The Trump administration is sparking concerns over just how seriously it is taking the opioids crisis as experts at the Office of National Drug Control Policy (ONDCP) are apparently being pushed aside in favor of the leadership of inexperienced political appointees, Politico reports. White House counselor Kellyanne Conway is overseeing the administration's efforts to combat the crisis, although her team does not have a permanent director and its top appointee for months was a 24-year-old former Trump campaign staffer. The acting director of the ONDCP, who has served in the office for decades, has reportedly not been invited to attend any of the meetings between Conway and her team.
"I haven't talked to Kellyanne at all and I'm from the worst state for this," added Republican Sen. Shelley Moore Capito of West Virginia. Regina LaBelle, who served as the ONDCP's chief of staff under former President Obama, said: "I don't know what the agency is doing. I really don't. They aren't at the level of visibility you'd think they'd be at by now."
President Trump has been criticized for failing to act in any meaningful way after declaring an opioids emergency last year. "The main response so far has been to call for a border wall and to promise a 'just say no' campaign," Politico writes, adding that Trump is expected to propose "massive cuts" to the ONDCP next week.
"It's fair to say the ONDCP has pretty much been systematically excluded from key decisions about opioids and the strategy moving forward," stressed a former Trump administration official. An estimated 175 people die a day from opioids; STAT announced last year that opioids could kill nearly 500,000 Americans in the next decade. Read more about concerns sparked by the Trump administration's approach to the crisis at Politico. Jeva Lange
Walmart announced Wednesday it is now offering a product that safely destroys all forms of unused opioid drugs, but experts say the item is not necessary.
Walmart's product, DisposeRx, and warm water will turn opioids — including powders, tablets, pills, capsules, liquids, and patches — into a biodegradable gel that cannot be converted back into a usable drug. Walmart said this is the first product of its kind, and with 42,000 Americans dying in 2016 from opioid overdoses, the company wanted to take "an active role in fighting our nation's opioid issue, an issue that has affected so many families and communities across America."
About one-third of medications sold go unused, and it's easy for excess pills to end up in the wrong hands, spreading addiction. But DisposeRx isn't necessary, Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University, told NPR. Opioids can just as easily be flushed down the toilet. "The problem is the general public just doesn't know that," he said. "Think about it. Every time someone taking an opioid medication urinates or defecates, it gets into the water supply. So that's not the real problem." Catherine Garcia
For the first time since the early 1960s, life expectancy in the United States has fallen for a second year in a row. "I'm not prone to dramatic statements, but I think we should be really alarmed," the chief of the morality statistics branch at the National Center for Health Statistics, Robert Anderson, told NPR.
Officials blame the rare U.S. life expectancy decline on opioid overdoses. The epidemic has reached such a state of crisis that STAT estimated earlier this year that the drugs could kill nearly 500,000 Americans in the next decade. In October, President Trump officially declared the crisis to be a national public health emergency and said the government would work on advertising campaigns and research into non-addictive pain management techniques to combat the soaring fatalities.
Americans' life expectancy dropped from 78.9 years to 78.7 years between 2014 and 2015, and from 78.7 years to 78.6 years between 2015 and 2016. "For any individual, that's not a whole lot," Anderson said. "But when you're talking about it in terms of a population, you're talking about a significant number of potential lives that aren't being lived." In 2016, an estimated 42,200 drug overdose deaths were attributed to opioids. In 2015, that number was 33,000.
The last time U.S. life expectancy dropped at all was in 1993, during the height of the AIDS epidemic. "Deaths from alcohol have been rising as well," Princeton University economist Anne Case added to NPR. "So we think of it all being signs that something is really wrong and whatever is it is that's really wrong is happening nationwide." Jeva Lange
Dr. John N. Kapoor, the billionaire founder of Insys Therapeutics, was arrested and charged Thursday with bribing doctors to prescribe Subsys, a spray meant for cancer patients that contains the highly addictive synthetic opioid fentanyl.
Kapoor, 74, was arrested in Phoenix, and is facing federal charges of racketeering, conspiracy to commit fraud, and conspiracy to violate an anti-kickback law; the racketeering and fraud charges alone carry possible prison sentences of up to 20 years. Subsys was approved by the FDA to treat cancer patients who have pain that can't be helped by any other narcotics, and a 30-day supply costs between $3,000 and $30,000, NBC News reports; in the last year, Insys has sold $240 million worth of Subsys. Prosecutors allege Insys paid doctors hundreds of thousands of dollars in exchange for them prescribing Subsys, which is 100 times stronger than morphine.
Three of the top prescribers have been convicted of accepting bribes from Insys, and Insys denies any wrongdoing, saying the company cannot be held responsible for how doctors prescribe products. Over the summer, former employee and whistleblower Patty Nixon told NBC News she was trained to make sure doctors prescribed Subsys, even to patients who did not have cancer. She contacted insurance companies on behalf of the patients and doctors, she said, sometimes pretending to work for a doctor who treated cancer patients to make it easier for her requests to go through. Catherine Garcia
Fred Trump Jr. suffered from alcoholism and died in 1981 at the age of 43. The president, who is famously a teetotaler, credited his older brother for steering him away from alcohol. "[Fred] had a problem with alcohol, and he would tell me, 'Don't drink,'" Trump said.
Trump went on to say that he has watched his friends struggle with alcohol over the years and that "the fact is, if we can teach young people and people generally not to start [taking drugs], it's really, really easy not to take them." He emphasized the importance of a "really tough, really big, really great advertising" campaign to raise awareness and added: "There is nothing desirable about drugs. They're bad."
The president also said that the government would require a particular "truly evil" opioid to be removed from the market, as well as promote research for non-addictive pain management techniques. Trump had been heavily criticized for not triggering a federal response to the crisis sooner, after saying he would make an announcement back in early August.
STAT estimated earlier this year that opioids could kill nearly 500,000 Americans in the next decade. Watch Trump's remarks about Fred below. Jeva Lange
Trump discuss his brother Fred's struggles with alcohol: "He really helped me. I had somebody that guided me." pic.twitter.com/GiPmhhML3H
— Axios (@axios) October 26, 2017
On Wednesday night, President Trump told reporters that he is "going to have a big meeting on opioids" Thursday, and White House officials tell USA Today that Trump will order the Health and Human Services department to declare the opioid crisis a public health emergency, a step short of the national emergency he promised to declare in August and again last week — to the surprise and consternation of his staff. Trump said the order would give the federal government the "power to do things that you can't do right now," and White House officials said the renewable 90-day order would give states more flexibility to spend the $1 billion for opioid treatment Congress approved last year as part of the 21st Century Cures Act, plus tap other funds.
States have already received half of their Cures Act funding, but it is taking time to reach addicts. Some of the lag involves setting up new programs and training, but federal rules on controlled substances have also gotten in the way. The public health emergency declaration should clear some of those, like prohibitions on prescribing opioid addiction treatments over the phone.
Trump's opioid commission, headed by New Jersey Gov. Chris Christie, had recommended a more robust national emergency declaration, which draws on a different law and would have presented Trump with the authority to waive privacy laws and Medicare regulation. The public health emergency declaration allows states to tap the HHS's Public Health Emergency Fund, which currently holds $57,000. "My view is that this action sends a clear signal from the president that he wants money appropriated into that fund," Christie told USA Today. "And it gives Congress a place to go with that money to give the administration some flexibility to use it." Trump won't request any funds in his executive order. Peter Weber
President Trump assured critics that he would officially declare the opioid crisis to be a national emergency next week, which was apparently news to his own officials. "They are not ready for this," one public health advocate told Politico after discussing Trump's promise with Health and Human Services officials. A senior Food and Drug Administration official agreed, calling it "such a mess."
Opioids are the leading cause of unintentional death in the United States. STAT estimated earlier this year that opioids could kill nearly 500,000 Americans in the next decade. But "Trump's off-script statement stunned top agency officials, who said there is no consensus on how to implement an emergency declaration for the drug epidemic," Politico writes.
Part of the disagreement boils down to how to declare the emergency: The Stafford Act, which is normally used for natural disasters like hurricanes or earthquakes, could open up federal dollars for the opioid crisis but might not be legally sound. Trump could instead declare a more narrowly focused public health emergency, but that would rely on the mere $57,000 in available money from HHS. Trump could also look to Congress, but that approach still hasn't been finalized.
“The reaction [to Trump's promise] was universal," one senior health official told Politico. "Believe it when [we] see it." Read more about why if the opioid crisis isn't a national emergency, nothing is, at The Week. Jeva Lange
On Sunday night, 60 Minutes and The Washington Post reported that Rep. Tom Marino (R-Pa.) had worked for two years to push through a bill promoted and apparently written by the pharmaceutical industry that stripped the Drug Enforcement Administration of its biggest tool to fight prescription opioids entering the black market. Marino is President Trump's nominee to head the Office of National Drug Control Policy. On Monday, Trump called Marino "a good man," a "great guy," and "a very early supporter of mine — the great state of Pennsylvania," but said that after Sunday's 60 Minutes, "we're going to look into the report. We're going to take it very seriously."
Trump did not say if he would withdraw Marino's name to be drug czar, but hinted that he might. "I have not spoken to him, but I will speak to him, and I'll make that determination," he told reporters in the Rose Garden. "And if I think it's 1 percent negative to doing what we want to do, I will make a change, yes."
Democrats and a few Republicans backed repealing the law — which passed on voice votes with no objections — and some Democrats urged Trump to dump Marino. Sen. Richard Blumenthal (D-Conn.) said the drug czar "is supposed to be a watchdog, not a lap dog," and warned that if Trump pursues the nomination, "it will be ugly."
Trump also said he plans to declare the opioid crisis a national emergency next week, calling the epidemic a "massive problem" he wants to get "absolutely right." Democrats and a few Republicans said they were stunned by the report, insisting they had been assured by DEA officials that the bill would not hamper the fight against opioid addiction. You can learn more about the reaction in Washington in the CBS News report below. Peter Weber