On August 10th our acting president declared the opioid crisis a national emergency (I feel the need to qualify his title—I simply cannot bring myself to write those words: ‘President Trump’). While not denying that opioids are a pressing problem–Kumo and I regularly skirt discarded needles on our walkabouts–I also feel that there are more obvious emergencies. Like lung cancer, which takes the lives of almost 160,000 American citizens annually.
According to this eye opening page of lung cancer statistics provided by the Bonnie J. Addario Foundation, lung cancer kills an average of 433 people a day in the U.S. That’s one person every 3.3 minutes.
Not to mince words, but lung cancer is a fucking disaster. A crisis of immense proportions, a holocaust, a catastrophe, a cataclysm. If this many people died from any other cause, our nation would be in an uproar and the media would be all over it.
But instead, lung cancer is the big assed elephant in the room. A silent killer, easy to ignore and then readily dismiss. An unsexy disease of smokers and old people. Only, it’s not. I don’t know how many times we have to say it, but ANYONE can get lung cancer.
The single biggest risk factor for lung cancer is BREATHING. Approximately 15-20% of those newly diagnosed have never smoked, and that percentage is significantly higher in women. Young, vibrant women like Kimberly Statham Ringen, Molly Golbon and Elizabeth Dessureault; each taken far too soon by this dreadful disease.
In truth, there’s nothing quiet about lung cancer. Up close and personal, it roars like the beast it is. A flipping deadly beast. So where is the outrage? Why has our nation (and the world) not united together to stop this serial killer?
1. FEMA money could be available to states.
The president could use authority under the Stafford Act to declare an emergency. That would open up resources that are usually reserved for natural disasters like hurricanes or floods, including FEMA’s disaster relief fund, which had about $1.5 billion available as of July.
2. Public health workers could be redeployed.
The president could ask HHS Secretary Price to declare an emergency under the Public Health Service Act. Unlike FEMA, HHS doesn’t have a standing emergency fund (although during last year’s Zika virus scare, many people urged that one be established), but money could be freed up. Right now, public health workers and researchers are working on projects defined by grants from HHS. If Price were to declare an emergency, those workers could be redeployed temporarily, from working on AIDS outreach for example, to work on substance abuse issues.
3. Access to medication-assisted treatment could get a boost.
In a public health emergency, the HHS secretary could make it easier to get medications to counter addiction. For example, Price could allow “standing orders” for the drug naloxone, used to reverse overdoses, which would allow certain populations to get the medication without a prescription. He could also waive the restrictions on doctors who want to administer methadone or buprenorphine to patients with opioid addictions. Those medications currently require a prescribing doctor to have special certification, and there are limits to the number of people doctors can treat.
4. Medicaid could pay for more treatment.
A public health emergency would also allow HHS to waive certain regulations. One major target could be a rule that restricts where Medicaid patients can get inpatient drug treatment. If HHS waived that rule, then Medicaid beneficiaries might find it easier to get treatment.
5. Congress could appropriate money.
Congress doesn’t need an emergency declaration to appropriate money for more drug treatment and intervention. But if the Trump administration were to issue such an order, it would put a lot of pressure on Congress to back it up with money. Last year, lawmakers passed a law to address addiction issues but refused to include $1.1 billion that President Barack Obama requested to expand treatment programs.
6. States could request aid.
Six states have already declared opioid emergencies. A federal emergency could open up paths for those states to request federal grants for specific purposes. Maryland, for example, has a tool that tracks overdoses in real time so emergency responders can identify where particularly potent synthetic opioids may be on the streets. Federal money could potentially allow other states to follow suit.
The reality is that lung cancer is unlikely to be declared a national emergency. However, by demanding that it be named one, we have the opportunity to put lung cancer in the national spotlight.
Me? I’m long on ideas but often short on carry-thru. Fortunately, some of my peers excel in those very areas in which I lack. While riding my initial wave of enthusiasm I reached out to Deana Hendrickson and Laura Greco, both of whom had already been making some noise about making some noise. We agreed to join our efforts into an actual nascent organization; an advocacy group designed by advocates for advocates. We’re calling it LAB, an acronym for Life and Breath.
Our lofty goal is to shake up the way advocacy for our disease is done. We’ll go after that declaration but we’re also working on some fresh ways to engage and possibly enrage as well. What we will not do is to go quietly into that good night.
So please join us at our first public event on November 2nd in Washington D.C. And stay tuned. We’re just getting started.