Friday, October 27, 2017

Trump's top health official makes Kentucky his first stop after declaring opioid epidemic a public-health emergency

Acting Health and Human Services Secretary Eric Hargan, center,
speaks with UK HealthCare Vice President Mark Birdwhistell
and project manager Beth Snider Friday at the Polk-Dalton Clinic
in North Lexington. (Associated Press photo by Adam Beam)
Kentucky Health News

The day after declaring the opioid epidemic a national public-health emergency without allocating more money for it, President Trump's top health official came to Kentucky and heard pleas for funds to meet the challenge.

In a visit that wasn't publicized in advance, acting Health and Human Services Secretary Eric D. Hargan visited a Lexington clinic Friday afternoon to meet with doctors, advocates and recovering addicts. They urged the Trump administration "to spend more money on fighting the drug epidemic," The Associated Press reports.

Hargan came to the University of Kentucky's Polk-Dalton Clinic in North Lexington, which treats pregnant women and babies addicted to opioids and other prescription painkillers. "Kentucky has one of the highest rates of babies born addicted to opioids," with 110 cases per month in 2015, AP notes.

After a private meeting with patients and advocates, Hargan toured the clinic and spoke with reporters from AP and Lexington's WKYT-TV.

“A lot of what I heard in the room is we need resources, we need money,” Alex Elswick, founder of a nonprofit that connects people to recovery resources who participated in the meeting, told AP.

"Hargan also heard from health care providers worried about the potential loss of services that came to Kentucky with the expansion of Medicaid under the Affordable Care Act," AP reports. "Agatha Critchfield, an obstetrician-gynecologist who oversees a drug treatment program for pregnant women . . . said one of the biggest things to help Kentucky was the expansion of the Medicaid program under former President Barack Obama’s health care law, which the Trump administration is trying to eliminate. She said the vast majority of patients the program treats are on Medicaid."

“Whatever your feelings are about it, substance-abuse services got better,” Critchfield said. “And so, certainly, I have concerns about that going away.”

AP notes, "It’s unclear how or when Trump’s declaration will let doctors prescribe medication, like buprenorphine, remotely without a face-to-face visit. The medicine helps people addicted to opioids with the painful withdrawal symptoms that come with quitting the drug, but doctors have been banned from prescribing it unless they meet with a patient in person. Asked if the declaration will lift those restrictions, Hargan said the Drug Enforcement Administration would have to weigh in along with state health officials."

Sperling's Best Places map, adapted
Hargan is a native of Mounds, Ill., a small town west of Paducah. He said he came to Kentucky first because it is one of the states most affected by opioids. Last year, the state had more than 1,400 drug-overdose deaths, a 39 percent increase from three years ago.

“So you look at a place that’s been very infected and also a place where they are on the forefront of developing a lot of innovative collaborative solutions,” Hargan told WKYT. “So you can put those two things together, and you can find messages, treatment and ways of dealing with it I think that can be applied nationally.”

While news reports generally said Trump made the emergency declaration, his order merely requsted the action by Hargan, who under federal law has the authority.

“When the president tells us to focus on the problem, we focus on the problem,” Hargan said. "Some of the things that I heard was that the need for resources. We heard loud and clear.”

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