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THE US PRESIDENT, DONALD TRUMP , has instructed
his administration to use ‘all appropriate emergency
and other authorities’ to respond to the country’s
opioid crisis.
The move follows the publication of an interim
report from the President’s Commission on Combating
Drug Addiction and the Opioid Crisis, which calls for a
rapid expansion of treatment capacity as well
enhanced access to ‘medication-assisted treatment’
and increased naloxone dispensing. Although the
document also calls for the declaration of a national
emergency, and Trump later used those words in
describing the situation to reporters, no formal
declaration has so far been made.
The number of opioid overdoses in the US has
quadrupled since 1999, says the report, with more
than 560,000 people dying as a result of a drug
overdose between 1999 and 2015. ‘Not coincidentally’,
the level of opioid prescribing quadrupled over the
same period, it states. ‘Americans consume more
opioids than any other country in the world,’ says the
document. ‘In fact, in 2015, the amount of opioids
prescribed in the US was enough for every American to
be medicated around the clock for three weeks. We
have an enormous problem that is often not beginning
on street corners; it is starting in doctor’s offices and
hospitals in every state in our nation.’
As access to prescription opioids has been
tightened, however, people have increasingly turned
to street drugs, with just 10 per cent of the almost
21m people with a ‘substance use disorder’ receiving
any type of specialist treatment – a factor that is
‘contributing greatly’ to the increase in overdose
deaths, the report says. More than 40 per cent of
people with a substance problem also have a mental
health problem, it adds, but ‘less than half’ receive
treatment for either.
‘Nobody is safe from this epidemic that threatens
young and old, rich and poor, urban and rural
communities,’ Trump told a press briefing. ‘Drug
overdose is now the leading cause of accidental death
in the United States. It is a problem the likes of which
we have not seen.’ He added, however, that the best
way to prevent addiction and overdose was to ‘prevent
people from abusing drugs in the first place’ and that
‘strong law enforcement’ was ‘absolutely vital’. Earlier
this year his administration signalled that it intended
to intensify the ‘war on drugs’ with a return to 1980s-
style prevention campaigns (DDN, May, page 5).
Deputy director of national affairs at the Drug
Policy Alliance, Grant Smith, stressed the ‘stark
contrast’ between the president’s preferred law
enforcement approach and the health-based response
prioritised by the opioid commission’s report.
‘President Trump made repeal of the Affordable Care
Act a top priority, which would threaten healthcare
and access to treatment and mental health services for
millions of people living with a substance use disorder,’
LIVE ACTION
PEOPLE VISITING THE ADDACTION
WEBSITE can now chat anonymously to
a support worker in real time, with the
aim of helping those not currently
accessing professional help. While some
of the 160-plus weekly calls to the pilot
service are five-minute ‘signposting’
chats, others can last an hour, says the
charity. ‘The majority has been people
really struggling with their own or
other people’s substance misuse and
mental health problems,’ said
Addaction Scotland director, Andrew
Horne. ‘It’s been non-stop and there
are a lot of people out there looking for
help.’ Service available at
www.addaction.org.uk
there are a
lot of people
look ing
for help
BOTTLING IT
DRINKS COMPANIES ARE FAILING to inform
consumers of drinking guidelines and health
harms, according to the Alcohol Health Alliance
(AHA). Research carried out nearly 18 months
after new guidelines were introduced (DDN,
www.drinkanddrugsnews.com
anDrew Horne
US ADMINISTRATION TO USE ‘ALL APPROPRIATE
AUTHORITY’ IN RESPONSE TO OPIOID CRISIS
earlier this year the
president’s administration
signalled its intention to
intensify the ‘war on drugs’
he said. ‘People who are looking for this administration
to use a national emergency to ramp up access to
treatment and step up a health-based response to the
opioid crisis are going to need to be vigilant that this
indeed happens’ and that any emergency declaration
does not ‘give the Trump administration more licence
to escalate the drug war’, he added.
President’s Commission on Combating Drug
Addiction and the opioid crisis: draft interim report at
www.whitehouse.gov
February 2016, page 4) found that just one of
315 labels across nearly 30 locations carried
information about the revised limits. ‘Self-
regulation has failed’ said AHA chair, Professor
Sir Ian Gilmore. ‘Instead of alcohol producers
deciding what to include on labels, the
government should now require all labels to
contain the latest guidelines and information
on the health conditions linked with alcohol.’
Right to know at ahauk.org health budget (DDN, September 2015, page 4),
as well as planned reductions until the end of
the decade.
‘Reducing spending on public health is
short-sighted at the best of times,’ said senior
fellow in public health and inequalities at The
King’s Fund, David Buck. ‘The government
must reverse these cuts and ensure councils
get adequate resources to fund vital public
health services.’
CUTS CHAOS IRISH INITIATIVES
LOCAL AUTHORITIES HAVE BEEN FORCED to
reduce planned public health spending by
£85m as a result of government cuts,
according to analysis by The King’s Fund.
‘Once inflation is factored in, we estimate
that, on a like-for-like basis, planned public
health spending is more than 5 per cent less
in 2017-18 than it was in 2013-14,’ says the
think tank. Money for tackling drug misuse in
adults will face a 5.5 per cent cut of £22m,
with specialist drug and alcohol services for
young people and smoking cessation also
facing substantial reductions.
Services are already struggling with the
impact of a £200m cut to the 2015-16 public IRELAND HAS LAUNCHED A ‘HEALTH-LED’
response to the country’s drug and alcohol
use, Reducing harm, supporting recovery,
which includes both the introduction of a
pilot supervised injection facility in Dublin
(DDN, December 2015, page 4) and the
establishment of a working group to look at
‘alternative approaches’ to the possession of
drugs for personal use.
‘Treating substance abuse and drug
addiction as a public health issue, rather than
a criminal justice issue, helps individuals,
helps families, and helps communities,’ said
Ireland’s Taoiseach, Leo Varadkar. Strategy at
www.merrionstreet.ie/en
September 2017 | drinkanddrugsnews | 5