a href=\"http:\/\/www.thecannabist.co\/2017\/05\/26\/trump-budget-opioid-addiction\/80340\/\">expanded health insurance coverage<\/a>, training and deploying health-care workers to fill the requests of states for help, and additional subsidies to fund addiction treatment.<\/p>\n<p>It will be on the administration to determine how to implement such a set of responses and what it might cost, but Kennedy says commission members worry that the administration will try to lowball that cost. \u201cTo implement the recommendations that we\u2019ll offer, it will require hundreds of billions of dollars,\u201d Kennedy says.<\/p>\n<p><a href=\"https:\/\/www.vox.com\/science-and-health\/2017\/8\/1\/15746780\/opioid-epidemic-end\">Vox recently published a good rundown<\/a> on what experts think will be needed to combat the crisis. A combination of tactics is called for, including both prevention (such as strengthened federal oversight to reduce the amount of opioids flooding the market and prescriptions handed out to patients) and medicinal treatment for addiction (such as using methadone or naltrexone to blunt the craving for opioids).<\/p>\n<p>The latest federal data show that <a href=\"http:\/\/www.thecannabist.co\/2017\/07\/12\/marijuana-overdose-statistics-dea\/83506\/\">more than 50,000 people died of drug overdoses in 2015<\/a> \u2013 6 in 10 from opioids \u2013 and <a href=\"http:\/\/www.thecannabist.co\/2017\/08\/08\/drug-overdose-deaths-2016\/85560\/\">experts expect the 2016 numbers to be much worse<\/a>, due to the worsening opioid crisis.<\/p>\n<h3>Trump\u2019s declaration of an opioid emergency will collide with the GOP repeal drive<\/h3>\n<p>Another concern that commission members have is that even if Trump declares a national emergency on opioids, efforts to combat them will end up getting undermined by Trump\/GOP health-care policies and priorities. Trump and Republicans have vowed to <a href=\"http:\/\/www.denverpost.com\/2017\/10\/13\/affordable-care-act-subsidies-health-care-debate\/\">keep pushing for repeal of the Affordable Care Act<\/a>, and any version of repeal would include <a href=\"http:\/\/www.denverpost.com\/2017\/10\/20\/why-baby-boomers-should-worry-about-medicaid-cuts\/\">enormous cuts to Medicaid<\/a>, which commission members fear would set back efforts to combat the crisis, including deep in Trump country.<\/p>\n<p>What\u2019s more, Kennedy says that continued sabotage of the ACA by Trump could also undermine such efforts, since destabilizing the exchanges could leave lower-income people without coverage options in parts of the country hit hard by the opioid epidemic.<\/p>\n<p>Kennedy tells me he has been pushing for the commission\u2019s final report to include a firm declaration that further efforts to repeal or sabotage the ACA would run counter to the goal of treating opioids as a national emergency. He says other members of the commission who are Republican governors, including Christie and <a href=\"http:\/\/www.thecannabist.co\/2017\/07\/28\/massachusetts-marijuana-law-baker\/84780\/\">Charlie Baker of Massachusetts<\/a>, agree with this. Another member, Gov. Roy Cooper of North Carolina, D, has voiced this sentiment publicly.<\/p>\n<p>\u201cThe current efforts to repeal the ACA, as opposed to strengthening it, are irreconcilable with dealing with this crisis in the way that it needs to be dealt with,\u201d Kennedy says, adding that there\u2019s widespread agreement on the commission on this point.<\/p>\n<p>This will set up a very bad political problem for Trump: His own declaration that opioids are a national emergency will \u2013 or should \u2013 dramatically undercut any further efforts to repeal or sabotage the health-care law, a goal Trump and Republicans can\u2019t seem to wean themselves off of.<\/p>\n<p>In the end, what will the commission members do if the administration falls short of the response they are advocating?<\/p>\n<p>\u201cEvery single member of this commission has principled independence on this issue,\u201d says Kennedy. \u201cI believe they\u2019ll distance themselves from the president if he doesn\u2019t follow our recommendations.\u201d<\/p>\n<p><em>Sargent is a Washington Post columnist.<\/em><\/p>\n<\/p><\/div>\n<\/p><\/div>\n<p><!-- .row --> <\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"media_block\"><\/div>\n<p>Members of Trump&#8217;s commission to combat the opioid epidemic are increasingly worried the Trump administration will not have a robust response. <\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7038,311,5662,6911,6813,77,5667,9,6855,5019,6983,441,1,3,61,162,1736],"tags":[7039,2889,5668,6912,6818,2655,5673,6856,5022,6984,3015,2740],"_links":{"self":[{"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/posts\/7807"}],"collection":[{"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/comments?post=7807"}],"version-history":[{"count":0,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/posts\/7807\/revisions"}],"wp:attachment":[{"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/media?parent=7807"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/categories?post=7807"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cannitrol.com\/blog\/wp-json\/wp\/v2\/tags?post=7807"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}