On October 15, 2016, then-presidential candidate Donald Trump outlined steps his administration would take to combat the opioid crisis. Below is a check-up on the 12 promises he made in that speech. We will update this list as new steps are taken by the administration.
The problem: Two million Americans are addicted to prescription opioids, 600,000 are addicted to heroin and some estimates say over 59,000 people died from drug overdose deaths in 2016.
1. We will stop the flow of illegal drugs into the country. The number of illegal border crossings has dropped by more than half in the last year. In June, there were 21,659 illegal crossings compared to 45,722 in the same month last year, according to the US Customs and Border Protection statistics. However, it's unclear if that decline has made a difference in the amount of heroin or fentanyl coming across the border. The number of opioid deaths rose in the first nine months of 2016, according to the National Center for Health Statistics. There are no figures for 2017 yet.
2. We are also going to put an end to "sanctuary cities," which refuse to turn over illegal immigrant drug traffickers for deportation. The administration has aggressively sought to end the designation of sanctuary cities and that effort has now been challenged in a lawsuit.
3. We will dismantle the illegal immigrant cartels and violent gangs, and we will send them swiftly out of our country. While Immigration, Customs and Enforcement agency (ICE) arrests have risen by 37 percent, actual deportations have fallen during the Trump Administration, according to the Department of Homeland Security (DHS). The head of ICE has pointed to a backlog in the Justice Department's Executive Office for Immigration Review as a cause of the lack of deportations.
4. We will aggressively prosecute traffickers of illegal drugs, and provide law enforcement and prosecutors with the resources and support they need to do their jobs. The president requested a 3.7 percent increase in spending for the Drug Enforcement Administration (DEA) in his fiscal year 2018 budget.
5. We will close the shipping loopholes that China and others are exploiting to send dangerous drugs across our borders in the hands of our own postal service. In order to "close the shipping loophole," experts say the first step is to digitally scan all postal packages that come into the United States. The U.S. Postal Service recently told Congress that they scan about half of all packages, but a bill introduced by Sen. Rob Portman would require the scanning of all packages. The White House supports this bill but the legislation has stalled in the Senate Finance Committee, where it has been for almost a year.
6. The FDA has been far too slow to approve abuse-deterring drugs. The Food and Drug Administration (FDA) approved the abuse deterrent drug RoxyBond in April. The FDA also took the historic step of removing the opioid Opana ER from the market specifically because of its addictive qualities.
7. And when the FDA has approved these medications, the rules have been far too restrictive, severely limiting the number of authorized prescribers as well as the number of patients each doctor can treat. As president, I'd work to lift the cap on the number of patients that doctors can treat, provided they follow safe prescribing practices and proper treatment supervision. The Obama Administration bumped the cap on the number of patients a doctor can treat from 200 to 275, but advocates say it should be at 500. The Trump Administration has not acted on this.
8. At the same time, DEA should reduce the amount of Schedule II opioids (drugs like oxycodone, methadone and fentanyl) that can be made and sold in the U.S. In early August 2017, the DEA announced it is proposing to further reduce the amount of opioids that can be produced in the United States by 20 percent.
9. I would also expand incentives for states and local governments to use drug courts and mandated treatment. The Trump Administration has tried to take credit for steps for work that happened during the Obama Administration. "Trump Administration Awards Grants to States to Combat the Opioid Crisis" reads an April press release from the Department of Health and Human Services (HHS) that announced a $485 million infusion to the states. But the bipartisan bill authorizing that money was supported by Vice President Biden and signed by President Obama in 2016.
10. I would dramatically expand access to treatment slots and end Medicaid policies that obstruct inpatient treatment. The president's fiscal year 2018 budget requested an increase in drug treatment funding by $200 million to $10.8 billion, although advocates say even that number falls short. Health care reform bills supported by the White House cut Medicaid's growth significantly, even though some 1.8 million people who got Medicaid through the Affordable Care Act rely on the program for drug abuse treatment. The president's budget request for 2018 also called for a $167 million cut to drug abuse prevention.
11. I would dramatically expand first responders' and caregivers' access to Narcan, an antidote that treats overdoses and saves thousands of lives. When CBS News interviewed Richard Baum, the acting director of the Office of National Drug Control Policy in late July 2017, he said the administration has been "advocating for access to Narcan" but they "have a lot more work to do."
12. I would also restore accountability to our Veterans Administration. Too many of our brave veterans have been prescribed these dangerous and addictive drugs by a VA that should have been paying them better attention. In late June, 2017 President Trump signed the bipartisan bill Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017 that was supported by the Veterans of Foreign Wars.
Since becoming president the President and administration officials have made other promises regarding the opioid crisis. We are tracking them here as well.
13. On March 29th, the president announced the creation of an "opioid commission," noting that an interim report would be produced by the end of June. The commission didn't meet for two months because of "scheduling delays" and the interim report was released a month late. It called for the president to declare the opioid crisis a "national emergency." No word from the White House on whether that will happen.
14. Counselor to the President Kellyanne Conway told CBS News in mid-July that one of her goals was to "de-stigmatize addiction." To date there has not been any initiatives announced on that front.