August 23, 2017

CONTACT: Karen Teber /

WASHINGTON (August 23, 2017) – President Trump has announced his intention to declare the opioid epidemic a national public health emergency and a new JAMA Viewpoint written by public health and law experts decisively makes the case for why and how the declaration would work.

In “Reframing the Opioid Epidemic as a National Emergency,” published online today in JAMA, Lawrence O. Gostin, faculty director of the O’Neill Institute for National and Global Health Law at Georgetown Law and colleagues say despite possible concerns, the declaration is fully warranted.

“A declaration of national emergency authorizes public health powers, mobilizes resources, and facilitates innovative strategies to curb a rapidly escalating public health crisis,” writes Gostin; James G. Hodge Jr., from the Center for Public Health Law and Policy at Arizona State University; and Sarah Noe, a University of Pennsylvania Law School student.

Gostin adds, “The opioid epidemic is taking lives and destroying families across America. Already 600,000 have died and 180,000 more deaths from opioids are predicted by 2020 -just three short years away. President Trump has promised to declare a national emergency and he must act quickly and decisively. And Congress must allocate the funds for prevention and treatment. It is quite clear that a punitive approach to opioid dependency does not work and is highly destructive. Instead, we need to fight a public health war to bring this epidemic under control.”

The authors note that modern public health emergency declarations are typical, particularly at the local level, for fast spreading diseases, biosecurity threats and humanitarian disasters. We need to apply this reasoning to opioids. Without a national emergency declaration, essential powers and resources needed for the widespread opioid epidemic are not available or are mired by legal obstacles.

But as Gostin and the others write, declaring a national emergency also raises valid concerns. “Principal among these is the potential for more punitive responses focused on incarceration.  There is also the concern that an emergency declaration could justify paternalistic interventions that deny rights to affected patients or their caregivers,” they write.

“Still, a federal emergency declaration is warranted,” Gostin and the authors conclude. “It may have taken years for this epidemic to reach crisis levels, but it could take only months for coordinated, bipartisan interventions across public and private sectors to take hold.”

The O’Neill Institute for National and Global Health Law at Georgetown University Law Center is the premier center for health law, scholarship, and policy. Its mission is to contribute to a more powerful and deeper understanding of the multiple ways in which law can be used to improve the public’s health, using objective evidence as a measure. The O’Neill Institute seeks to advance scholarship, science, research, and teaching that will encourage key decision-makers in the public, private, and civil society to employ the law as a positive tool for enabling more people in the United States and throughout the world to lead healthier lives.