In the days since President Donald Trump’s Thursday announcement declaring the nation’s opioid epidemic a “public health emergency” via the Public Health Services Act, Connecticut politicians have expressed concern about the lack of significant funding allocated to address the crisis.

Republicans and Democrats alike have acknowledged the accuracy of Trump’s statement. But while Republicans have applauded the president’s declaration, many Democrats have criticized him for not going far enough. Declaring the situation a national emergency through the Federal Emergency Management Agency would have appropriated about $1.5 billion to fight the epidemic. As it stands, Trump’s declaration made available only the money in the national Public Health Emergency Fund, which totals a meagre $57,000.

“[Trump’s] announcement underscores the seriousness of the epidemic, but there were no new resources or even specific actions that would have an impact on the epidemic,” state Rep. Jim Himes, D-Conn, told the News.

In an interview with the News, U.S. Rep. Rosa DeLauro, D-New Haven, condemned Trump’s decision not to allocate substantial new funds to the issue, adding that shifting around “already insufficient resources” will not solve the problem. DeLauro has proposed the Public Health Emergency Preparedness Act to Congress as a means of combating the opioid crisis. The Act would add $5 billion to the Public Health Emergency Fund.

Experts in the field of opioid addiction agree — the federal government must supply significant funding to combat the crisis. In particular, this funding must go to supplying life-saving drugs that help to reverse the effects of an opioid overdose in the short term and to fight opioid addiction in the long term: naloxone and buprenorphine.

“If we want to see overdose deaths come down, we have to see that people who are addicted to opioids can more easily access outpatient buprenorphine treatment than heroin, pain pills or fentanyl,” explained Andrew Kolodny, the co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University.

Kolodny said Trump should seek an appropriation of $60 billion over the next 10 years to create this outpatient treatment system.

Gary Mendell, founder and CEO of Shatterproof, an organization working to combat addiction through advocacy, said he believes that the single most important priority for federal funding is to supply and distribute naloxone. For $500 million dollars, he said, naloxone could be everywhere — in appropriate homes, as well as in public spaces. Second in importance, Mendell said, is providing funds to train a workforce to treat those with “this” disorder.

Connecticut representatives and experts are also looking to combat the opioid crisis from the supply side.

Himes stressed the importance of ensuring that doctors are prescribing pain medicine responsibly. Trump similarly addressed the necessity of responsible physician prescription of opioids, saying that all federally employed physicians will be educated on proper prescribing standards consistent with recommendations by the Centers for Disease Control and Prevention. Mendell said it makes no sense for such a measure not to be broadened to include all physicians in the country.

Kolodny stressed the importance of providing education, monitoring doctors and regulating the Food and Drug Administration, which controls pharmaceutical companies. He said the United States is facing an opioid crisis in large part due to the “brilliant marketing” and power of pharmaceutical companies such as Purdue Pharma, which is based in Stamford.

Congress has failed to regulate the FDA because of the sway such pharmaceutical companies have in politics, Kolodny said.

When pressed on the lack of FDA regulation, DeLauro avoided the question, arguing that the “FDA [was] a self-regulating agency.”

As Purdue Pharma’s home base, Connecticut has a particularly complicated relationship with the opioid epidemic.

DeLauro said that Connecticut is on track to see over 1,000 opioid-related deaths this year and that thousands more people in the state are suffering from opioid addiction or in recovery.

“We should be leading the way as a pharmaceutically oriented state in finding alternatives to opioid therapy,” Himes said.

Connecticut has been working to combat the crisis, he said, notably by expanding Medicaid so people can afford necessary treatments, as well as by the expansive provision of naloxone.

Yale researchers, David A, Fiellin, M.D. and Gail D’Onofrio, M.D. M.S., have been key in expanding emergency department-initiated naloxone treatment. Kolodny referred to their work as an “innovative model of care,” and said their method has become a model for emergency rooms in other parts of the country.

DeLauro said the 21st Century Cures Act of 2016, which provides state grants like the one that financed Fiellin and Onofrio’s initiative, will expire at the end of September 2018 and must be renewed, expanded and funded in full.

More than 59,000 people died from drug overdoses in the United States in 2016.

Clara Molot | clara.molot@yale.edu