美国国家公共电台 NPR The Scary Sound Machine That Is 'Trying To Set People A Little Bit Off-Kilter'（在线收听）

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This is an alarming number. More than 140 Americans die every day from an opioid overdose. That's according to the CDC. And today, President Trump will make an announcement about the opioid crisis, but it's still not clear what that will entail. The president first said he would declare a national emergency in August, but the proposal has stalled. NPR's Greg Allen reports on what happened to the plan.

GREG ALLEN, BYLINE: When President Trump announced two months ago that he'd declare opioids a national emergency, like many, Dr. Andrew Kolodny expected immediate action.

ANDREW KOLODNY: If you're calling something an emergency, you expect people to act urgently and to respond as if it's an emergency.

ALLEN: Kolodny co-directs the opioid policy research collaboration (ph) at Brandeis University. He says it's been frustrating, waiting for the administration to deliver a plan for a crisis Trump first acknowledged on the campaign trail when he was running for president. After taking office, President Trump appointed a commission to study the opioid crisis, headed by New Jersey Governor Chris Christie.

In an interim report, the commission called on the president to declare a national emergency, a measure that would free up funds for treatment, ensure wider access for the anti-overdose drug naloxone and improve monitoring of opioid prescriptions to prevent abuse.

In August, days before the president said he'd declare a national emergency, Secretary of Health and Human Services Tom Price said he didn't think one was necessary. Flash forward two months, though, and Tom Price is gone. Dr. Keith Humphreys, professor of psychiatry at Stanford University and a former adviser in the Obama administration, notes that Price was not a friend to addiction treatment programs.

KEITH HUMPHREYS: When he was a congressman, he opposed the parity law, which required insurers to cover addiction treatment. He was very skeptical of methadone maintenance, which is a very good treatment for heroin addiction. So having him out of the way is a potential plus.

ALLEN: In a policy change, the director of the Food and Drug Administration yesterday told a congressional committee, the agency will begin working to promote medication-assisted treatment using methadone, buprenorphine or naltrexone to help addicts in recovery. That's significant because some states currently won't pay for some of those treatments.

Advocates will be listening for what, if anything, the president says about that - also, whether he'll use his authority to negotiate cheaper prices for treatment drugs, including naloxone. But in the president's address today, advocates say the key issue will be what he says about funding. Congress is currently spending $500 million a year on addiction treatment programs. Andrew Kolodny says to help the more than 27 million Americans abusing opioids, much more is needed. He puts the price tag at $6 billion each year.

KOLODNY: You want that opiate-addicted individual to be able to access effective outpatient treatment more easily than they can get pills, heroin or fentanyl.

ALLEN: Kolodny criticizes the Obama administration for being slow to acknowledge opioids, a crisis, he says, that began in 1996 and which the CDC declared an epidemic in 2011. President Obama's HHS Secretary, Kathleen Sebelius, agrees.

KATHLEEN SEBELIUS: Did we do enough? Probably not. Recognizing how widespread this was, what factors were contributing to it, would've been helpful a number of years ago.

ALLEN: And Sebelius says it might've prevented many overdose deaths. Sebelius notes that the Affordable Care Act and the expansion of Medicaid greatly expanded addiction treatment coverage. If President Trump is serious about tackling opioids, she says, his first step should be to stop fighting to repeal Obamacare. Greg Allen, NPR News.

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