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The national opioid epidemic has been an ongoing crisis in America over the last two decades and continues to have detrimental effects on communities across the country. Hospitals, organizations, and communities alike have made efforts to reduce opioid misuse. At Affirm Health, our mission is "to help healthcare leaders drive responsible, compliant prescribing across their entire organization." We strive to not only ensure our own team is fighting against opioid abuse, but we are providing others with resources to do the same. The US Government has taken its own strides in addressing and combatting the epidemic. Below we summarize the history and progress we have made as a nation since President Trump's Administration began in 2017.
Overview of the Opioid Crisis
The opioid epidemic has escalated since the early 2000s. The Centers for Disease Control and Prevention reported almost 64,000 Americans died from a drug overdose in 2016, more than three times the rate of drug overdose deaths in 1999. Additionally, in 2016, an average of 20.1 million Americans had a substance use disorder.
According to the National Institute on Drug Abuse, pharmaceutical companies have played a role in the rise of opioid use. In the late 1990s, providers began prescribing them at higher rates and more frequently after companies assured them that patients using opioids would not become addicted. After increased prescribing of opioids, a widespread misuse and abuse began among prescription and non-prescription opioids– proving them to be highly addictive. After nearly 20 years of increased opioid-related overdose and death rates, the HHS declared a public health emergency in 2017 and announced a 5-Point Strategy To Combat the Opioid Crisis, which aimed to lessen the damages caused by opioid misuse. Since then, many initiatives have been started to manage the epidemic in the United States. 
Overview of the Trump Administration's Opioid Initiatives
Abuse & Addiction Prevention:
- $13 billion in funding proposed for Health and Human Services to support a prevention media campaign as well as to enhance state surveillance efforts, including improving state-based Prescription Drug Monitoring Programs (PDMPs).
- Rx Awareness Campaign launched by the Center for Disease Control, which features the real-life stories of people affected by opioid addiction and overdose.
- The Drug-Free Communities Support Program initiated by the Office of National Drug Control Policy and Substance Abuse and Mental Health Services Administration in order to strengthen collaboration between groups that work to prevent youth substance abuse.
- "Blueprint" for healthcare providers continuing education updated by the Food and Drug Administration to expand information on the principles of pain management, including how to assess, treat, and monitor patients when opioids are appropriate.
- New policies introduced by the Center for Medicare & Medicaid Services, which offer better tools to manage and prevent overuse among beneficiaries with Medicare Advantage and Part D health plans.
- The Department of Justice expanded educational efforts to doctors and pharmacists as they obtain registrations for prescribing medication. 
Combating opioid fraud & illegal opioid suppliers:
- A surge was initiated by the DEA to focus on unusual dispensing or disproportionate amounts of drugs, enhancing attempts of drug diversion.
- The Opioid Fraud and Abuse Detection Unite (OPFAD) was created by the DOJ to investigate and prosecute healthcare fraud related to the opioid epidemic. The program consisted of 12 Assistant U.S. Attorneys being assigned to opioid "hot-spots" to carry out the investigations.
- The largest healthcare fraud enforcement act, called the Medicare Fraud Strike Force, by the DOJ and HHS, charged 120 people with unlawfully administering opioids. The scandal resulted in $1.3 billion in fraudulent billing to Medicare and other insurance programs and/or providers.
- The Interdict Act was signed in January 2019 by President Trump to authorize funding for U.S. Customs and Border Protection, in an effort to prevent and halt all unlawful importation of illegal drugs and substances. 
Expanding Access to Treatment:
- Top innovator companies have developed a partnership with the National Institutes of Health (NIH) attempting to facilitate the development of new treatments for addiction, overdose-reversal, pain, and non-addictive therapies.
- The newly updated State Targeted Response to the Opioid Crisis grant program, which enacts an assortment of efforts for prevention, treatment, and recovery services, was funded $485 million by the HHS.
- President Trump's Budget proposal includes resources to expand the grants mentioned above.
- Sublocade ™ was approved by the FDA as the first injectable option of buprenorphine, once a month, to treat opioid abuse and addiction.
- A total of $144 million in grants was awarded by SAMHSA over the next three to five years to support opioid efforts, including substance abuse. 
President Trump's Response to the Opioid Crisis
Shortly after his inauguration, President Trump established the President’s Commission on Combating Drug Addiction and the Opioid Crisis, which had the following mission: "To study the scope and effectiveness of the Federal response to drug addiction and the opioid crisis and to make recommendations to the President for improving that response." The Commission disbanded in 2017 as officials declared it had served its purpose in combatting the epidemic at the time.
In October 2017, President Trump declared the opioid crisis a U.S. public health emergency. Since then, the Trump Administration has taken an all-inclusive government approach taking the necessary measures to address and aide the epidemic. 
One year later, in March 2018, President Trump launched his Initiative to Stop Opioid Abuse which sought out to address and tackle the driving forces behind the opioid crisis. His initiative was broken down into three parts: 1) to educate Americans on the dangers associated with opioids in order to reduce demand and over-prescribing, 2) reduce the number of illicit drugs on the market by cracking down on drug suppliers both internally and externally in the US, and 3) provide relief, treatment, and aide in recovery to those batting opioid addiction. 
In October 2018, The Trump Administration proposed $6 billion in funding to fight opioid abuse and misuse over the next two-years. A Safer-Prescribing Plan was put into action to cut opioid prescriptions by one-third in the following three years. Trump has also advocated for higher border security in order to end illegal drug trafficking.
Later that year, President Trump passed the Support Act, the largest legislative piece addressing one drug crisis in history. In response to the Support Act, the National Council for Behavioral Health was disappointed in the act's attempt to provide long-term prevention, treatment and recovery service options, which the country desperately needed. Specifically, the council wanted to expand the two-year Certified Community Behavioral Health Clinic (CCBHC) program, as a part of the Excellence in Mental Health and Addiction Treatment Expansion Act. This act showed great results in addictions services and prevention efforts. However, the National Council was in favor of the crucial policy changes included in the legislation. 
"Everyone here today is united by the same vital goal: to liberate our fellow Americans from the grip of drug addiction and to end the opioid crisis once and for all," Trump said at the Rx Drug Abuse and Heroin Summit in April 2019. "We will never stop until our job is done." 
In continuation of his commitment to combating the opioid crisis, President Trump and First Lady Melania Trump attended the Rx Drug Abuse and Heroin Summit in Atlanta in April 2019. They addressed the crowd by confirming their continued efforts to fight the U.S.'s opioid epidemic and the progress the Trump administration has made towards this goal. Trump has plans to continue making strides to address and commit funds, relief, and prevention efforts towards the opioid crisis in the United States in his next term of Presidency. 
Our nation's leaders, the medical industry, and law enforcement have progressed towards better solutions to combat the adversity the U.S has faced amidst this crisis. President Trump and his administration have prioritized the cause and have made notable efforts to reverse the effects the opioid epidemic has had on our communities. Still, the opioid crisis has continued to present challenges and hardships to our nation since the start of the century. For all these recent measures, there is evidence that we are falling behind. The rate of death from opioids continues to surpass each previous year. The question remains as to whether we've scaled our efforts as a nation according to the size of the problem.
For more information on the U.S. Opioid Epidemic, news, and other related updates, please visit our Resources page and blog to stay informed on the latest happenings. AffirmHealth is dedicated to providing our clients with leading knowledge and reports of the ongoing opioid status in the United States.
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