MARY LOUISE KELLY, HOST:
The opioid crisis in this country claims more than 115 lives every day. President Trump says the solution to this epidemic lies in tougher enforcement.
More than three months after the president declared opioid abuse a public health emergency, activists and health care providers have been waiting for some other action. But the White House has not given any signals that a comprehensive strategy is coming, as NPR's Greg Allen reports.
GREG ALLEN, BYLINE: President Trump spent just over a minute of his 80-minute State of the Union address talking about opioids. He said the administration is committed to helping get treatment to those who need it.
But in a speech this week in Cincinnati, he said he believes the key to halting the epidemic is stricter law enforcement.
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PRESIDENT DONALD TRUMP: People form blue ribbon committees. They do everything they can. And frankly, I have a different take on it. My take is you have to get really, really tough - really mean with the drug pushers and the drug dealers. We could do all the blue ribbon committees we want.
ALLEN: The president's mention of a blue ribbon committee sounds like a slam on one Trump himself convened last year, chaired by former New Jersey Governor Chris Christie. The White House opioid commission issued more than 50 recommendations. The administration has so far followed up on just a few of them. A policy change announced in October, for example, allows states to use Medicaid to pay for residential drug treatment at facilities with more than 16 beds.
Most of the actions taken by the Trump administration on opioids, however, have focused on enforcement. In Tampa today, Attorney General Jeff Sessions touted the success of an effort that uses medical data to crack down on pharmacies and doctors that dispense suspicious amounts of opioids.
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JEFF SESSIONS: We are not going to stand by and let more of our friends, families and members get addicted, destroyed or die from drug overdose.
ALLEN: Advocates and providers who work on the front lines of the opioid crisis, however, are scathing about what they see as a lack of action from the White House.
Former Congressman Patrick Kennedy, who served in the White House opioid commission, says he's incredulous that after declaring a public health emergency in October, the president still hasn't requested any money from Congress to combat the epidemic.
PATRICK KENNEDY: I mean, this is just a mental health crisis of the first order, and this administration has done nothing.
ALLEN: What's missing, Kennedy says, is a coordinated federal response similar to that in the mid-'90s when the U.S. spent $24 billion a year to address the HIV/AIDS crisis.
KENNEDY: We're talking about a major league crisis, and they're taking credit for little things while the whole country's burning down.
ALLEN: Sixty-four thousand people died from drug overdoses in 2016, and data from the CDC indicates deaths are rising. But more than a year after taking office, President Trump still has not filled a position vital to the administration's opioid response - the head of the Office of National Drug Control Policy - the drug czar. In last year's budget, Trump recommended cutting the office's budget by 95 percent and may do so again this year.
KENNEDY: It's very hard to make sense of. I mean, it's like closing the fire station in the middle of a wildfire.
ALLEN: Keith Humphreys is a professor of psychiatry at Stanford and former policy adviser to the drug czar's office in the Obama administration. A law signed by President Obama that designated a billion dollars to help the states combat opioids runs out of money this year. Humphreys has seen no sign President Trump intends to ask Congress to renew that funding.
KEITH HUMPHREYS: The 2018 budget had a $400 million cut to the substance abuse and mental health services administration, which is the lead agency that funds treatment in the United States. So the administration's impulse seems to be not to spend more - in fact, to spend less.
ALLEN: The White House is preparing to act on one of the recommendations of its opioid commission - that it launch a campaign to educate the public, especially young people, on the dangers of opioids. The campaign is being developed not by the Office of National Drug Control Policy but by a team in the White House led by Kellyanne Conway. Greg Allen, NPR News.
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