- Associated Press - Wednesday, April 24, 2019

ATLANTA (AP) - President Donald Trump pledged on Wednesday to battle the deadly epidemic of opioid drug abuse “until our job is done,” and he claimed progress even though it is unclear whether the crisis has diminished.

Trump spoke at an annual conference of health, law enforcement, elected and other officials who work to combat drug abuse and addiction, and used the appearance to advocate for the wall he wants to build on the U.S.-Mexico border, saying without evidence that it will help keep drugs out of the U.S. His wife, Melania, introduced him.

“My administration is deploying every resource at our disposal to empower you, to support you and to fight right by your side,” Trump said. “We will not solve this epidemic overnight but we will stop. … There’s just nothing going to stop us, no matter how you cut it.”

Before leaving the White House for the Atlanta event, Trump claimed credit for progress in combating the drug scourge.

“It’s a big problem. It’s a big addiction and we’re handling it,” the president told reporters. He said doctors, laboratories, clinics and drug companies have assisted the administration.

There have been signs of progress, including a drop in the number of prescriptions for opioid painkillers. However, opioid abuse claimed a record of nearly 48,000 American lives in 2017. An estimated 2 million people are addicted to the drugs, which include both legal prescription pain medications and illegal drugs such as heroin.

While prescription opioids initially accounted for most deaths, the epidemic is now driven by illicit heroin and fentanyl. Those two drugs were implicated in the vast majority of opioid overdoses reported in 2017, according to federal figures.

Keith Humphreys, a drug policy adviser to presidents from both political parties, said some states and communities are making headway, but not because of action by Trump. Humphreys said other states have regressed.

Humphreys said Trump’s declaration of opioids addiction as a public health emergency in 2017 failed to translate into significant concrete action. Members of Congress, he said, “figured out they were going to have to do it themselves - and they did.”

Trump said the administration has committed $6 billion to combat the crisis, set aside money to prevent youth substance abuse, and increased the distribution of the overdose-reversing drug naloxone.

“Pretty amazing stuff,” the president remarked.

Efforts to curb opioid use are being undertaken by an array of government agencies. Trump said states are now allowed to use Medicaid dollars to pay for residential treatment facilities, expanding access to care. He said the Department of Veterans Affairs has greatly reduced the number of veterans being treated with opioids.

Trump also discussed law enforcement efforts, including shutting down online criminal drug-selling networks and more aggressive efforts to seize illegal drugs and stop immigrants from entering the country without authorization.

He said that almost 400 miles of wall will be in place along the border with Mexico by the end of 2020 and that it “will have a tremendous impact on drugs coming into our country.”

Trump’s statement contradicts a 2018 report by the U.S. Drug Enforcement Administration that cites common drug smuggling methods that would not be choked off by a border wall; the most common trafficking technique is to hide the drugs in passenger vehicles or tractor-trailers as they drive into the U.S. at official crossings.

The first lady spoke briefly about her visits to hospitals and treatment centers and her meetings with doctors and nurses as part of her own campaign to highlight the “terrible toll the opioid epidemic is having on children and young mothers.”

“My husband is here today because he cares deeply about what you’re doing to help the millions of Americans affected by the opioid epidemic,” she said.

It’s difficult to get a complete and authoritative accounting of how much the federal government is spending to fight opioid abuse since it occurs across many programs, including Medicaid, which doesn’t require annual funding approval from Congress, and dozens of other programs that do. Public health experts say the amount probably is not enough.

The wide-ranging opioids legislation that Trump signed last fall outlined many steps to improve care and access to treatment. For example, it allowed nurse practitioners to prescribe addiction treatment medication, boosted incentives for people to get training in addiction medicine and allowed Medicare to cover the use of methadone for opioid addiction.

Humphreys, who worked with lawmakers on the measure, said the parties disagreed on the fundamental question of how much money to dedicate to the problem, so instead they cobbled together various small improvements they could agree on.

“And that’s all good,” Humphreys said. “But it’s not transformative.”

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Superville reported from Washington. AP Health Writer Matthew Perrone in Washington contributed to this report.

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