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In his speech to rally support for Tennessee Republicans, President Donald Trump spoke briefly about progress in the fight against the opioid crisis. He remarked on the new money approved in the latest congressional spending bill.
"We got $6 billion for opioid and getting rid of the scourge that’s taking over our country," Trump said May 29. "And the numbers are way down."
"We’re getting the word out — bad. Bad stuff. You go to the hospital, you have a broken arm, you come out, you’re a drug addict with this crap. It’s way down. We’re doing a good job with it. But we got $6 billion to help us with opioid."
We wondered what opioid numbers he was talking about, and whether they are really "way down."
The White House cited an article about the decline in the number of opioid prescriptions. But the reduction in prescriptions might mean less than it seems, and opioid deaths remain high.
Reporting on a study from a health data firm, an April 19 Washington Post article said the number of prescriptions filled at retail pharmacies (measured in morphine equivalents) dropped 10 percent in 2017. The study by the IQVIA Institute for Human Data Science suggested that public outrage over over-prescribing had led to restraint by physicians.
But a drop in opioid prescriptions isn’t a guaranteed sign of progress. A review of studies of prescription monitoring programs published in the Indiana Health Law Review found that about one-third of the time, these efforts take place in states where overdoses rose after the programs expanded. In West Virginia, for example, even with a "significant drop in opioids dispensed" between 2008 and 2015, the number of heroin poisonings doubled.
"Fewer prescriptions have not translated into lower overdoses," said the article's author Northeastern University opioid researcher Leo Beletsky. "Quite the opposite."
As for Trump’s statement that the numbers are "way down," the government’s most recent statistics through October 2017 show a rise in overdose deaths from the year before.
For all opioids, including illegal and prescription drugs, deaths were up 15 percent. For the synthetic opioids alone, such as fentanyl, deaths were up 57 percent.
Deaths from prescription painkillers such as oxycodone (the natural/semi-synthetic category) rose by a small fraction.
The only possible bright spot in the numbers is that while the death toll continues to rise, it rose at a slower rate than the year before.
The timing of the funding increase Trump mentioned also undercuts his claim.
The appropriations bill that provided $6 billion to federal, state and local agencies to turn back the opioid crisis became law at the end of March.
It is dubious to argue that this money flowed quickly enough to have a measurable impact on the opioid problem, especially since the total amount would come over two years.
Trump said that in the opioid crisis, "the numbers are way down." One study shows a 10 percent decline in the the number of opioid prescriptions at retail pharmacies.
However, the latest government figures show a 15 percent increase in opioid overdose deaths between 2016 and 2017. And research casts doubt on the tie between reduced prescribing and a drop in the number of overdoses.
We rate this claim False.
C-SPAN, Donald Trump speech in Nashville, May 29, 2018
National Center for Health Statistics, Drug overdose data, May 6, 2018
National Institute on Drug Abuse, Opioid Overdose Crisis, March 2018
Washington Post, Wonkblog Opioid prescriptions fell 10 percent last year, study says, April 19, 2018
Indiana Health Law Review, Deploying Prescription Drug Monitoring to Address the Overdose Crisis: Ideology Meets Reality, May 9, 2018
Email interview, Leo Beletsky, associate professor of law and health sciences, Northeastern University, May 31, 2018
Email interview, Steven Cheung, director of rapid response, press office, White House, May 30, 2018
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