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The White House opioid summit provides optimism

March 2, 2018
by Ron Manderscheid, PhD, Exec Dir, NACBHDD and NARMH
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On Thursday, I had the opportunity to participate in the White House Opioid Summit held in the East Room. This event represented the very first time that the administration has described its strategy for addressing the opioid tragedy. A workable national strategy is essential because opioid addiction has evolved into a major public health emergency during the past several years.

The written welcome from President Trump set the tone, “My Administration is committed to fighting the drug epidemic and to helping to get treatment for those in need—for those who have been so terribly hurt. Too many families and communities in America have been affected by this terrible affliction. It is robbing so many of their potential. But we can and will break the cycle, and your tireless efforts motivate us to keep up the fight.”

First Lady Melania Trump opened the summit with brief remarks. She noted the tragedy of losing a family member to drugs, particularly a child or teen. She also called out a mother in the audience who had lost her son about a year ago. Seeing tragedies such as this will cause us to redouble our efforts, she concluded.

A panel on prevention, treatment, and recovery followed, which was moderated by Kellyanne Conway, counselor to the president. Panelists were Secretaries Alex Azar, Department of Health and Human Services (HHS); Ben Carson, Housing and Urban Development (HUD); and David Shulkin, Veterans Administration (VA). Each secretary described the strategy being employed by his respective department. Highlights included Secretary Azar’s efforts to eliminate the Medicaid Institution for Mental Disease (IMD) exclusion for substance use interventions through the 1115 waiver; Secretary Carson’s new Envision program designed to help housing beneficiaries re-establish hope and social support in their lives; and Secretary Shulkin’s efforts to change prescription practices in the VA, thus reducing dramatically the number of VA patients exposed to opioids as part of their pain treatment.

It is clear from this panel that the three departments are undertaking important work to expand our national capacity to undertake needed prevention, treatment, and recovery efforts. As promised, new funds of $6 billion become available in FY2018 and FY2019, we should see a further expansion of these important efforts.

Very brief comments were made by the new Office of National Drug Control Policy (ONDCP) Acting Director James Carroll, who pointedly noted that he has a family member who suffers from a drug use problem. Acting Director Carroll asked the audience for help with his important new mission.

A second panel followed on law enforcement and interdiction, again led by Conway. Panelists were Attorney General Jeff Sessions, Secretary Kirstjen Nielsen, secretary of the Department of Homeland Security (DHS), and Deputy Secretary John Sullivan, State Department.

The attorney general described the intense efforts being made to remove drug dealers from the streets and to confiscate illegal opioids. Secretary Nielsen reviewed DHS efforts to interdict illegal opioids before they enter the United States, principally on the Mexican border and through mail channels. Deputy Secretary Sullivan described State Department efforts to work directly with other countries, such as China, to reduce the availability of opioids, principally fentanyl derivatives, at their source.




Dr. Manderscheid,

Thank you for sharing your White House experience. It is important to be able to gain some insight as to how those in political power are viewing this crisis. I have been consistently impressed by the compassion by our president and his administration with respect to our opiate crisis. I also appreciate the fact that you included a piece about America's veterans, as they clearly need to remain part of our discussion as we work to find solutions to our opioid epidemic.

Yesterday I was reading an article from the U.S. Department of Veteran Affairs ( In this article the topic of medical marijuana is covered. I was pleased to learn that the VA has publically stated their position on how they intend to manage the topic of medical marijuana and veterans: " Veteran participation in state marijuana programs does not affect eligibility for VA care and services. VA providers can and do discuss marijuana use with Veterans as part of comprehensive care planning, and adjust treatment plans as necessary."

While the VA also acknowledges the federal schedule 1 status of marijuana and indicate that they will not be directly involved in making medical marijuana recommendations, this seems like a bit of a shift in policy. I believe this also serves as an acknowledgement of the science that is emerging behind the use of medical marijuana for conditions like PTSD and various pain conditions.

Again, thank you for sharing your remarks.


Mark Welty, Ph.D., LPCC-S


Ron Manderscheid

Exec. Dir., NACBHDD and NARMH

Ron Manderscheid


Ron Manderscheid, Ph.D., serves as the Executive Director of the National Association of County...

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