WASHINGTON, Nov. 1, 2017 – An expanded federal drug-court system, better access to alternatives to opioids for people in pain, and educational requirements for drug prescribers are just a few of the dozens of recommendations from the commission set up by President Trump to combat the opioid crisis.

The six-member commission, chaired by New Jersey Gov. Chris Christie, released its report on Thursday, just days after President Trump declared the epidemic a national public health emergency. The president, however, did not earmark any new money to fight the drug scourge, and neither does the commission. The group does, however, call for federal block grant funding, which would send money directly to the states, “where the battle is happening every day.”

“Without comprehensive action, including your national public health emergency, the death count will continue to rise,” Christie stressed in a letter to Trump that accompanied the report. “Money is being wasted and accountability for results is not as intense as it should be,” he continued. “Block granting them would allow more resources to be spent on administering life-saving programs.”

The mortality count is staggering. Last year, an estimated 64,000 people died of drug overdoses in the U.S., with opioids blamed for most of the deaths. By comparison, just over 58,000 Americans were killed in the 20 years of the Vietnam War. And while the epidemic first surfaced most prominently in poorer communities in Appalachia, in the Rust Belt and in New England, the report notes that “prescription opioids now affect a wide age range, families both well-off and financially disadvantaged, urban and rural, and all ethnic and racial groups.”

The White House press office said the administration is looking forward to reviewing the commission’s recommendations. In a statement, it referred to President Trump’s “powerful address” last week “on combating drug demand and the opioid crisis.

“Due to a lack of attention for nearly a decade, this tragedy has devastated Americans and America’s communities for far too long,” it said, adding that the president has “prioritized these crucial issues by declaring a nationwide public health emergency.

The report includes 56 distinct recommendations, many of which now fall to Congress, a number of federal departments, and local governments to fund and implement.

They include:                    

  • Expanding the use of drug courts, which serve as alternatives to the traditional court system. The commission noted that as of 2015, less than a third of federal judicial districts and 44 percent of U.S. counties operated drug courts, which have been shown to reduce recidivism rates and facilitate addiction treatment.
  • Allowing more emergency responders to administer the overdose-reversal drug naloxone.
  • Requiring more educational requirements for prescribers. The report calls on the Drug Enforcement Administration to require prescribers seeking to renew licenses for prescribing opioids first demonstrate they have participated in an education program regarding the drugs’ prescription. The report also recommends that HHS develop a “national curriculum and standard of care for opioid prescribers,” and that pharmacists receive training “on best practices to evaluate the legitimacy of opioid prescriptions.”

The commission rejected endorsing the use of marijuana for pain. In his cover letter to Trump, Christie said that research by the National Institute on Drug Abuse “found that marijuana use led to a 2½ times greater chance that the marijuana user would become an opioid user and abuser.” Christie said there is also “a lack of sophisticated outcome data on dose, potency and abuse potential for marijuana.”

Besides Christie, a Republican, the other commission members are: Massachusetts Gov. Charlie Baker, a Republican; North Carolina Gov. Roy Cooper, a Democrat; former Rhode Island Democrat Rep. Patrick Kennedy; and Bertha Madras, a professor of psychobiology at Harvard Medical School.

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