Public health 'emergency' does not open up additional funding to fight drug scourge
Fog rolls in thick from the Ohio River to the foothills of the Appalachian Mountains, where West Virginians in the epicentre of the opioid crisis want clarity about U.S. President Donald Trump's plan to lift a community battling deadly drug abuse.
"We can be the generation that ends the opioid epidemic," Trump proclaimed in a speech Thursday, formally declaring the opioid crisis a "national public-health emergency."
Cynical residents of Huntington, W.Va., a town known as the "overdose capital of America," will believe it when they see it.
Huntington is well acquainted with the despair of addiction. Though it welcomes any help it can get, the community of 50,000 isn't waiting for a federal saviour. It can't afford to, with local estimates of the overdose rate at 10 times the national average. In August 2016, a staggering 26 people overdosed in the span of just four hours.
As Trump took over cable news on Thursday for his announcement of a public health emergency — a declaration that lasts 90 days and can be renewed but offers no new cash — women in scrubs at Lily's Place, a local neonatal care facility, missed the whole speech. They were busy cuddling and soothing drug-affected babies born with the tremors and vomiting associated with withdrawal.
Olivia Meade, the facility's director of development, watched the address online with a secretary and an intern in a front office.
What Meade still wants to know, she said, is whether a declaration of a public health emergency means she'll finally be able to accept newborns exposed to drugs in utero from mothers who live in neighbouring Ohio or Kentucky.
Lisa Collinsworth, right, holds her baby son Luke during a visit with him at Lily's Place, a treatment centre for opioid-dependent newborns in Huntington, W.Va., in 2015. (Jonathan Ernst/Reuters)
"Still, it's a step in the right direction," she said, at least in terms of building national awareness about the epidemic.
A few blocks away and across the railroad tracks, Teddy Johnson, who lost his 23-year-old son Adam to a heroin overdose 10 years ago, switched off live news coverage of Trump's address and headed out his door to bring fresh flowers to lay at Adam's grave.
He thinks Trump is serious about tackling the opioid epidemic. But Johnson has doubts about whether Trump's talk of solving "the worst drug crisis in American history" goes beyond just words.
"You gotta have a plan," he said, picking grass from the edges of Adam's stone marker. "You can't just say you're gonna stop this; you're gonna stop that. It's easy to say.
Teddy Johnson lays flowers and visits the grave of his son, Adam, who overdosed on heroin in 2007 in Huntington, W.Va. (Matt Kwong/CBC)
"It's all going to probably come down to funding," he said. "We definitely need three times the recovery places."
That, too, could prove a challenge. Rather than opening up new funds that Trump can tap into for treatment or prevention, there's only $57,000 allocated in a Public Health Emergency Fund, an amount critics slammed as negligible considering drug overdoses killed a record 64,000 people last year.
Downtown at the First Steps drop-in centre on Thursday, Thomas Wade, a 27-year-old recovering heroin addict, lounged in the back watching Predator on TV, then headed outside for a cigarette, rubbing his tattooed arms. The president's speech had just ended.
Told that Trump hoped a "truly evil" drug — hinting at the powerful synthetic opioid Fentanyl — would "be taken off the market immediately," Wade scoffed.
So it goes for Huntington, a once-prosperous coal town longing to reverse its fate. Today, ambulances scream through the streets with alarming regularity. Deaths in West Virginia, mostly attributed to drug overdoses, have nearly bankrupted the state's indigent burial program for five consecutive years.
Without any extra spending and with Trump's apparent focus on a "Just say no"-style anti-drugs campaign, Dr. Michael Kilkenny, the physician director at the Cabell-Huntington Health Department, mused about the actual substance in Trump's announcement.
"The question is: Did he make a declaration that carries more authority than my declaration? I can make a declaration in Cabell County. It brings with it no resources; it suspends no rules; it changes nothing but the awareness."
But the declaration carries symbolic value, even if it doesn't bring extra money.
"It's definitely a start. I'm thankful he's kept his promise to declare or make an emergency declaration," said Matt Boggs, the executive director of Recovery Point, a nonprofit long-term residential recovery program with a lengthy waiting list.
He hopes the administration will support expanding needle exchanges to curb the use of shared syringes, potentially spreading Hepatitis C and HIV.
He also hopes the president's reference to providing "life-saving overdose medications" means the wider distribution and cheaper availability of Naloxone, a product that often comes in the form of a nasal spray and can reverse the effects of an opioid overdose. Boggs and many others who work with addicts carry an emergency supply on them.
One welcome move is the president's promise to waive restrictions on drug-addiction treatment facilities with more than 16 beds, allowing Medicaid funds to be used. Addicts are often seen to be at risk of relapsing or fatally overdosing when they're placed on long waiting lists for long-term treatment.
The lack of nearby available options for Dave and Kate Grubb, whose daughter, Jessie, became addicted to heroin after a sexual assault in college, meant her family had to drive her six hours to Michigan for treatment.
In their home near Charleston, about an hour east of Huntington in Cabell County, Kate Grubb showed a photo of herself receiving a hug from former president Barack Obama when he came to speak about the opioid crisis in 2015.
Jessie was 30 when she overdosed fatally on oxycodone last year. The pills were prescribed by a doctor who somehow missed her addiction history after she had routine hip surgery.
New legislation, Jessie's Law, is winding its way through Congress and would ensure any addiction histories are provided clearly to medical professionals prescribing medication. It has the backing of Trump's opioid commission in a draft report.
"What always goes through the back of my head is how Jessie would love this. That she could be helping and making a difference," Kate Grubb said. "But unfortunately, it's because she's not here that she's making a difference."