WASHINGTON -- President Donald Trump on Thursday declared the opioid crisis a nationwide public health emergency — a step that won't bring new dollars to fight a scourge that kills nearly 100 Americans a day but will expand access to medical services in rural areas, among other changes.
"This epidemic is a national health emergency," Trump said in a speech at the White House, where he bemoaned a crisis he said had spared no segment of American society.
"As Americans we cannot allow this to continue," he said.
Administration officials have made clear that the declaration, which lasts for 90 days and can be renewed, comes with no dedicated dollars. But they said it will allow them to use existing money to better fight the crisis. Officials also said they would urge Congress, during end-of-the year budget negotiations, to add new cash to a public health emergency fund that Congress hasn't replenished for years.
The Public Health Emergency Fund currently contains just $57,000, according to the Department of Health and Human Services, a negligible amount. Officials would not disclose how much they were seeking.
But critics said that wasn't enough.
"How can you say it's an emergency if we're not going to put a new nickel in it?" said Dr. Joseph Parks, medical director of the nonprofit National Council for Behavioral Health, which advocates for addiction treatment providers. "As far as moving the money around," he added, "that's like robbing Peter to pay Paul."
Democratic House leader Nancy Pelosi also was critical, calling the new declaration "words without the money."
Trump's audience Thursday included parents who have lost children to drug overdoses, people who have struggled with addiction, and first responders whose have used overdose reversal drugs to save lives. Officials also hinted that the president might choose to speak more personally about his own experience with addiction: His older brother, Fred Jr., died of alcoholism. It's the reason the president does not drink.
Leading up to the announcement, Trump had said he wanted to give his administration the "power to do things that you can't do right now." As a candidate, he had pledged to make fighting addiction a priority, and pressed the issue in some of the states hardest hit.
"When I won the New Hampshire primary, I promised the people of New Hampshire that I would stop drugs from pouring into your communities. I am now doubling down on that promise, and can guarantee you we will not only stop the drugs from pouring in, but we will help all of those people so seriously addicted get the assistance they need to unchain themselves," Trump told a crowd in Maine weeks before last November's election.
Once in office, Trump assembled a commission, led by Gov. Chris Christie of New Jersey, to study the problem. The commission's interim report argued an emergency declaration would free additional money and resources, but some in Trump's administration disagreed.
Christie, in a statement, said Trump was taking "bold action" that shows "an unprecedented commitment to fighting this epidemic and placing the weight of the presidency behind saving lives across the country."
Officials said the administration had considered a bolder emergency declaration, under the Stafford Act, which is typically used for natural disasters like hurricanes. But they decided that measure was better suited to more short-term, location-specific crises than the opioid problem. Drug overdoses of all kinds kill an estimated 142 Americans every day.
As a result of the public health emergency declaration, officials will be able to expand access to telemedicine services, include substance abuse treatment for people living in rural and remote areas. Officials will also be able to more easily deploy state and federal workers, secure Department of Labor grants for the unemployed, and shift funding for HIV and AIDs programs to provide more substance abuse treatment for people already eligible for those programs.
Trump also directed other departments and agencies to exercise their own available emergency authorities to address the crisis.
But Sen. Richard Blumenthal (D-CT), said the effort falls far short of what is needed and will diverts staff and resources from other vital public health initiatives.
"Families in Connecticut suffering from the opioid epidemic deserve better than half measures and empty rhetoric offered seemingly as an afterthought," he said in a statement. He argued, "An emergency of this magnitude must be met with sustained, robust funding and comprehensive treatment programs."
Democrats also criticize Trump's efforts to repeal and replace the "Obamacare" health law. Its Medicaid expansion has been crucial in confronting the opioid epidemic.
Adopted by 31 states, the Medicaid expansion provides coverage to low-income adults previously not eligible. Many are in their 20s and 30s, a demographic hit hard by the epidemic. Medicaid pays for detox and long-term treatment.
Nearly a year ago, Congress also approved $1 billion to tackle addiction as part of the 21st Century Cures Act. States got half their Cures Act grants in April and will get the rest next year.
Places such as Fellowship House in Birmingham, Alabama, are using drugs like Suboxone, a combination of buprenorphine and naloxone, with patients for the first time.
"When I took Suboxone, it was like a miracle," said one Fellowship House patient, 43-year-old John Montesano, a former long-haul truck driver with a 20-year pill addiction, chronic pain and no health insurance. "I'd be dead now" without it, he said. "Or worse, not dead" and still using.
Montesano recently marked six months without a relapse. He attends daily recovery meetings, works at a sandwich shop and plans to reunite with his wife. As long as the money goes for treatment "the way Fellowship House does it," he said, Congress "should release all the money they can spare."