​President Trump on October 26, 2017, formally declared the opioid epidemic a public health emergency under federal law. According to the White House, the action will expand access to telemedicine service for substance abuse and mental health treatment, which could help reach rural communities hit hard by the opioid crisis. The declaration will also help to overcome “bureaucratic delays and inefficiencies," the White House said, by allowing the U.S. Department of Health and Human Services to quickly make temporary hires and appointments of specialists who can respond to the crisis. The Department of Labor will be granted the ability to issue dislocated-worker grants to help those who have been displaced from the workforce as a result of the opioid crisis, the White House said. The administration fell short of declaring the opioid epidemic a “national emergency," which, according to an October 27, 2017, article in the New York Times, would have prompted a rapid allocation of federal funds. The announcement made no mention of whether the administration would request any additional funds for expanding mental health treatment, the Times article said. The administration said it will be producing advertising aimed at keeping people from starting opioids in the first place, which the Times compared to the “Just Say No" advertisements of the 1980s. The president of the American Hospital Association said in an October 26, 2017, statement that his organization welcomes news of the declaration and urged the government to take steps such as eliminating barriers to treatment created by the Medicaid Institutions for Mental Disease exclusion, making it easier to share patient substance-use records and ensuring comprehensive coverage to give patients the services they need.

HRC Recommends: Prescription opioid misuse poses a high risk for addiction, diversion, and subsequent heroin use. Furthermore, risk of long-term opioid use increases quickly after initial prescription (see HRC Alerts, March 29, 2017: Unwitting Enablers: Annals of Surgery Looks at Role Surgeons Play in the Opioid Crisis). Healthcare organizations may wish to consider adopting standardized tools and approaches for pain management, with an emphasis on nonopioid strategies, and to work with prescribers on addressing the needs of patients at increased risk for opioid use disorder. Risk managers may also wish to investigate how elements of the presidential declaration, such as expanded access to telemedicine and government resources, may affect their organizations.