Back in August, President Donald Trump said that the opioid epidemic is “a national emergency.” But more than two months later, Trump has yet to file the paperwork to formally declare the crisis an emergency, as his own opioid commission recommended, and potentially release some federal resources to address the issue.
When asked over the weekend, White House officials gave me the same answer they gave me just one week after Trump’s initial comments: The declaration is undergoing legal review. They added that policy advisers are currently working out details with the relevant agencies.
The White House also pointed to Trump’s comments on Friday: “We are studying national emergency right now. Believe it or not, doing national emergency, as you understand, is a very big statement. We will be doing that.”
When an emergency declaration will actually come — if it will come at all — remains unclear.
Meanwhile, the numbers in the opioid crisis keep getting worse. In 2016, more than 64,000 people died of drug overdoses in the US, according to provisional data released by the Centers for Disease Control and Prevention (CDC) last week. That’s a jump from more than 52,000 in 2015. The spike was driven largely by a rise in deaths from the synthetic opioid fentanyl, which was linked to nearly 20,000 overdose deaths in 2016, up from less than 10,000 in 2015, and surpassed common opioid painkillers and heroin in overdose deaths for the first time last year.
The declaration of a national emergency would not be a cure-all to the epidemic; as experts explained to me, it would at best be a start. Depending on how it’s done, it could unlock limited federal resources to help scale up addiction treatment and, according to Trump’s opioid commission, let the federal government negotiate down the price on the opioid overdose antidote naloxone. (Much more on all the potential effects of a declaration in Vox’s explainer.)
But experts and advocates in the addiction field are hoping for something. The annual overdose death toll is already in the tens of thousands, and it has been going up for years. And according to a 2016 report from the surgeon general, only 10 percent of Americans with a drug use disorder get treatment for addiction — largely because treatment remains too expensive, short in supply, and otherwise inaccessible.
Yet the federal government hasn’t done much to alleviate this. Congress in 2016 passed its biggest measure yet responding to the crisis, adding $1 billion in funding for treatment over two years — far from the tens of billions a year that experts estimate is needed.
And since Trump took office, his administration has worked against some of the solutions to the crisis. Trump’s budget proposal would do little to nothing to boost prevention or access to addiction treatment. Congress, with Trump’s full support, has worked (unsuccessfully — for now) to repeal Obamacare and, as a result, reduce access to insurance that can pay for addiction treatment.
Trump’s opioid commission, meanwhile, is still meeting. It expects to finalize its recommendations on November 1 — more than three months after it released its preliminary report proposing, among other moves, a national emergency declaration.
For more on the opioid epidemic, read Vox’s explainer.