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How should we fight the opioid crisis? A White House commission offered these 56 strategies

President Donald Trump’s opioid commission said Thursday that in order to fight the opioid crisis, the country should increase federal funding and addiction prevention programs, expand federal drug courts and devise new law enforcement strategies to reduce opioid supply, according to a final report it sent to the White House.

The Commission on Combating Drug Addiction and the Opioid Crisis, chaired by New Jersey Gov. Chris Christie, spent the last seven months surveying the opioid crisis as it continued to unfold across the United States, gathering testimony and public input from health and law enforcement, policymakers and individuals and families.

Read all 56 of the commission’s final recommendations here.

What did the commission recommend?
Some of the other recommendations in the commission’s final report included:

  • expand the nationwide prescription drug monitoring program to include a data-sharing hub with the Department of Justice
  • increase block grant funding to states
  • improve coordination between all federal programs and agencies that target the opioid crisis
  • mandate that prescribers undergo approved and continuous training before they can be licensed to prescribe opioids
  • provide more resources for opioid addiction treatment, overdose reversal and recovery
  • assist more research and development into alternative pain management therapies and medications to replace opioids.

Harvard Medical School’s Bertha Madras, who served on the commission along with Governor Charlie Baker of Massachusetts, Governor Roy Cooper of North Carolina, former Rhode Island congressman Patrick Kennedy and Florida Attorney General Pam Bondi, authored the 131-page final report. Madras said the commission tried to figure out how the nation reached this point and then attempted to “reverse-engineer solutions” that take into account “the mistakes of the past” and prevent those issues from happening again.

“If we don’t stop the pipeline into substance use, if we don’t promote prevention, we are going to have an open-ended catastrophe that goes on for generations,” Madras said.

What did the commission learn?

The commission has held a series of meetings over the past several months, in which they’ve heard from doctors, public health advocates, lawmakers, drug makers and health insurance representatives.

Many of them shared personal stories of addiction. On Wednesday, Doug Griffin, a father from Newton, New Hampshire, detailed for the commission how his daughter, Courtney, struggled with fentanyl. At times, he said, she obtained pills at high school, and he would find her “curled up in a ball” in the floor of her closet. In 2014, she overdosed and died. She was 20 years old. While reading his testimony, Griffin’s voice broke and he cried.

“I pray your children are spared from this plague, and that you never know what it’s like to be me,” he said.

Roxanne Schwartz of Lebanon, New Jersey, told the commission how she and her family managed to gain treatment for her son’s addiction to opioids only to spend $300,000 and hundreds of hours appealing insurance claim denials.

“Even when you have access to care, there are barriers to treatment,” Schwartz said, saying that parity coverage for mental health issues was essential in helping more Americans meet the challenges of addiction treatment and recovery.

Christie said he found recent testimony from health insurance company executives “sickening” after they said “everything’s going great and they’re making great progress when it’s simply not true.”

Why it matters
In 2016, an estimated 64,000 Americans died of drug overdose, according to preliminary data from the Centers for Disease Control and Prevention. Roughly one-third of those deaths were attributed to fentanyl, a potent synthetic opioid often shipped directly to the U.S. from China, according to the Department of Justice. Christie said 175 people are dying daily in the United States as a result of drug overdose.

“This is an attack from within,” Christie said. “We are killing ourselves and it’s unacceptable from my perspective not to step up.”

What’s next?
The Department of Justice is “focused on dismantling illegal drug distribution networks” and internet drug dealers, said Rod Rosenstein, the department’s deputy attorney general. He said the has launched more than 1,000 active federal investigations that involve heroin and fentanyl, Rosenstein said.

Trump established the commission by executive order in March. In July, the commission released an interim report, with its “first and most urgent” recommendation being that Trump should declare the opioid crisis a national emergency. Six out of 10 Americans said Trump has not done enough to address the opioid crisis, according to an Oct. 3 PBS NewsHour/Marist poll.

Last week, the president declared a public health emergency, but did not set aside new money to target rising opioid use and overdose deaths.

It’s not clear when the White House will approve, or reject, the final report. In a statement, the White House said “we are grateful for the Commission’s extensive work since March, and look forward to reviewing these recommendations as the entire Administration continues to work to lessen drug demand and the opioid crisis.”

As for the commission: Unless Trump says otherwise, the group will dissolve in 30 days.

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