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State Health Officials Met With Trump Before Opioid Crisis Announcement

RACHEL MARTIN, HOST:

Opioid abuse causes a 9/11-scale loss of life every three weeks in America. Last year, more than 50,000 people died from a drug overdose. The largest annual jump ever recorded. The evidence suggests the problem is even worse this year.

Yesterday, after meeting with state and federal officials, President Donald Trump declared a public health emergency. The move directs all federal agencies to use their authority to cut the numbers of opioid deaths.

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PRESIDENT DONALD TRUMP: We can be the generation that ends the opioid epidemic. We can do it.

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MARTIN: Dr. Rebekah Gee was at that meeting with the president. She is the secretary of health for the state of Louisiana. And she joins us now on the line. Doctor Gee, thanks so much for being with us.

REBEKAH GEE: Thanks so much. Good morning.

MARTIN: Good morning. Did you hear what you wanted to hear from the president yesterday?

GEE: Well, what we did here, which is great, is that there is a focus on it. In Louisiana, over the past four years, our deaths have doubled. We lose over a thousand people. That's more than motor vehicle accidents, homicide and suicide combined. So what we heard was a focus. We need more. But I'm very happy that we're embarking on this journey.

MARTIN: So there's an important distinction to make here because the president declared a national public health emergency. That is different than declaring a national state of emergency because if he had done the latter, that would have freed up more money - more federal funds to combat the opioid crisis. Do you wish he had done that?

GEE: Well, I - we do need more money. And the governor and I - I went with Governor John Bel Edwards. And he and I both spoke with Chris Christie who headed up the opioid commission. We stressed three things - one, how important the Medicaid expansion is for the opioid crisis.

In our state, when we started in 2016 in January, 1 in 4 people had no insurance. Now fewer than 1 in 10 lack insurance. Thousands have gotten addiction treatment through the expansion. To end it during an opioid crisis is a huge mistake and would be a big step back.

Second, we need relief on naloxone. It's very expensive. It ranges from a hundred dollars to over $4,000 a dose.

MARTIN: We should just say, naloxone is this drug that can be used when someone is having an overdose in the moment.

GEE: That's right. Narcan, it's also called. It can be injected. And it saves lives. And it needs to be affordable to states. And then, third, we need more resources. Louisiana, it would cost us over $600 million to treat the over 100,000 people who are addicted to opioids. We cannot afford it. We need relief. And so we expect more and hope more from the federal government in terms of additional resources.

MARTIN: So how are you going to get that because the 2018 budget plan submitted to Congress - the Trump administration in that plan cut nearly $400 million from substance abuse and mental health services. It's this agency within the Health and Human Services that oversees addiction treatment programs. So where - you say you need more money, but the administration seems to be cutting money for opioid addiction.

GEE: Well, after our meeting at the White House in the beautiful East Room, we met with Richard Baum, who's head of - he's the acting drug czar. And he and his staff are still trying to figure out how to implement what Trump said during that meeting as well as to make sense of the specifics in his speech.

So, you know, partly, it's that the opioid commission recommendations have not come out yet. So once those come out - and those will be released soon - I expect there to be more action because we - you know, more money is needed for an epidemic of this proportion.

You can do things that are no cost. I was excited about the Medicaid policy change where we can do more inpatient treatment. Requiring federal docs to be able to give opioid treatment is very important.

MARTIN: Although that only applies to states that expanded Medicaid under the Affordable Care Act. It doesn't help states that didn't do that.

GEE: Well, it's hard to say. The - even the drug czar wasn't quite sure what that meant. But it could mean federally qualified health centers and VA docs. And if that's the case, that would be very helpful.

Of course, it was announced that CVS had a seven-day limit. That's something we've put in Louisiana. And with those limits, we've seen a 25 percent decrease in less than a year in the number of prescriptions and as well as the overall dosing of opioids.

So there are no cost interventions, particularly that can help stop the curb of addiction and those need to happen. But there needs to be money for treatment, and that's just the end of the story. We have to have better prices on Narcan. And we have to have more money for treatment.

MARTIN: Let me ask you, just in conclusion, I mean, what can you do at the state level? Six states have already unilaterally declared states of emergency over opioids. Is Louisiana considering doing that? And what would that - what difference would that make?

GEE: Well, we have not declared a state of emergency. We've been in a severe budget crisis. So we focused on limiting the number of people who get addicted by making sure that we don't hand out too many pills.

Louisiana's the top six in the nation number of pills per people. We have more pills than people every year in our state by far that are given out. So prescription drug monitoring, mandatory physician education - but we just simply do not have the money and need more federal relief.

MARTIN: We'll see if that happens. Dr. Rebekah Gee, she is the secretary of health for the state of Louisiana. She was in this meeting with the president yesterday over the opioid epidemic. Thanks so much for your time this morning Dr. Gee.

GEE: Thanks very much for having me. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.